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Breast cancer survivors
Women under 45
Women over 45
Men with breast cancer
Metastatic breast cancer
Triple negative breast cancer
BRCA mutation carriers
Her2+ breast cancer
Other mutations: People with other genes that increase the risk for breast cancer.
Special populations: People with a family history of cancer
Weight gain in breast cancer survivors can affect survival and quality-of-life. This study found that breast cancer survivors are more likely to gain weight than women of the same age who are at high risk, but have never been diagnosed with cancer. The study looked at which groups of survivors were more likely to gain weight. (8/24/15)
The weight change that is associated with being a breast cancer survivor with a family history of breast cancer.
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 is one of the few studies that have 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.
This study shows that an association between breast cancer survivors with a family history of breast cancer and weight gain. While this does not show that being diagnosed with breast cancer directly causes weight gain, maintaining a healthy weight is an important issue that should be discussed with your health care provider because research has shown negative associations with weight gain and increased health problems.
The National Comprehensive Cancer Network sets recommendations on weight management and nutrition for cancer survivors.
NCCN Principles of Weight Loss
NCCN General Principles of Nutrition
NCCN General Principles of Weight Management
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.
Whether breast cancer survivors with a family history of breast cancer gain more weight after their diagnosis compared to previvors.
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 (DCIS or stage 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.
The study had 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 were not at elevated risk were not included in the comparisons.
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.
Gross A, May B, Axilbund J, et al. “Weight Change in Breast Cancer Survivors Compared to Cancer-Free Women: A Prospective Study in Women at Familial Risk of Breast Cancer.” Cancer Epidemiology, Biomarkers & Prevention, published online first July 15, 2015.
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.
National Comprehensive Cancer Network: Survivorship Guidelines
American Institute for Cancer Research: Dealing with Weight Gain or Weight Loss after Treatment
FORCE information: Nutrition and lifestyle
Be Empowered Webinar: Exercise and fitness for survivors and previvors
Be Empowered Webinar: How do I get motivated? Changing your lifestyle and diet
Research Study Search: Exercise and Weight Management