Locally advanced breast cancer more deadly in obese

Last Updated: 2008-03-14 13:00:17 -0400 (Reuters Health)

WASHINGTON (Reuters) - Women with locally advanced breast cancer who are overweight have a worst prognosis than their slimmer counterparts, U.S. researchers reported on Friday.

An aggressive type of breast cancer, known as inflammatory breast cancer, was also seen in significantly more obese and overweight patients than in normal-weight patients, according to the study, published in the journal Clinical Cancer Research.

"The more obese a patient is, the more aggressive the disease," said principal investigator Dr. Massimo Cristofanilli of the University of Texas M.D. Anderson Cancer Center in Houston. "We are learning that the fat tissue may increase inflammation that leads to more aggressive disease."

Cristofanilli and colleagues studied 602 women with locally advanced breast cancer. They classified the patients by body mass index (BMI), the ratio of height to weight, frequently used to measure obesity. (People with BMIs of less than 18.5 are underweight; between 18.5 and 24.9 is considered normal; 25.0 to 29.9 is overweight; and 30 or higher is obese.)

After 5 years, the researchers report that 58.6 percent of the obese women, 58.3 percent of the overweight women and 69.3 percent of the normal-weight women were still alive.

After 10 years, 57.3 percent of normal- or underweight had survived compared with 42.4 percent of obese women and 44.1 percent of overweight women.

"Obesity goes far beyond just how a person looks or any physical strain from carrying around extra weight. Particular attention should be paid to our overweight patients," Cristofanilli said.

Many studies have shown that the obese have a greater risk of several types of cancer. Last month British researchers reported in The Lancet medical journal that obesity can double the risk of leukemia, multiple myeloma, thyroid cancer, colon and kidney cancers.

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Breastcancer.org says:

Locally advanced breast cancer more deadly in obese

Much research has shown that being overweight or obese increases the risk of breast and other cancers. The study reviewed here found that being overweight or obese also can affect the type of breast cancer a woman may get, as well as length of survival after breast cancer diagnosis.

The researchers found that:

  • Overweight and obese women were more likely than women of a healthy weight to develop a relatively rare but serious type of aggressive breast cancer called inflammatory breast cancer. Inflammatory breast cancer symptoms include redness, warmth, and tenderness of the breast. Inflammatory breast cancer usually is diagnosed at stage III or stage IV, and can be difficult to treat.
  • Overweight and obese women were more likely than women of a healthy weight to have more aggressive forms of breast cancer. This means that the cancers are less likely to respond to treatment. It also means that the women had worse prognoses. Five years after breast cancer diagnosis, 58.6% of obese women and 58.3% of overweight women were alive. In comparison, about 70% percent of women at a healthy weight were still alive 5 years after diagnosis.

Fatty tissue can cause more inflammation in the body and this inflammation can make breast cancer more aggressive. Hormones such as estrogen are stored in fat cells and this may explain in part why breast cancer is more aggressive in overweight or obese women.

This study used body mass index (BMI) to classify the women's weight. BMI takes both height and weight into account. Losing weight is hard work, but keeping your BMI in the normal range is worth the effort. A healthy weight can improve your overall health, lower your risk of breast and other cancers, and make it more likely that you'll survive if you're diagnosed with breast cancer.

If your BMI is high, talk to your doctor about a safe and sensible plan to get your BMI in the normal range. The National Institutes of Health offers an online BMI calculator that allows you to calculate your BMI. For more information on creating a healthy diet plan that includes exercise, visit the breastcancer.org page on Balancing Your Diet in the Nutrition section.

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