According to results recently published in the Archives of Surgery, women with a higher body weight at diagnosis and/or women with estrogen receptor-negative, early breast cancer have a higher risk of dying from their disease than women with lower body weight or women with estrogen receptor-positive, early breast cancer.

Breast cancer is the second leading cause of cancer-related deaths for women in the United States. Women with early breast cancer, or cancer that has not spread to distant sites in the body, have a high rate of long-term survival following standard treatment options. Unfortunately, there remains a significant proportion of women with early breast cancer who ultimately succumb to their disease. Researchers have focused significant amounts of time in evaluating which patient and/or disease characteristics are associated with better or worse outcomes in breast cancer, so that treatment may be tailored to the individual case in order to provide improved outcomes for all patients.

The stage of breast cancer refers to the extent of spread of cancer and treatment options are largely dictated by the stage at which a woman is diagnosed. Stage I breast cancer refers to cancer that that is 2 centimeters or smaller in size and has not spread from its site of origin. Stage IIA breast cancer refers to cancer that is no larger than 2 centimeters, but has spread to lymph nodes under the arm, or is between 2 and 5 centimeters and has not spread to local lymph nodes. Other biologic factors, such as estrogen receptor (ER) status, are included in treatment choices in breast cancer. A significant portion of women with breast cancer have ER-positive breast cancer, or cancer that is stimulated to grow from exposure to the female hormone(s) estrogen and/or progesterone. Estrogen receptor status is determined through laboratory processes and patients with ER-positive breast cancer can receive hormonal agents that prevent or reduce the exposure of cancer cells to the stimulatory hormones.

Researchers from California recently analyzed data from over 1,300 women who were diagnosed with breast cancer between 1988 and 1995. The study included the analysis of tissue samples of the cancer and complete medical records of all patients. Patients were followed approximately 7 years from their diagnosis, with variables such as age at diagnosis, size of cancer, existence of spread to lymph nodes, stage of cancer, race, menopausal status, aggressiveness of cancer, type of treatment utilized, body weight and estrogen receptor status compared to their long-term outcomes. The data revealed that body weight or body mass index (a weight to height ratio), and estrogen receptor status affected long-term survival of patients diagnosed with stages I-IIA breast cancer. Patients in the highest category of body weight had 2.5 times the risk of dying from breast cancer than those in the lowest category of body weight. In addition, women with ER-negative breast cancer were approximately 2 times more likely to die of breast cancer than those with ER-positive breast cancer. Patients in the upper half of body weight upon diagnosis plus those having ER-negative cancer experienced a risk 5 times greater than those in the lower half of body weight upon diagnosis plus ER-positive cancer.

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The researchers concluded that body weight upon diagnosis, as well as the ER status of breast cancer, appears to be significantly associated with outcomes in early breast cancer. Specifically, patients with a higher body weight and those with ER-negative cancers have a significantly poorer prognosis at 5 years than those with a lower body weight and ER-positive status. Patients should speak with their physician about their ER status, as well as the risks and benefits of different treatment choices depending upon their prognosis.

Reference: Enger S, Greif J, Polikoff J, et al. Body weight correlates with mortality in early-stage breast cancer. Archives of Surgery. 2004; 2004;139:954-960.

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