Changes in weight, physical and psychosocial patient-reported outcomes among obese women receiving treatment for early-stage breast cancer: A nationwide clinical study Journal Article


Authors: Di Meglio, A.; Michiels, S.; Jones, L. W.; El-Mouhebb, M.; Ferreira, A. R.; Martin, E.; Matias, M.; Lohmann, A. E.; Joly, F.; Vanlemmens, L.; Everhard, S.; Martin, A. L.; Lemonnier, J.; Arveux, P.; Cottu, P. H.; Coutant, C.; Del Mastro, L.; Partridge, A. H.; André, F.; Ligibel, J. A.; Vaz-Luis, I.
Article Title: Changes in weight, physical and psychosocial patient-reported outcomes among obese women receiving treatment for early-stage breast cancer: A nationwide clinical study
Abstract: Background: Evidence on how weight loss correlates to health-related quality-of-life (HRQOL) among obese breast cancer (BC) patients is limited. We aimed to evaluate associations between weight changes and HRQOL. Methods: We included 993 obese women with stage I-II-III BC from CANTO, a multicenter, prospective cohort collecting longitudinal, objectively-assessed anthropometric measures and HRQOL data (NCT01993498). Associations between weight changes (±5% between diagnosis and post-treatment [shortly after completion of surgery, adjuvant chemo- or radiation-therapy]) and patient-reported HRQOL (EORTC QLQ-C30/B23) were comprehensively evaluated. Changes in HRQOL and odds of severely impaired HRQOL were assessed using multivariable generalized estimating equations and logistic regression, respectively. Results: 14.1% women gained weight, 67.3% remained stable and 18.6% lost weight. Significant decreases in functional status and exacerbation of symptoms were observed overall post-treatment. Compared to gaining weight or remaining stable, obese women who lost weight experienced less of a decline in HRQOL, reporting better physical function (mean change [95%CI] for gain, stability and loss: −12.9 [-16.5,-9.3], −6.9 [-8.2,-5.5] and −6.2 [-8.7,-3.7]; pinteraction[weight-change-by-time] = 0.006), less dyspnea (+18.9 [+12.3,+25.6], +9.2 [+6.5,+11.9] and +3.2 [-1.0,+7.3]; pinteraction = 0.0003), and fewer breast symptoms (+22.1 [+16.8,+27.3], +18.0 [+15.7,+20.3] and +13.4 [+9.0,+17.2]; pinteraction = 0.044). Weight loss was also significantly associated with reduced odds of severe pain compared with weight gain (OR [95%CI] = 0.51 [0.31–0.86], p = 0.011) or stability (OR [95%CI] = 0.62 [0.41–0.95], p = 0.029). No associations between weight loss and worsening of other physical or psychosocial parameters were found. Conclusions: This large contemporary study suggests that weight loss among obese BC patients during early survivorship was associated with better patient-reported outcomes, without evidence of worsened functionality or symptomatology in any domain of HRQOL. © 2020 The Author(s)
Keywords: breast cancer; weight loss; obesity; survivorship; patient-reported outcomes; weight change; health-related quality-of-life
Journal Title: Breast
Volume: 52
ISSN: 0960-9776
Publisher: Elsevier Inc.  
Date Published: 2020-08-01
Start Page: 23
End Page: 32
Language: English
DOI: 10.1016/j.breast.2020.04.002
PROVIDER: scopus
PUBMED: 32344296
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Lee Winston Jones
    129 Jones