Increased risk of contralateral breast cancers among overweight and obese women: a time-dependent association
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Bilal Majed Adrien Dozol Laureen Ribassin-Majed Kamel Senouci Bernard Asselain
- چاپ و سال / کشور: 2010
Description
Breast cancer (BC) survivors are at increased risk of second cancers. Obesity is commonly recognized as a risk factor of BC in postmenopausal period and a prognosis factor in BC regardless of menopausal status. Our aim was to study whether overweight BC survivors were at increased risk of contralateral BC (CBC). Our population was a large cohort of women followed since a first BC without distant spread and/or synchronous CBC. Body mass index (BMI) was assessed at diagnosis time. Binary codings of BMI were used to oppose overweight and obese patients to the others. Survival analyses were used including Cox models. Assumed hypothesis of proportional hazards was explored using graphical methods, Schoenfeld residuals and time-dependant covariates. In case of nonproportional hazards, survival models were computed over time periods. Over 15,000 patients were included in our study. Incidence of CBC was 8.8 (8.3–9.3)/1000 personyears and increased during follow-up. A significant timedependent association between overweight and CBC was observed. After 10 years of follow-up, we found a significant increased hazard of CBC among patients with a BMI above 25 kg/m2: the adjusted hazard ratio was 1.50(1.21–1.86), P = 0.001. After 10 years of follow-up, our study found a poorer prognosis among overweight BC survivors regarding CBC events. While benefits from diet habits and weight control may be expected during the long-term follow-up, they have yet to be established using randomized clinical trials.
Breast Cancer Res Treat (2011) 126:729–738 DOI 10.1007/s10549-010-1153-z Received: 10 May 2010 / Accepted: 24 August 2010 / Published online: 26 September 2010 Springer Science+Business Media, LLC. 2010
