Weight, weight gain, and survival after breast cancer diagnosis
Weight, weight gain, and survival after breast cancer diagnosis
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DOI：
10.1200/jco.2005.01.079
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发表时间：
2005-03-01
影响因子：
45.3
通讯作者：
Holmes, MD
中科院分区：
文献类型：
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作者：
Kroenke, CH;Chen, WY;Holmes, MD
目的确定诊断前的体重和诊断后的体重增加是否是乳腺癌生存的预测指标。方法患者包括1976年至2000年间被诊断为偶发性、侵袭性、非转移性乳腺癌的5,204名护士健康研究参与者，其中860例死亡，533例乳腺癌死亡，681例复发（定义为继发性肺癌、脑癌、骨癌或肝癌，以及乳腺癌死亡）。我们计算了体重指数（BMI）从之前到第一次报告的BMI的变化！诊断后12个月。考克斯比例风险模型用于评估诊断前BMI类别和BMI变化与事件发生时间的相关性。我们分层吸烟，绝经状态，乳腺癌相关的variables.Results在多变量调整分析，诊断前的体重与乳腺癌复发和死亡呈正相关，但这是显而易见的，只有在从不吸烟者。同样，在从不吸烟的女性中，体重增加0.5至2.0 kg/m2的女性（2）（中位增重，6.0 lb;相对风险[RR]，1.35; 95% CI，0.93 - 1.95）或超过2.0 kg/m（2）（中位增重17.0磅; RR 1.64; 95%CI 1.07 - 2.51）在随访（中位9年）期间，与保持体重的女性相比，乳腺癌死亡风险升高（线性趋势检验，P = 0.03）。绝经前妇女的体重与绝经后妇女的体重之间的相关性更强。乳腺癌复发率和全因mortals.Conclusion体重和体重增加与乳腺癌复发率和死亡率较高，但协会是最明显的从不吸烟的妇女。
Purpose To determine whether weight prior to diagnosis and weight gain after diagnosis are predictive of breast cancer survival.Methods Patients included 5,204 Nurses' Health Study participants diagnosed with incident, invasive, nonmetastatic breast cancer between 1976 and 2000,- 860 total deaths, 533 breast cancer deaths, and 681 recurrences (defined as secondary lung, brain, bone, or liver cancer, and death from breast cancer) accrued to 2002. We computed the change in body mass index (BMI) from before to the first BMI reported ! 12 months after the date of diagnosis. Cox proportional hazards models were used to evaluate associations of categories of BMI before diagnosis and of BMI change with time to event. We stratified by smoking, menopausal status, and breast cancer-related variables.Results In multivariate-adjusted analyses, weight before diagnosis was positively associated with breast cancer recurrence and death, but this was apparent only in never smokers. Similarly, among never-smoking women, those who gained between 0.5 and 2.0 kg/m(2) (median gain, 6.0 lb; relative risk [RR], 1.35; 95% Cl, 0.93 to 1.95) or more than 2.0 kg/m(2) (median gain, 17.0 lb; RR, 1.64; 95% Cl, 1.07 to 2.51) after diagnosis had an elevated risk of breast cancer death during follow-up (median, 9 years), compared with women who maintained their weight (test for linear trend, P = .03). Associations with weight were stronger in premenopausal than in postmenopausal women. Similar findings were noted for breast cancer recurrence and all-cause mortality.Conclusion Weight and weight gain were related to higher rates of breast cancer recurrence and mortality, but associations were most apparent in never-smoking women.