Association between weight gain during adjuvant chemotherapy (CTx) for early-stage breast cancer (BC) and survival outcomes.
e12057 Background: Obese and overweight women have an increased risk of BC and worse outcomes at the time of diagnosis compared to those at normal weight. Studies suggest that women tend to gain weight after BC cancer diagnosis and during CTx for early-stage disease, which may in turn increase risk for worse outcomes. We examined if weight gained during adjuvant CTx was associated with worse outcomes. Methods: We queried the prospectively maintained UT MD Anderson Cancer Center Breast Cancer (UTMDACC) Database for data on patients (pts) who received adjuvant third-generation CTx for early-stage BC cancer, including: demographics; tumor characteristics; and, body mass index (BMI) at diagnosis, pre- and post-CTx and one year after completion of treatment. Univariate and multivariate analysis (MA) by Cox regression were performed for survival outcomes across 3 categories according to BMI variation from start to end of CTx: >0.5-point loss or gain and stable BMI (± 0.5). Results: We included 1998 pts in this study. Women over 50 years old and post-menopausal were more likely to lose weight during adjuvant CTx, whereas women under 30 years old gained more weight (p<0.0001). At one year post-CTx, all pts tended to return to their original weight (ρ=0.3, p<0.0001). On MA, a BMI increase of 0.5 points was o associated with increased loco regional recurrence risk for both the entire cohort (HR 2.4; 95% CI, 1.122-5.166; p=0.0241) adjusting for grade and stage and for post-menopausal women (HR 3.774, 95% CI 1.241-11.447, p=0.0193) adjusting for Her2 status. Age <30 years old (HR, 2.52; 95% CI, 1.009-6.293; p=0.0478) and tumor stage 3 comparing to 1 (HR, 4.598; 95% CI, 2.754-7.677; p<0.0001) were associated with increased risk of death and tumor grade 2 (vs 3; HR, 0.547; 95% CI, 0.353-0.847; p=0.0069) was a protective factor on MA for the entire cohort. Conclusions: Weight gain during adjuvant CTx was associated with increased loco regional recurrence for the entire cohort and post-menopausal women, including pts who at year 1 returned to their normal weight. The effect of increased BMI during CTx on breast stroma, molecular profile and how it affects local recurrence is intriguing and needs to be further evaluated.