Division of Hematology/Oncology, School of Medicine, University of North Carolina at Chapel Hill, 170 Manning Drive, Campus Box 7305, Chapel Hill, NC, 27599-7305, USA.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Breast Cancer Res Treat. 2018 Jan;167(1):235-248. doi: 10.1007/s10549-017-4501-4. Epub 2017 Sep 14.
This study investigates weight trajectories in pre- versus postmenopausal breast cancer (BC) survivors diagnosed with hormone receptor-positive tumors, with a specific focus on discerning menopausal status and type of endocrine treatment (ET) as risk factors for weight gain during ET.
We conducted a retrospective review of electronic medical records. Descriptive statistics and Chi-squared and t tests were used to compare pre- and postmenopausal women. Chi-squared tests and ANOVA were used for within-group associations between patient characteristics and weight trajectories. Log-binomial regression models were used to estimate relative risk for weight gain.
The final sample was 32% premenopausal (n = 140) and 68% postmenopausal (n = 298). Relative risk (RR) for weight gain during ET was highest in women who were premenopausal (RR = 1.29, 1.03-1.52) and had Stage 3 BC (RR = 2.12, 1.59-2.82), mastectomy (RR = 1.49, 1.19-1.88), axillary node dissection (RR = 1.39, 1.11-1.73), and chemotherapy (RR = 1.80, 1.37-2.36). For each kg of weight gained between BC diagnosis and start of ET, and for each additional year of age, RR of gaining weight during ET decreased (RR = 0.98, 0.97-0.99, and RR = 0.99, 0.98-0.99, respectively). Menopausal status and type of ET were not significant predictors of weight gain. In multivariable analysis, only weight loss between BC diagnosis and start of ET was significant.
The association of weight loss prior to ET and subsequent substantial weight gain during ET warrants further investigation.
本研究旨在调查激素受体阳性肿瘤确诊的绝经前和绝经后乳腺癌(BC)幸存者的体重变化轨迹,并特别关注绝经状态和内分泌治疗(ET)类型作为 ET 期间体重增加的风险因素。
我们对电子病历进行了回顾性审查。使用描述性统计和卡方检验和 t 检验比较绝经前和绝经后妇女。使用卡方检验和 ANOVA 分析患者特征与体重变化轨迹之间的组内关联。使用对数二项式回归模型估计体重增加的相对风险。
最终样本中,绝经前患者占 32%(n=140),绝经后患者占 68%(n=298)。在 ET 期间体重增加的相对风险(RR)最高的是绝经前(RR=1.29,1.03-1.52)和 III 期 BC(RR=2.12,1.59-2.82)、乳房切除术(RR=1.49,1.19-1.88)、腋窝淋巴结清扫术(RR=1.39,1.11-1.73)和化疗(RR=1.80,1.37-2.36)的女性。在 BC 诊断和 ET 开始之间每增加 1 公斤体重,以及每增加 1 岁,ET 期间体重增加的 RR 都会降低(RR=0.98,0.97-0.99,和 RR=0.99,0.98-0.99,分别)。绝经状态和 ET 类型不是体重增加的显著预测因素。在多变量分析中,只有 BC 诊断和 ET 开始之间的体重减轻具有统计学意义。
ET 前体重减轻与随后 ET 期间体重显著增加之间的关联值得进一步研究。