Basic Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Dec 24, 2019; 10(12): 382-390
Published online Dec 24, 2019. doi: 10.5306/wjco.v10.i12.382
Body mass index trends and quality of life from breast cancer diagnosis through seven years’ survivorship
Allison Brandt Anbari, Chelsea B Deroche, Jane M Armer
Allison Brandt Anbari, Chelsea B Deroche, Jane M Armer, Sinclair School of Nursing, University of Missouri, Columbia, MO 65211, United States
Author contributions: Anbari AB designed the research questions for secondary analysis, assisted with analysis of the data, and wrote the background and significance; Deroche CB ran the analysis, assisted with interpretation, and completed the graph/table design; Armer JM conducted the data collection during the seven-year study, assisted with analysis and interpretation of the data, and contributed to the implications and discussion of the work.
Supported by the National Institute for Nursing Research, National Institutes of Health, No. R01 NR05342 and R01 NR010293.
Institutional review board statement: This study was approved by the institutional review board of University of Missouri.
Conflict-of-interest statement: The authors have declared no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Allison Brandt Anbari, PhD, RN, Assistant Professor, Sinclair School of Nursing, University of Missouri, S312 School of Nursing, Columbia, MO 65211, United States. anbaria@missouri.edu
Telephone: +1-573-8820287 Fax: +1-573-8844544
Received: May 31, 2019
Peer-review started: June 4, 2019
First decision: August 2, 2019
Revised: September 9, 2019
Accepted: November 4, 2019
Article in press: November 4, 2019
Published online: December 24, 2019
Processing time: 202 Days and 10.8 Hours
ARTICLE HIGHLIGHTS
Research background

Weight gain is a potential negative outcome of breast-cancer treatment, occurring in 50%-to-96% of breast cancer patients, although the amount of weight gain is inconsistently reported in the literature. Weight gain can influence quality of life (QOL) during survivorship and even cancer reoccurrence.

Research motivation

We were motivated to do this analysis to examine body mass index (BMI) trends among breast cancer survivors and the trends’ relationship to QOL indicators over seven years. Identifying trends and their relationships to QOL provides insight into cancer survivorship care and care-planning.

Research objectives

We conducted this analysis to assess BMI trends among breast cancer survivors and to investigate whether those trends were related to quality of life. We identified small positive upticks in BMI over time amongst our participants. Future research should continue to examine weight changes in this population.

Research methods

Data for this analysis were collected during a study entitled the Breast Cancer and Lymphedema Project. Three-hundred seventy-eight women enrolled in the study at breast cancer diagnosis or just after surgery for breast cancer treatment. Participants were followed over seven years and the research team recorded their weight and 36-Item Short Form Survey (SF-36) scores at designated intervals during the study. BMI trends, change in BMI, and change in SF-36 subscales over seven years were calculated using a random-intercept repeated-measures regression. This method was selected because the data were longitudinal, and it allows for non-dependency between collection time points.

Research results

We found small upward trends in our participants’ BMI and those upward trends corresponded in a statistically significant way to several of the SF-36 subscales. Age and region were also significantly associated with BMI increase in the normal and obese BMI categories. Our results add to the existing body of work regarding BMI and breast cancer treatment. These results contribute to what is known and support efforts to continue research into breast cancer survivorship and the potentially chronic sequelae of treatment.

Research conclusions

We place an emphasis on the need for continued support and surveillance through the years of survivorship. Our results support continued research in breast cancer survivorship research. Application of weight management and health promotion for survivorship care-planning in the clinical setting has potential to enhance optimal self-care and QOL in living with a chronic condition such as breast cancer survivorship.

Research perspectives

We believe future research involving breast cancer survivors should go beyond weight loss and perhaps focus more on weight management, healthy lifestyle changes, and health promotion. Our results also bring awareness to the potential influences of rural and urban environments and how those environments may contribute to our understanding of the issues surrounding cancer survivorship.