Addressing health disparities in survivors of breast cancer through lifestyle modifications and group support.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 177-177
Author(s):  
Susan H. McDunn ◽  
Olatokunbo Olorunfemi ◽  
Wendy Rogowski ◽  
Bettina Tahsin ◽  
Venita James ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Underserved Populations ◽  
Hospital Setting ◽  
Cancer Recurrence ◽  
Well Being ◽  
Lifestyle Modifications ◽  
Registered Dietician ◽  
Baseline Weight ◽  
Improvement Programs

177 Background: Obesity and inactivity have been shown to adversely affect outcomes in survivors of breast cancer. These factors may contribute to poorer outcomes in women of black and Hispanic populations, and those from lower socioeconomic backgrounds. We sought to improve overall well-being and limit weight gain in patients from these underserved populations through a group lifestyle intervention in a public hospital setting. Methods: 46 women were recruited and gave informed consent after completion of adjuvant chemotherapy for stage I-III breast cancer to participate in this feasibility pilot program. Blood work, body measurements, diet, two-minute walk tests, and PHQ9 depression scores were collected at the first and last of six monthly sessions. The group classes were led by a registered dietician and included diet and light exercise instruction at each visit. Results: Patient demographics and results are in the table below. Trends for non-completers included younger age, ethnicity, no hormonal therapy, lower baseline weight, lower HOMA IR, and dropout after two sessions. Among the 40% who completed all six sessions, there was a trend toward greater well-being (lower PHQ) with slight weight gain and increased insulin resistance. Completers tended to start in the same cohort and were more likely to complete if they attended more than two visits. Conclusions: Greater well-being may be an important outcome for group lifestyle improvement programs in populations with disparities. Motivations for better attendance may include group bonding. Participants will continue to be followed to obtain information on long-term weight change and cancer recurrence.[Table: see text]

scholarly journals Post-diagnosis weight gain and breast cancer recurrence in women with early stage breast cancer

2006 ◽  
Vol 99 (1) ◽  
pp. 47-57 ◽  
Author(s):  
Bette J. Caan ◽  
Jennifer A. Emond ◽  
Loki Natarajan ◽  
Adrienne Castillo ◽  
Erica P. Gunderson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Early Stage ◽  
Cancer Recurrence ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Recurrence

Is obesity associated with increased recurrence risk in estrogen receptor (ER)-positive breast cancer?

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 171-171 ◽  
Author(s):  
K. K. L. Yap ◽  
D. N. Efiom-Ekaha
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Pearson Correlation ◽  
Cancer Recurrence ◽  
Oncotype Dx ◽  
Breast Cancer Recurrence ◽  
Breast Cancers ◽  
Obese Women ◽  
Er Positive ◽  
Positive Breast Cancer

171 Background: Oncotype DX Score is a 21-gene expression analysis that has been validated clinically as a reliable predictor of breast cancer recurrence for ER-positive, node-negative breast cancers. Obesity is recognized as a risk factor for many cancers, including breast cancer. Additionally obesity has been shown to be an independent prognostic factor in breast cancer. The primary objective of this study is to determine the correlation between obesity and Oncotype DX score, hence the relationship between obesity and breast cancer recurrence in ER-positive breast cancer. The secondary objective is to investigate the association between weight gain after diagnosis and breast cancer recurrence. Methods: An IRB-exempted retrospective chart review of female patients at Wellspan Group with ER-positive breast cancer who had Oncotype DX analysis in 2008 and 2009. Data collected included Oncotype DX score and BMI (at diagnosis, 6 months and 12 months). Data were analyzed to determine the correlation between Oncotype DX score and BMI at diagnosis, at 6 months and at 12 months. The correlation between Oncotype DX score and BMI changes at 12 months also was determined. Results: A total of 125 patients were identified; 103 had BMI recorded at diagnosis, 88 had BMI recorded at 6 months and 87 had BMI recorded at 12 months. Of these, we were able to determine the BMI changes at 12 months for 82 patients. The Pearson correlation scores were 0.091 (p = 0.361), 0.074 (p = 0.492), and 0.047 (p = 0.669) for BMI at diagnosis, at 6 months and at 12 months respectively. The Pearson correlation score was 0.007 (p = 0.948) for BMI changes at 12 months. Conclusions: Obesity and weight gain are not independent predictors of recurrence in patients with ER-positive breast cancer. The reported adverse prognostic associations may be more prominent in ER-negative breast cancers. This is consistent with the reports suggesting a higher rate of ER-negative, high-grade cancers in obese women as well as a greater magnitude of benefit from dietary and weight reduction interventions seen in women with ER-negative cancers.

Weight, Weight Gain, and Survival After Breast Cancer Diagnosis

2005 ◽  
Vol 23 (7) ◽  
pp. 1370-1378 ◽  
Author(s):  
Candyce H. Kroenke ◽  
Wendy Y. Chen ◽  
Bernard Rosner ◽  
Michelle D. Holmes
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Proportional Hazards ◽  
Linear Trend ◽  
Menopausal Status ◽  
Cancer Recurrence ◽  
Cox Proportional Hazards ◽  
Breast Cancer Recurrence ◽  
Health Study ◽  
Breast Cancer Death

