Abstract 140: Weight changes in African American and White breast cancer patients undergoing chemotherapy.
Authors: Sheppard Vanessa B. , Dash Chiranjeev , Oppong Bridget , Hirpa Fikru , Dennis Elizabeth , Adams-Campbell Lucile L. 
Published: August 2014

PURPOSE: Weight gain after a breast cancer diagnosis is associated with cancer recurrence, worse cancer prognosis, higher comorbidity, and increased likelihood of inaccurate chemotherapy dose reductions during treatment. This health problem is especially relevant for African Americans, as they are more likely to be obese and to present comorbid conditions compared to their White counterparts. However, limited research describes patterns of weight change by race. The goal of this study was to assess and compare weight change after chemotherapy in Black and White breast cancer patients.

METHODS: Ninety-eight Black and White women diagnosed with invasive non-metastatic breast cancer were recruited from two metropolitan areas. Medical records were abstracted to obtain clinical (e.g. cancer stage) and treatment variables (e.g. chemotherapy regimen). Weight change was examined in women who underwent chemotherapy and it was conceptualized as the relative percent of weight change and change in body mass index (BMI - kg/m2) categorized as normal, overweight, and obese. Differences in baseline characteristics by race were evaluated using the chi-square or Fisher's exact test for categorical variables and t-test for continuous variables. We performed bivariate associations between study variables and relative weight change.

RESULTS: African-American women had higher BMI at baseline (at the start of therapy) as compared to Whites (p&lt;0.001). African American women were also more likely to have at least one comorbid condition compared to Whites. Most (62%) participants maintained their pre-treatment weight. About a third of the sample (29%) experienced a weight gain of more than 5% of their baseline weight after treatment for breast cancer.

Only 9% of women lost more than 5% of their pre-treatment weight. Normal weight women had the highest mean relative weight increase (3.57%; 95% CI: 1.05%, 6.10%) compared to those that were overweight or obese. Fifteen percent of women shifted to a higher BMI category; 26% of those that were normal became overweight; 17% of overweight patients became obese. Blacks were more likely than whites to shift to a higher BMI (p=0.006).

CONCLUSIONS: The American Cancer Society guidelines recommend cancer survivors to maintain a normal weight and avoid weight gain. We found that women in all BMI categories were likely to gain weigh with those in the normal category having the highest risk of weight gain. Results underscore the need for integrating weight control within cancer treatment plans to prevent weight gain and promote weight maintenance in patients undergoing chemotherapy. Interventions that address dietary habits and promote increased physical activity to maintain fat-free mass may be warranted. Future studies that help to elucidate behaviors and/or biological factors that contribute to weight gain overall and in blacks will be important.

Citation Format: Vanessa B. Sheppard, Chiranjeev Dash, Bridget Oppong, Fikru Hirpa, Elizabeth Dennis, Lucile L. Adams-Campbell. Weight changes in African American and White breast cancer patients undergoing chemotherapy. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 140. doi:10.1158/1538-7445.AM2013-140