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World J Clin Oncol. Aug 10, 2014; 5(3): 272-282
Published online Aug 10, 2014. doi: 10.5306/wjco.v5.i3.272
Weight gain following breast cancer diagnosis: Implication and proposed mechanisms
Grace Makari-Judson, Barry Braun, D Joseph Jerry, Wilson C Mertens
Grace Makari-Judson, Barry Braun, D Joseph Jerry, Wilson C Mertens, The Rays of Hope Center for Breast Cancer Research, Springfield, MA 01107, United States
Grace Makari-Judson, Wilson C Mertens, Baystate Regional Cancer Program, Baystate Medical Center/Tufts University School of Medicine, Springfield, MA 01199, United States
Barry Braun, Department of Kinesiology, University of Massachusetts, Amherst, MA 01003, United States
D Joseph Jerry, Department of Veterinary and Animal Sciences, University of Massachusetts, Amherst, MA 01003, United States
D Joseph Jerry, Pioneer Valley Life Sciences Institute, Springfield, MA 01107, United States
Author contributions: Makari-Judson G, Braun B, Jerry DJ and Mertens WC contributed to concept and design; Makari-Judson G, Braun B, Jerry DJ and Mertens WC contributed to manuscript writing; Makari-Judson G, Braun B, Jerry DJ and Mertens WC contributed to final approval of manuscript.
Correspondence to: Grace Makari-Judson, MD, Baystate Regional Cancer Program, Baystate Medical Center/Tufts University School of Medicine, 376 Birnie Avenue, Springfield, MA 01199, United States. grace.makari-judson@baystatehealth.org
Telephone: +1-413-7945433 Fax: +1-413-7943613
Received: January 11, 2014
Revised: March 27, 2014
Accepted: June 20, 2014
Published online: August 10, 2014
Processing time: 202 Days and 8.3 Hours
Abstract

Weight gain occurs in the majority of women following breast cancer treatment. An overview of studies describing weight gain amongst women treated with early to modern chemotherapy regimens is included. Populations at higher risk include women who are younger, closer to ideal body weight and who have been treated with chemotherapy. Weight gain ranges between 1 to 5 kg, and may be associated with change in body composition with gain in fat mass and loss in lean body mass. Women are unlikely to return to pre-diagnosis weight. Possible mechanisms including inactivity and metabolic changes are explored. Potential interventions are reviewed including exercise, dietary changes and pharmacologic agents. Although breast cancer prognosis does not appear to be significantly impacted, weight gain has negative consequences on quality of life and overall health. Future studies should explore change in body composition, metabolism and insulin resistance. Avoiding weight gain in breast cancer survivors following initial diagnosis and treatment should be encouraged.

Keywords: Breast cancer; Weight gain; Exercise; Survivorship; Insulin resistance

Core tip: Weight gain occurs in the majority of women following breast cancer treatment, especially those who are younger, closer to ideal body weight and who have been treated with chemotherapy. Although weight gain may be modest, changes are consistent with sarcopenic obesity. Women are unlikely to return to pre-diagnosis weight. Although the degree of weight gain does not appear to significantly alter prognosis, associated changes in metabolism and inactivity are of concern. Interventions should be promoted to avoid weight gain.