The impact of obesity on receipt of adjuvant chemotherapy for breast cancer in the National Comprehensive Cancer Network (NCCN) centers Journal Article


Authors: Brewster, A. M.; Etzel, C.; Zhou, R.; Wong, Y.; Edge, S.; Blayney, D. W.; Wilson, J.; Hudis, C.; Ottesen, R.; Hughes, M. E.; Weeks, J. C.; Theriault, R. L.
Article Title: The impact of obesity on receipt of adjuvant chemotherapy for breast cancer in the National Comprehensive Cancer Network (NCCN) centers
Abstract: Disparities in the receipt of adjuvant chemotherapy for early stage breast cancer is an important factor influencing mortality. We investigated whether greater body mass index (BMI) decreases receipt of adjuvant chemotherapy among women with operable breast cancer. In the NCCN breast cancer outcomes database, we identified women aged ≤70 with newly diagnosed stage I, II, or III breast cancer between 1997 and 2007, for whom use of adjuvant chemotherapy was classified as either standard-of-care or discretionary based on their clinical characteristics. Body mass index was assessed in categories (<18.5 kg/m 2 [underweight], 18.5 to <25 kg/m2 [normal], 25 to <30 kg/m2 [overweight], 30-39 kg/m2 [obese], ≥40 kg/m2 [extreme obese]). Multivariable logistic regression analysis was used to examine the association between BMI and receipt of chemotherapy in each classification group. 9,527 women were eligible for the study; 40% normal weight or less; 31% overweight; 24% obese; and 5% extremely obese. In multivariable analysis, there was no significant association between BMI and receipt of chemotherapy in either classification group. Among women for whom chemotherapy would be considered standard-of-care, older age (P < 0.001), comorbidity (P < 0.001), and non-Hispanic black ethnicity (P = 0.002) were associated with a lower likelihood of receipt of chemotherapy; however, the effect of ethnicity was not modified by obesity. Among women treated for operable breast cancer in the NCCN centers, BMI had no impact on receipt of adjuvant chemotherapy and did not modify the lower likelihood of chemotherapy among non-Hispanic black patients. Further investigation is needed into other factors that contribute to patient disparities in the receipt of chemotherapy in major academic centers. © 2011 Springer Science+Business Media, LLC.
Keywords: adult; controlled study; aged; middle aged; major clinical study; adjuvant therapy; cancer adjuvant therapy; chemotherapy, adjuvant; chemotherapy; cancer staging; antineoplastic agent; neoplasm staging; cohort studies; breast cancer; obesity; breast neoplasms; health care quality; prescription; body mass; body mass index; comorbidity; age distribution; onset age; ethnicity; drug use; negro; drug indication; adjuvant; healthcare disparities; standard-of-care
Journal Title: Breast Cancer Research and Treatment
Volume: 130
Issue: 3
ISSN: 0167-6806
Publisher: Springer  
Date Published: 2011-12-01
Start Page: 897
End Page: 904
Language: English
DOI: 10.1007/s10549-011-1516-0
PROVIDER: scopus
PUBMED: 21809116
PMCID: PMC3436594
DOI/URL:
Notes: --- - "Export Date: 3 January 2012" - "CODEN: BCTRD" - "Source: Scopus"
Altmetric
Citation Impact
MSK Authors
  1. Clifford Hudis
    894 Hudis