Caan Bette J, Emond Jennifer A, Natarajan Loki, Castillo Adrienne, Gunderson Erica P, Habel Laurel, Jones Lovell, Newman Vicky A, Rock Cheryl L, Slattery Martha L, Stefanick Marcia L, Sternfeld Barbara, Thomson Cynthia A, Pierce John P
Division of Research, Kaiser Permanente Medical Group, 2000 Broadway, 94612 Oakland, CA, USA.
Breast Cancer Res Treat. 2006 Sep;99(1):47-57. doi: 10.1007/s10549-006-9179-y. Epub 2006 Mar 16.
To examine whether weight gain after diagnosis of breast cancer affects the risk of breast cancer recurrence.
Patients included 3215 women diagnosed with early stage breast cancer (Stage I >1 cm., II, and IIIA) who were enrolled either in an observational cohort of breast cancer survivors or were part of the comparison group of a dietary intervention trial to prevent breast cancer recurrence. We computed weight change from 1 year prior to diagnosis to study enrollment. Delayed entry Cox proportional hazards models were used to evaluate associations of categories of weight change with time to recurrence, controlling for known prognostic factors.
Neither moderate (5-10%) nor large (> 10%) weight gain (HR 0.8, 95% CI, 0.6-1.1; HR 0.9, 95% CI, 0.7-1.2, respectively) after breast cancer diagnosis was associated with an increased risk of breast cancer recurrence in the early years post-diagnosis (median time of 73.7 months from diagnosis).
Our research provides evidence that weight gain commonly seen in the first several years following a breast cancer diagnosis does not increase a woman's risk for breast cancer recurrence in the first 5-7 years post-diagnosis. However, this research does not address the effects of weight gain on overall survival or on the risk of other new cancers, other prognostic outcomes of concern to the breast cancer survivor.
研究乳腺癌确诊后体重增加是否会影响乳腺癌复发风险。
患者包括3215名被诊断为早期乳腺癌(I期>1厘米、II期和IIIA期)的女性,她们要么纳入了乳腺癌幸存者观察队列,要么是预防乳腺癌复发饮食干预试验对照组的一部分。我们计算了从诊断前1年到研究入组时的体重变化。采用延迟入组Cox比例风险模型评估体重变化类别与复发时间的关联,并对已知的预后因素进行控制。
乳腺癌诊断后,中度(5 - 10%)或大量(>10%)体重增加(风险比分别为0.8,95%置信区间为0.6 - 1.1;风险比为0.9,95%置信区间为0.7 - 1.2)与诊断后早期乳腺癌复发风险增加均无关联(诊断后中位时间为73.7个月)。
我们的研究表明,乳腺癌诊断后的头几年常见的体重增加不会增加女性在诊断后5 - 7年内乳腺癌复发的风险。然而,本研究未涉及体重增加对总生存期或其他新发癌症风险的影响,以及乳腺癌幸存者关注的其他预后结果。