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Obesity and Premenopausal ER+ breast cancer: a link?

June 3, 2014

Obese premenopausal women with estrogen-receptor positive (ER+) breast cancer are at a greater risk for death from their disease (21.5%) than their normal weight counterparts (16.6%) (p<.00001)
http://am.asco.org/obesity-contributes-higher-mortality-among-premenopausal-women-er-breast-cancer

If you aren’t aware, this year’s annual meeting of the American Society for Clinical Oncology is currently taking place. This is one of my favorite conferences to attend (I couldn’t go this year), but there is a lot of great stuff available online.

The Relative Risk between the two premenopausal groups for ER+ was 1.34 which means that being obese increases your risk by 1/3 more that your breast cancer will recur in 10 years. (This was a 10 year study).

Treatment did not make a significant difference for either group.

In my opinion, this study has a few interesting results

The first is that weight was a factor only for premenopausal women; age did not matter, only hormone status. Once the hormones were out of the picture, the weight had a neutral effect if the patient was ER+.
The other was that weight had no effect on ER- disease.

An implication (and this is only speculation at this point) is that you may be able to improve survival by encouraging your premenopausal early diagnosed breast cancer patient who is obese to lose weight. Remember, this was a 10-year study, so there is time to lose weight and help reduce that risk of cancer recurrence.

However, I should caution that this study DOES NOT directly study that effect, and there is the confounding problem that patients who are obese may actually be “under dosed” with chemotherapy due to their body weight not being accurately adjusted for during treatment. Many times in clinical trials, healthier more normal weight patients are included, and the dosing is more appropriate for that population, than the sicker, more diverse general population.

A second study also investigated the effects of weight loss on inflammatory biomarkers in breast cancer survivors and

found  encouraging results that might support the role of weight loss in reducing risk of breast cancer recurrence.

Losing Weight Helped Breast Cancer Survivors reduce Inflammation Biomarkers

Losing Weight Helped Breast Cancer Survivors reduce Inflammation Biomarkers

 

http://am.asco.org/shape-2-lean-studies-highlight-benefits-weight-loss-breast-cancer-survivors

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