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Changes in Body Fat and Weight After a Breast Cancer Diagnosis: Influence of Demographic, Prognostic, and Lifestyle Factors

From the Department of Epidemiology and Public Health, Yale School of Medicine, New Haven, CT; The Fred Hutchinson Cancer Research Center, Seattle, WA; Cancer Research and Treatment Center, Department of Internal Medicine, University of New Mexico, Albuquerque, NM; Department of Preventive Medicine, University of Southern California, Los Angeles, CA; Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD

Address reprint requests to Melinda L. Irwin, PhD, MPH, Department of Epidemiology and Public Health, Yale School of Medicine, PO Box 208034, New Haven, CT 06520-8034; e-mail: melinda.irwin{at}yale.edu

PURPOSE: Obese women and women who gain weight after a breast cancer diagnosis are at a greater risk for breast cancer recurrence and death compared with lean women and women who do not gain weight after diagnosis. In this population-based study, we assessed weight and body fat changes from during the first year of diagnosis to during the third year after diagnosis, and whether any changes in weight and body fat varied by demographic, prognostic, and lifestyle factors in 514 women with incident Stage 0-IIIA breast cancer.

METHODS: Patients were participants in the Health, Eating, Activity, and Lifestyle (HEAL) study. Weight and body fat (via dual-energy x-ray absorptiometry scans) were measured during the baseline visit and 2 years later at a follow-up visit. Analysis of covariance methods were used to obtain mean weight and body fat changes adjusted for potential cofounders.

RESULTS: Women increased their weight and percent body fat by 1.7 ± 4.7 kg and 2.1% ± 3.9%, respectively, from during their first year of diagnosis to during their third year of diagnosis. A total of 68% and 74% of patients gained weight and body fat, respectively. Greater increases in weight were observed among women diagnosed with a higher disease stage, younger age, being postmenopausal, and women who decreased their physical activity from diagnosis to up to 3 years after diagnosis (P for trend < .05).

CONCLUSION: Weight and body fat increased in the postdiagnosis period. Future research should focus on the effect of physical activity on weight and fat loss and breast cancer prognosis.

Supported by National Cancer Institute contracts N01-CN-75036-20, NO1-CN-05228, NO1-PC-67010, and training grant T32 CA09661. A portion of this work was conducted through the Clinical Research Center at the University of Washington and supported by the National Institutes of Health Grant M01-RR-00037. Data collection for the Women's CARE Study at the University of Southern California was supported by contract N01-HD-3-3175 from the National Institute of Child Health and Human Development, and patient identification was supported in part by 050Q-8709-S1528 from the California Department of Health Services.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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