Purpose To determine whether weight prior to diagnosis and weight gain after diagnosis are predictive of breast cancer survival. Methods Patients included 5,204 Nurses' Health Study participants diagnosed with incident, invasive, nonmetastatic breast cancer between 1976 and 2000; 860 total deaths, 533 breast cancer deaths, and 681 recurrences (defined as secondary lung, brain, bone, or liver cancer, and death from breast cancer) accrued to 2002. We computed the change in body mass index (BMI) from before to the first BMI reported ≥ 12 months after the date of diagnosis. Cox proportional hazards models were used to evaluate associations of categories of BMI before diagnosis and of BMI change with time to event. We stratified by smoking, menopausal status, and breast cancer–related variables. Results In multivariate-adjusted analyses, weight before diagnosis was positively associated with breast cancer recurrence and death, but this was apparent only in never smokers. Similarly, among never-smoking women, those who gained between 0.5 and 2.0 kg/m2 (median gain, 6.0 lb; relative risk [RR], 1.35; 95% CI, 0.93 to 1.95) or more than 2.0 kg/m2 (median gain, 17.0 lb; RR, 1.64; 95% CI, 1.07 to 2.51) after diagnosis had an elevated risk of breast cancer death during follow-up (median, 9 years), compared with women who maintained their weight (test for linear trend, P = .03). Associations with weight were stronger in premenopausal than in postmenopausal women. Similar findings were noted for breast cancer recurrence and all-cause mortality. Conclusion Weight and weight gain were related to higher rates of breast cancer recurrence and mortality, but associations were most apparent in never-smoking women.

Randomized pilot study of a weight gain prevention intervention for breast cancer patients receiving neoadjuvant chemotherapy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11090-e11090
Author(s):  
Karen Basen-Engquist ◽  
James L. Murray ◽  
George Baum ◽  
Angelica M. Gutierrez-Barrera ◽  
Banu Arun
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Cancer Patients ◽  
Weight Gain Prevention ◽  
Breast Cancer Patients ◽  
Prevention Intervention ◽  
Igf I ◽  
Baseline Weight ◽  
Igfbp 3

e11090 Background: Weight gain is a common problem after breast cancer diagnosis and treatment, particularly for women who receive chemotherapy. The weight gain has negative effects on quality of life, increases risk for chronic disease, and may increase risk of breast cancer recurrence. This pilot study tested a behavioral weight gain prevention intervention on weight, IGF-I, and IGFBP-3. Methods: Thirty-nine breast cancer patients receiving neoadjuvant chemotherapy were randomized to the weight gain prevention intervention or usual care. The intervention focused on exercise (resistance training, aerobic) and eating a low energy dense diet. Participants received 20 sessions during chemotherapy (14 in person and 6 by telephone) and 9 sessions after surgery (3 in person, 6 by telephone). They completed weight and other assessments at baseline (t0), mid-chemotherapy (T1), post-chemotherapy (t2), post surgical recovery (T3), after the post-surgical intervention (T4) and long term follow-up 6-9 months post surgery (T5). Serum was collected at T0, T2, T3, and T5 and analyzed for IGF-I and IGFBP-3. Results: Controlling for baseline weight, the intervention group weighed less than the control group at T1-T4, a result which approached significance (p=.08) in the intent to treat analysis. There was also a significant obesity x treatment group interaction, indicating that the intervention was most effective for patients who were obese at baseline (p=0.03). The groups did not differ in weight at the post-intervention follow-up (p=0.839). There was no significant difference between the groups in IGF-I or IGFBP-3. Conclusions: A diet and exercise intervention delivered during and after chemotherapy can promote weight loss in breast cancer patients, but the results may not be sustained after the intervention ends. [caption]Participants’ weights in kilograms, adjusted for baseline weight (least squares means).[caption] [Table: see text]

scholarly journals Clinical and genetic predictors of weight gain in patients diagnosed with breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1561-1561
Author(s):  
Sangeetha Meda Reddy ◽  
Maureen Sadim ◽  
Irene B. Helenowski ◽  
Jun Li ◽  
Nengjun Yi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Cancer Patients ◽  
Menopausal Status ◽  
High Risk Patient ◽  
Cancer Recurrence ◽  
Her2 Status ◽  
Breast Cancer Patients ◽  
Mortality And Morbidity ◽  
Response To Chemotherapy

1561 Background: Obesity and weight gain in breast cancer patients has been associated with decreased quality of life, decreased response to chemotherapy, increased cancer recurrence, and higher all-cause mortality. Our study was designed to identify factors that contribute to this weight gain. Methods: Chart review was conducted on 565 breast cancer patients to obtain weights and BMIs over an 18 month period from diagnosis, tumor characteristics (ER/PR/Her2 status, grade, presence of LN metastases, stage), demographics (age, race), clinical factors (menopausal status), and treatment regimens (chemotherapy, hormone therapy, radiation). Blood samples were genotyped for polymorphisms in FTO (fat mass and obesity-associated protein) and the adiponectin pathway, two pathways found to be associated with obesity and breast cancer risk. Results: See table. For genetic analysis, one statistically significant epistatic and three gene x environmental interactions were detected for adiponectin SNPs: rs822396d x BMI at diagnosis (effect size 8.65), rs2232853a x age (2.75), rs1501299a x BMI at diagnosis (3.63), and rs266729d x rs7539542d (6.40). Conclusions: We have identified multiple clinical and genetic variables that are likely predictors of weight gain in breast cancer patients. We are conducting a prospective study of 200 breast cancer patients to validate the findings of this retrospective study. By identifying a high risk patient population, we hope to target them for aggressive lifestyle interventions to prevent weight gain and thereby improve their mortality and morbidity. [Table: see text]

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