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Study: Weight gain associated with breast cancer survivorship

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Contents

At a glance                  Questions for your doctor
Findings               In-depth                
Clinical trials Limitations
Guidelines Resources


STUDY AT A GLANCE

This study is about:

The weight change that is associated with being a breast cancer survivor with a family history of breast cancer.

Why is this study important?

Weight gain is associated with various health issues. Weight gain is a risk factor for postmenopausal breast cancer.  Among breast cancer survivors, higher Body Mass Index (BMI) and weight gain increases risk for breast cancer recurrence and/or a new primary cancer. This study compared weight gain between previvors (women at increased risk of breast cancer) and breast cancer survivors and looked specifically at women with a family history of breast cancer.  

Study findings:

  • Overall, breast cancer survivors gained about 3 pounds more weight than previvors.
  • Women who received chemotherapy were twice as likely to gain at least 11 pounds at the researchers’ follow-up point compared with women who were never diagnosed with cancer. 
  • ER-negative breast cancer survivors had the greatest weight gain. This group gained on average approximately 7 more pounds than previvors.
  • On average, premenopausal survivors gained more weight than postmenopausal survivors.

What does this mean for me?  

This study shows that in women with a family history of cancer a breast cancer diagnosis and treatment is linked to weight gain. This study did not look at specific causes of, or ways to manage this weight gain. However, there are expert guidelines and programs available to help cancer survivors control their weight. Knowing your risk for weight gain after diagnosis and treatment may help you and your doctor create a plan for weight management after treatment.

posted 8/24/15

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References

Gross A, May B, Axilbund J, et al. “Weight Change in Breast Cancer Survivors Compared to Cancer-Free Women: A Study in Women at Familial Risk of Breast Cancer.” Cancer Epidemiology, Biomarkers & Prevention, published online first July 15, 2015.

Disclosure

FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.

Kroenke C, Chen W, Rosner B, Holmes M. “Weight, Weight Gain, and Survival After Breast Cancer Diagnosis.” Journal of Clinical Oncology (2005) 23:1370-78.

This article is relevant for:

Women diagnosed with early stage (1-3) breast cancer

This article is also relevant for:

Men with breast cancer

Triple negative breast cancer

ER/PR +

People with a genetic mutation linked to cancer risk

Breast cancer survivors

Women under 45

Women over 45

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IN-DEPTH REVIEW OF RESEARCH

Study background:

Many studies have noted weight gain in breast cancer survivors, but they do not directly compare these women with women who have never been diagnosed with cancer.  Without the comparison, it is harder to see whether breast cancer survivors are actually gaining more weight or not. 

Researchers of this study wanted to know:

Whether breast cancer survivors with a family history of breast cancer gain more weight after their diagnosis compared to previvors.

Population(s) used in the study:  

The study compared 303 breast cancer survivors with 307 previvors who had not had breast cancer. All women had either a family history of breast or ovarian cancer, a BRCA1/2 mutation, or a diagnosis of early breast cancer (diagnosed at age 40 or younger). Participating breast cancer survivors had a personal history of breast cancer ( or I-III breast cancer) that had been treated with surgery. The previvors included in the study were matched to the survivors based on age and menopausal status.  The breast cancer survivors in this study were further subdivided into two categories: survivors who had been diagnosed with breast cancer 5 years or less prior to the study start date, and survivors who had been diagnosed with breast cancer more than 5 years prior to the study start date. 

Study results:

  • Overall, breast cancer survivors gained on average approximately 3 more pounds than previvors.
  • When compared with other subtypes, breast cancer survivors who were diagnosed with ER-negative invasive breast cancer within the 5 years prior to the study start date had the greatest weight gain. This group gained on average approximately 7 more pounds than previvors.
  • Premenopausal breast cancer survivors diagnosed with breast cancer within the 5 years prior to the study start date gained on average approximately 6 more pounds than premenopausal previvors.  
  • Postmenopausal breast cancer survivors diagnosed with breast cancer within the 5 years prior to the study start date gained on average approximately 4 more pounds than postmenopausal previvors.
  • Overall, breast cancer survivors who had received chemotherapy with or without hormone therapy gained on average approximately 4 pounds compared to previvors. An average weight gain of approximately 8 pounds was seen in breast cancer survivors treated with chemotherapy only.
  • Compared to previvors, survivors who received chemotherapy were 2.1 times more likely to gain at least 11 pounds at the researchers’ follow-up point.

Limitations

The majority of the study population was white, which means that these findings might not apply to breast cancer survivors of other racial or ethnic backgrounds. Researchers also did not directly measure the women’s weights—they relied on self-reporting, which may not have been accurate.  Additionally, breast cancer survivors who did not have a family history of cancer were not included in the comparisons. 

Conclusion:

This is a highly relevant study for breast cancer survivors. It shows that in women with a family history of breast cancer and/or a mutation in a gene that increases cancer risk, breast cancer survivorship is a risk factor for weight gain. However, it is important to remember that this is only an association—the study does not show that the weight gain is caused by the breast cancer or the chemotherapy used to treat the breast cancer. More research is needed to find the exact cause, but the study’s authors note that the chemotherapy associated weight gain might be due to less physical activity or with changes in the patient’s metabolism. 

