University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
Kaiser Permanente, Center for Integrated Health Care Research, 501 Alakawa St. Suite 201, Honolulu, HI, 96817, USA.
BMC Cancer. 2021 Sep 8;21(1):1005. doi: 10.1186/s12885-021-08740-5.
Weight changes are common among breast cancer patients. The majority of studies to date have focused on weight gain after a breast cancer diagnosis and its implications on health in survivors. Fewer studies have examined weight loss and its related characteristics. Weight changes have been reported to be influenced by several factors such as age, treatment, stage and pre-diagnostic weight. We evaluated weight changes during key treatment time points in early stage breast cancer patients.
We characterized 389 female patients diagnosed in Hawaii with early stage breast cancer from 2003 to 2017 in the Multiethnic Cohort (MEC) linked with Kaiser Permanente Hawaii electronic medical record data. We evaluated weight changes from surgery to 4 years post-diagnosis with six time points along a patient's treatment trajectory (chemotherapy, radiation, endocrine, or surgery alone) and annually thereafter, adjusting for age, race/ethnicity and initial body mass index (BMI).
We found key time points of significant weight change for breast cancer patients according to their adjuvant treatment. In patients who had surgery alone (S), surgery-radiation (SR), or surgery-endocrine therapy (SE), the majority of patients had stable weight, although this consistently decreased over time. However, the percentages of patients with weight loss and weight gain during this time steadily increased up to 4 years after initial surgery. Weight loss was more common than weight gain by about 2 fold in these treatment groups. For patients with surgery-chemotherapy (SC), there was significant weight loss seen within the first 3 months after surgery, during the time when patients receive chemotherapy. And this weight loss persisted until year 4. Weight gain was less commonly seen in this treatment group.
We identified key time points during breast cancer treatment that may provide a therapeutic window to positively influence outcomes. Tailored weight management interventions should be utilized to promote overall health and long term survivorship.
体重变化在乳腺癌患者中很常见。迄今为止，大多数研究都集中在乳腺癌诊断后的体重增加及其对幸存者健康的影响上。较少的研究探讨了体重减轻及其相关特征。体重变化据报道受到多种因素的影响，如年龄、治疗、分期和诊断前体重。我们评估了早期乳腺癌患者在关键治疗时间点的体重变化。
我们对 2003 年至 2017 年期间在夏威夷被诊断为早期乳腺癌的 389 名女性患者（来自夏威夷多族裔队列（MEC））进行了特征描述，并与 Kaiser Permanente Hawaii 电子病历数据相关联。我们评估了从手术到诊断后 4 年的体重变化，在患者的治疗轨迹上有六个时间点（化疗、放疗、内分泌治疗或单独手术），并在考虑年龄、种族/族裔和初始体重指数（BMI）后每年进行调整。
我们发现根据辅助治疗，乳腺癌患者的体重有几个关键的变化时间点。在单独手术（S）、手术放疗（SR）或手术内分泌治疗（SE）的患者中，大多数患者的体重稳定，尽管随着时间的推移，体重持续下降。然而，在此期间，体重减轻和体重增加的患者比例稳步增加，直至初始手术后 4 年。在这些治疗组中，体重减轻比体重增加常见约 2 倍。对于接受手术化疗（SC）的患者，在手术后的前 3 个月内，即患者接受化疗期间，体重明显减轻。这种体重减轻一直持续到第 4 年。在这个治疗组中，体重增加较少见。
我们确定了乳腺癌治疗期间的关键时间点，这些时间点可能为积极影响结果提供治疗窗口。应利用量身定制的体重管理干预措施，促进整体健康和长期生存。
