Body mass index (BMI), waist-to-hip ratio (WHR), and tumor characteristics affect disease-free survival. Larger breast size may increase breast cancer risk, but its influence on disease-free survival is unclear. The purpose of this study was to elucidate whether breast size independently influenced disease-free survival in breast cancer patients.
Body measurements were obtained preoperatively from 772 breast cancer patients in a population-based ongoing cohort from southern Sweden. The research nurse measured breast volumes with plastic cups used by plastic surgeons doing breast reductions. Clinical data were obtained from patient charts and pathology reports.
Patients with a BMIÂ =Â 25Â kg/m(2) had larger tumors (pÂ Â 0.85 had larger tumors (pÂ =Â 0.013), more advanced histological grade (pÂ =Â 0.0016), and more axillary nodal involvement (pÂ =Â 0.012). Patients with rightÂ +Â left breast volumeÂ =Â 850Â mL were more likely to have larger tumor sizes (pÂ =Â 0.018), more advanced histological grade (pÂ =Â 0.031), and more axillary nodal involvement (pÂ =Â 0.025). There were 62 breast cancer events during the 7-year follow-up. Breast volumeÂ =Â 850Â mL was associated with shorter disease-free survival (pÂ =Â 0.004) and distant metastasis-free survival (pÂ =Â 0.001) in patients with estrogen receptor (ER)-positive tumors independent of other anthropometric measurements and age. In patients with ER-positive tumors, breast size was an independent predictor of shorter disease-free (HR 3.64; 95Â % CI 1.42-9.35) and distant metastasis-free survival (HR 6.33; 95Â %CI 1.36-29.43), adjusted for tumor characteristics, BMI, age, and treatment.
A simple and cheap anthropometric measurement with standardized tools may help identify a subgroup of patients in need of tailored breast cancer therapy.
Abstract Background. Complementary and alternative medicine (CAM) use is common among breast cancer patients. Several CAM therapies may have negative side effects or interact with conventional therapies. We studied biologically based CAM use with and without vitamins/minerals in relation to patient and tumor characteristics as well as treatment in an ongoing prospective cohort of 855 primary breast cancer patients. Methods. Patients from two hospitals in southern Sweden were included. Pre-operative and follow-up questionnaires containing questions on food intake, lifestyle, and concomitant medications, including natural remedies, were completed up to five years postoperatively. Clinical information was obtained from clinical records and tumor characteristics from pathology reports. Results. CAM and/or vitamins/minerals were used by 34.2% pre-operatively and by 57.9% during at least one visit. Over 100 different preparations were reported. At least eight of the commonly used preparations may interact with conventional breast cancer therapies. CAM users more often had a BMI