UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
Kirsten A. Nyrop , Allison Mary Deal , Hyman B. Muss , Jordan T Lee , Samara Ann Dixon , Shlomit Strulov Shachar
Background: We investigated weight change in postmenopausal Stage I-III breast cancer (BC) survivors on adjuvant endocrine treatment (ET) -- tamoxifen or aromatase inhibitors (AI) [anastrozole, exemestane, letrozole]. Clinical focus on > 2kg (4.7lbs) weight change within first 2 years of ET. Methods: Retrospective chart review. Weight measures taken during routine clinic visits. Fisher’s exact tests and ANOVA were used to compare patient characteristics between weight change groups. Results: Sample N = 212; 75% Caucasian, mean age 66 (8.4). Stage I: 51%, Stage 2: 38%, Stage III: 11%. Body Mass Index (BMI) at diagnosis 29.6 (6.4). 42% chemotherapy, 64% radiation. ET: 10% tamoxifen only, 45% anastrozole only, 16% letrozole only, 2% exemestane only, 15% more than one AI; 12% both tamoxifen and AI. Comorbidities: 0-1 32%, 2-3 48%, > 4 20%. Weight gain > 2kg was associated with higher BC stage (p = 0.01) and chemotherapy (p = 0.006). Both > 2kg weight loss and > 2kg weight gain were associated with higher baseline BMI (p = 0.005) and greater number of baseline comorbidities (p = 0.02). No significant association between weight change and race, radiation, or ET type. (Table 1) Conclusions: In our sample, 27% had clinically significant weight loss and 37% weight gain within first 2 years of ET. We found no significant differences in weight change by type of ET. The first 2 years of ET present an opportunity to educate BC survivors about the importance of weight management for overall wellness, prognosis and survival.
> 2kg weight loss | Stable weight | > 2kg weight gain | |
---|---|---|---|
Year 1 | 23% | 49% | 28% |
Year 2 | 27% | 36 % | 37% |
Age at start of ET | 66.8 (8.7) | 66.6 (8.5) | 64.0 (7.8) |
Race – Caucasian | 25% | 37% | 38% |
BMI at diagnosis ** | 31.1 (7.1) | 27.7 (6.5) | 30.3 (5.3) |
Comorbidities * | 2.6 (1.6) | 1.9 (1.5) | 2.5 (1.6) |
Stage ** | |||
Stage I | 35% | 30% | 35% |
Stage II | 22% | 44% | 35% |
Stage III | 9% | 27% | 64% |
Chemotherapy ** | |||
No | 33% | 38% | 29% |
Yes | 18% | 33% | 49% |
Radiation | |||
No | 28% | 33% | 39% |
Yes | 26.5% | 37.5% | 36% |
Endocrine Treatment | |||
Tamoxifen | 28% | 48% | 24% |
Anastrozole | 34% | 31% | 35% |
Letrozole | 14% | 40% | 46% |
Exemestane | 20% | 20% | 60% |
More than one AI | 16% | 36% | 48% |
Tamoxifen and AI | 32% | 40% | 28% |
*p ≤ 0.05 **p ≤ 0.01
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