Receipt of appropriate primary breast cancer therapy and adjuvant therapy are not associated with obesity in older women with access to health care.
Meyers Primary Care Institute
Age Factors; Aged; Aged, 80 and over; Body Mass Index; Breast Neoplasms; Chemotherapy, Adjuvant; Delivery of Health Care; Female; Health Services Accessibility; Humans; Obesity; Recurrence; Treatment Outcome
Health Services Research | Medicine and Health Sciences
PURPOSE: Many studies have reported body mass index (BMI) increases the risk of breast cancer recurrence and breast cancer-specific mortality. Few studies have reported or examined whether breast cancer treatment differs by BMI. The purpose of this study was to examine the association between BMI at breast cancer diagnosis and receipt of appropriate primary tumor therapy and adjuvant therapy.
METHODS: We identified 897 women age >or= 65 years diagnosed with stage I or II breast cancer from 1990 to 1999 at five health care organizations. We used medical records to confirm demographics, tumor characteristics, treatment, comorbid conditions, and to calculate BMI at diagnosis (< 25 kg/m(2), n = 328; 25 to < 30 kg/m(2), n = 305; 30 to < 35 kg/m(2), n = 188; >or= 35 kg/m(2), n = 76). We defined primary therapy based on National Guidelines as receiving breast-conserving surgery with radiation therapy and axillary node dissection, simple mastectomy with axillary node dissection, or modified radical mastectomy (73% overall); adjuvant therapy was defined as receipt of hormonal therapy, chemotherapy, or both (60% overall).
RESULTS: The median BMI was 26.7 kg/m(2) (range, 14.6 to 61.2). The proportion of women receiving primary therapy and adjuvant therapy was lowest for women less than 25 kg/m(2) (69% and 56%, respectively) and greatest for obese I (78% and 64%, respectively). There were no differences in receipt of primary or adjuvant treatment across BMI in univariate or multivariable models (after adjusting for age, stage, comorbidity, diagnosis year, and hormone receptor positivity).
CONCLUSION: Receipt of appropriate primary therapy and adjuvant therapy is not associated with BMI in older women with access to health care. Additional research in larger samples and more diverse settings is needed.
J Clin Oncol. 2007 Aug 10;25(23):3428-36.
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Buist, Diana S. M.; Ichikawa, Laura; Prout, Marianne N.; Yood, Marianne Ulcickas; Field, Terry S.; Owusu, Cynthia; Geiger, Ann M.; Quinn, Virginia P.; Wei, Feifei; and Silliman, Rebecca A., "Receipt of appropriate primary breast cancer therapy and adjuvant therapy are not associated with obesity in older women with access to health care." (2007). Meyers Primary Care Institute Publications and Presentations. 189.