Gross Amy L, May Betty J, Axilbund Jennifer E, Armstrong Deborah K, Roden Richard B S, Visvanathan Kala
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Johns Hopkins Kimmel Cancer Center, Baltimore, Maryland. The Johns Hopkins School of Medicine, Baltimore, Maryland.
Cancer Epidemiol Biomarkers Prev. 2015 Aug;24(8):1262-9. doi: 10.1158/1055-9965.EPI-15-0212. Epub 2015 Jul 15.
This study prospectively examines weight gain in breast cancer survivors compared with cancer-free women from a familial risk cohort.
Absolute and percent weight change over 4 years was compared among 303 breast cancer survivors and 307 cancer-free women matched on age and menopausal status, from the same familial risk cohort. Linear and logistic regression was used to estimate the association between survivor status and weight gain.
Overall, breast cancer survivors gained significantly more weight [β = 3.06 pounds; 95% confidence intervals (CI), 0.94-5.17] than cancer-free women. Significant weight gain was observed in survivors diagnosed less than 5 years prior to baseline (β = 3.81 pounds; 95% CI, 1.22-6.29) and women with estrogen receptor (ER)-negative tumors (β = 7.26 pounds; 95% CI, 2.23-12.30). Furthermore, survivors treated with chemotherapy were 2.1 times more likely to gain at least 11 pounds during follow-up compared with cancer-free women (OR, 2.10; 95% CI, 1.21-3.63). Weight gain was even greater among survivors who took statins while undergoing chemotherapy treatment (Pinteraction = 0.01).
This is the first study to demonstrate that weight gain is an important issue in breast cancer survivors with a familial risk. In the first five years posttreatment, breast cancer survivors gain weight at a faster rate than cancer-free women, particularly after chemotherapy and statin use but not after hormone therapy alone.
Our findings provide support for the development of weight gain interventions for young breast cancer survivors with a familial risk.
本研究前瞻性地比较了乳腺癌幸存者与来自家族性风险队列的无癌女性的体重增加情况。
在来自同一家族性风险队列、年龄和绝经状态匹配的303名乳腺癌幸存者和307名无癌女性中,比较了4年间的绝对体重变化和体重变化百分比。采用线性回归和逻辑回归来估计幸存者状态与体重增加之间的关联。
总体而言,乳腺癌幸存者比无癌女性体重增加明显更多[β = 3.06磅;95%置信区间(CI),0.94 - 5.17]。在基线前不到5年被诊断的幸存者(β = 3.81磅;95% CI,1.22 - 6.29)和雌激素受体(ER)阴性肿瘤的女性(β = 7.26磅;95% CI,2.23 - 12.30)中观察到显著的体重增加。此外,与无癌女性相比,接受化疗的幸存者在随访期间体重增加至少11磅的可能性高出2.1倍(OR,2.10;95% CI,1.21 - 3.63)。在化疗期间服用他汀类药物的幸存者中体重增加更为明显(P交互作用 = 0.01)。
这是第一项证明体重增加是有家族性风险的乳腺癌幸存者中的一个重要问题的研究。在治疗后的头五年,乳腺癌幸存者体重增加的速度比无癌女性更快,尤其是在化疗和使用他汀类药物后,但仅在激素治疗后并非如此。
我们的研究结果为针对有家族性风险的年轻乳腺癌幸存者制定体重增加干预措施提供了支持。