Vagenas Dimitrios, DiSipio Tracey, Battistutta Diana, Demark-Wahnefried Wendy, Rye Sheree, Bashford John, Pyke Chris, Saunders Christobel, Hayes Sandra C
Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, Queensland, Australia.
BMC Cancer. 2015 Jan 31;15:28. doi: 10.1186/s12885-015-1026-2.
While weight gain following breast cancer is considered common, results supporting these findings are dated. This work describes changes in body weight following breast cancer over 72 months, compares weight with normative data and explores whether weight changes over time are associated with personal, diagnostic, treatment or behavioral characteristics.
A population-based sample of 287 Australian women diagnosed with early-stage invasive breast cancer was assessed prospectively at six, 12, 18 and 72 months post-surgery. Weight was clinically measured and linear mixed models were used to explore associations between weight and participant characteristics (collected via self-administered questionnaire). Those with BMI changes of one or more units were considered to have experienced clinically significant changes in weight.
More than half (57%) of participants were overweight or obese at 6 months post-surgery, and by 72 months post-surgery 68% of women were overweight or obese. Among those who gained more weight than age-matched norms, clinically significant weight gain between 6 and 18 months and 6 and 72 months post-surgery was observed in 24% and 39% of participants, respectively (median [range] weight gain: 3.9 kg [2.0-11.3 kg] and 5.2 kg [0.6-28.7], respectively). Clinically-significant weight losses were observed in up to 24% of the sample (median [range] weight loss between 6 and 72 months post-surgery: -6.4 kg [-1.9--24.6 kg]). More extensive lymph node removal, being treated on the non-dominant side, receiving radiation therapy and lower physical activity levels at 6 months was associated with higher body weights post-breast cancer (group differences >3 kg; all p < 0.05).
While average weight gain among breast cancer survivors in the long-term is small, subgroups of women experience greater gains linked with adverse health and above that experienced by age-matched counterparts. Weight change post-breast cancer is a contemporary public health issue and the integration of healthy weight education and support into standard breast cancer care has potential to significantly improve the length and quality of cancer survivorship.
虽然乳腺癌后体重增加被认为很常见，但支持这些发现的结果已过时。这项研究描述了乳腺癌患者72个月内体重的变化，将体重与标准数据进行比较，并探讨体重随时间的变化是否与个人、诊断、治疗或行为特征相关。
对287名被诊断为早期浸润性乳腺癌的澳大利亚女性进行基于人群的抽样，在术后6个月、12个月、18个月和72个月进行前瞻性评估。临床测量体重，并使用线性混合模型探讨体重与参与者特征（通过自填问卷收集）之间的关联。体重指数（BMI）变化一个或多个单位的人被认为经历了临床上显著的体重变化。
超过一半（57%）的参与者在术后6个月超重或肥胖，到术后72个月，68%的女性超重或肥胖。在体重增加超过年龄匹配标准的参与者中，分别有24%和39%的参与者在术后6至18个月和6至72个月出现临床上显著的体重增加（体重增加中位数[范围]：分别为3.9千克[2.0 - 11.3千克]和5.2千克[0.6 - 28.7千克]）。在高达24%的样本中观察到临床上显著的体重减轻（术后6至72个月体重减轻中位数[范围]：-6.4千克[-1.9 - -24.6千克]）。更广泛的淋巴结清扫、在非优势侧接受治疗、接受放射治疗以及术后6个月较低的身体活动水平与乳腺癌后更高的体重相关（组间差异>3千克；所有p < 0.05）。
虽然乳腺癌幸存者的长期平均体重增加幅度较小，但部分女性亚组体重增加更多，这与不良健康状况相关，且高于年龄匹配的同龄人。乳腺癌后的体重变化是一个当代公共卫生问题，将健康体重教育和支持纳入标准乳腺癌护理有可能显著改善癌症幸存者的生存期和生活质量。
