by Antonio Di Meglio, Stefan Michiels, Lee W. Jones, Mayssam
El-Mouhebb, Arlindo R. Ferreira, Elise Martin, Margarida Matias, Ana Elisa
Lohmann, Florence Joly, Laurence Vanlemmens, Sibille Everhard, Anne-Laure
Martin, Jerome Lemonnier, Patrick Arveux, Paul H. Cottu, Charles Coutant, Lucia
Del Mastro, Ann H. Partridge, Fabrice André, Jennifer A. Ligibel, Ines Vaz-Luis
The Breast: VOLUME 52, P23-32, AUGUST
01, 2020
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.