It is also important to note that the average overall weight gain in this study was approximately 3 pounds in breast cancer survivors. Currently we do not know whether gaining that amount increases risk of second primary cancer development or cancer recurrence. For comparison, a study done by Dr. Michelle Holmes’ research group found that women who gained between 0.5 and 2.0 kg/m2 (average weight gain of approximately 7 pounds) and women who gained more than 2.0 kg/m2 (average weight gain of approximately 20 pounds) had elevated risk of breast cancer death compared to women who maintained their weight.

In summary, there is an association between breast cancer and weight gain, and potential health problems are associated with weight gain. Researchers do not know the exact effect that gaining 3 pounds will have on breast cancer survivors. American Cancer Society guidelines say women should try to maintain their weight after a breast cancer diagnosis. 

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posted 8/24/15

Expert Guidelines
Expert Guidelines

Both the National Comprehensive Cancer Network and the American Cancer Society have recommendations for physical activity for cancer survivors:

  • Physical activity and exercise recommendations should be tailored to each person's abilities and preferences. 
  • People should try to engage in some physical activity daily; this may include:
    • taking the stairs.
    • walking more.
  • Each week, people should try to achieve the following: 
    • At least 150 minutes of moderate-intensity exercise, with an ideal goal of 300 minutes, 75 minutes of vigorous activity or a combination of the two.
    • Two to three sessions of strength/resistance training that include all of the major muscle groups (chest, shoulders, arms, back, core, and legs). 
    • Stretch major muscle groups at least two days per week.  
  • Avoid sitting or lying down for long periods and other prolonged sedentary behavior. 

Updated: 02/06/2022

Expert Guidelines
Expert Guidelines

Nutrition for people diagnosed with cancer

The National Comprehensive Cancer Network (NCCN) recommends the following for cancer survivors: 

  • Think about your food choices and amount of fruits, vegetables and unrefined grains you eat compared with red and processed meats, alcohol, and foods or drinks with added fat or sugar. 
  • Think about your eating habits, including portion size, snacking, how often you eat out and use of added fats or sugars.
  • All survivors should be encouraged to:
    • Make informed choices about food to ensure variety and adequate nutrient intake.
    • Limit refined sugars.
    • Eat a diet that is at least 50% plant-based, consisting mostly of vegetables, fruit and whole grains.
    • Track calorie intake; monitoring of calories is an effective way to manage weight.
    • Minimize alcohol intake to no more than one drink per day for a woman and two drinks per day for a man.
  • For patients desiring further dietary guidelines, the USDA approximate food plate volumes are:
    • Vegetables and fruits should comprise half the volume of food on the plate
    • Vegetables: 30% of plate; Fruits 20% of plate
    • Whole grains: 30% of plate
    • Protein: 20% of plate
  • Recommended sources of nutrients:
    • Fat: plant sources such as olive or canola oil, avocados, seeds and nuts, and fatty fish.
    • Carbohydrates: fruits, vegetables, whole grains and legumes.
    • Protein: poultry, fish, legumes, low-fat dairy foods, and nuts.

The Academy of Nutrition and Dietetics, the United States Office of Disease Prevention and Health Promotion  and the American Institute for Cancer Research also publish expert guidelines on nutrition and health. 

Updated: 12/12/2021

Questions To Ask Your Doctor
Questions To Ask Your Doctor

  • How can I manage my weight?
  • Cancer treatment is hard on my body—how do I exercise when I don’t feel like I can/want to?
  • My weight fluctuates—should I be worried if I gain a few pounds?
  • What are the current guidelines for weight management for cancer survivors?
  • Can you refer me to a registered dietitian who specializes in oncology nutrition? 

Open Clinical Trials
Open Clinical Trials

The following are studies focused on exercise for people diagnosed with breast cancer. 

Visit our Featured Research Page and Research Search and Enroll Tool to find additional studies enrolling people with, or at high risk for cancer.

Updated: 12/27/2021

Open Clinical Trials
Open Clinical Trials

The following are studies focused on nutrition for people diagnosed with breast cancer. 

Visit our Featured Research Page and Research Search and Enroll Tool to find additional studies enrolling people with, or at high risk for cancer.

Updated: 07/19/2022

Peer Support
Peer Support

The following organizations offer peer support services for people with, or at high risk for breast cancer:

Updated: 11/29/2022

Find Experts
Find Experts

The American College of Sports Medicine has a “ProFinder” search tool that allows you to locate certified fitness professionals by location and specialty.

Updated: 11/10/2021

Find Experts
Find Experts

Nutritionists and dieticians are experts in food and diet with a focus on helping people maintain or improve their health. Dieticians are experts who have received additional training and certification. You can find a registered dietician in your area through Eatright.org, the website for the Academy of Nutrition and Dietetics. You can search for nutritionists by specialty, including "cancer," "weight management" and "heart health."

Updated: 12/26/2022

Who covered this study?

NBC News

Breast cancer survivors gain more weight, study finds This article rates 4.0 out of 5 stars

HealthDay

Breast cancer survivors tend to gain weight: study This article rates 4.0 out of 5 stars

Newsmax Health

Breast sancer survivors prone to weight gain: Johns Hopkins study This article rates 3.5 out of 5 stars

Time

Why breast cancer survivors gain more weight This article rates 3.5 out of 5 stars

How we rated the media

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