Abstract A08: Weight, inflammation, cancer-related symptoms and health-related quality of life among breast cancer survivors
Authors: Imayama Ikuyo , McTiernan Anne , Alfano Catherine M. , Neuhouser Marian L. , George Stephanie M. , Smith Ashley Wilder , Baumgartner Richard N. , Baumgartner Kathy B. , Bernstein Leslie , Ballard-Barbash Rachel 
Published: January 2014

Abstract
Purpose: Body size, weight change, and inflammatory biomarkers are associated with survival in women with breast cancer. Associations between these factors and cancer-related symptoms and health-related quality of life (HRQOL) are not established.
Patients and methods: The Healthy, Eating, Activity, and Lifestyle Study is a cohort of stage 0-IIIA breast cancer survivors. Height, weight and the inflammatory biomarker C-reactive protein (CRP) were measured at approximately 30-months post-diagnosis. Cancer-related symptoms (arm and chest wall symptoms, vasomotor symptoms, urinary incontinence, vaginal symptoms, cognition/mood problems, sleep, sexual interest/function) and HRQOL (SF-36) were assessed at approximately 39-months post-diagnosis; weight was measured in a subset of women at 4-12 months post-diagnosis. Data on 664 participants were analyzed (n=484 for weight change analysis). We assessed associations between body mass index (BMI, &lt;25, 25-29.9, ≥30kg/m2), post-diagnosis weight change (lost ≥5%, weight change &lt;5%, gained ≥5%), and CRP (tertile) with cancer-related symptoms and HRQOL using analysis of covariance.
Results: Mean (SD) age and BMI at the 30-month assessment were 57.5 (9.9) years old and 28.0 (6.3) kg/m2, respectively. Sixty two percent of the participants were overweight or obese (BMI ≥25 kg/m2). Compared to survivors with BMI &lt;25 kg/m2, obese (BMI ≥30 kg/m2) survivors had 26.0% greater arm symptom scores (adjusted means 0.77 vs. 0.97), 32.0% worse urinary incontinence severity (1.00 vs. 1.32), 11.5% lower physical functioning (77.1 vs. 68.2), but 9.7% less trouble falling asleep (2.59 vs. 2.34) and 17.5% less severe vaginal symptoms (0.80 vs. 0.66, all p&lt;0.05). Overweight (25≥ BMI &lt;30kg/m2) survivors had 23.4% more severe arm symptoms (0.77 vs. 0.95), 30.0% worse urinary incontinence severity (1.00 vs. 1.30), and 5.8% lower physical functioning scores (77.1 vs. 72.6, all p&lt;0.05 vs. BMI &lt;25kg/m2). Compared with survivors with weight change of &lt;5%, participants who gained ≥5% of baseline weight had lower physical functioning (-6.6%), role-physical (-16.8%) and vitality scores (-8.9%); weight loss of ≥5% was associated with less severe arm (-27.0%) and chest wall symptom scores (-29.1%, all p&lt;0.05). Increasing CRP tertile was associated with more severe chest wall symptoms, more difficulty with bladder control, and decreased physical functioning, and role-physical (all Ptrend&lt;0.05). Survivors in the highest CRP tertile [mean(SD) 10.8(12.9)mg/L] had 17.0% greater chest wall symptom scores, 16.0% worse urinary incontinence severity, 17.0% lower physical functioning, and 24.7% lower role-physical scores (all p&lt;0.05 vs. lowest CRP tertile).
Conclusion: BMI ≥25 kg/m2, weight gain ≥5%, and higher levels of CRP were associated with greater cancer-related symptom scores and poorer HRQOL in breast cancer survivors.
Citation Format: Ikuyo Imayama, Anne McTiernan, Catherine M. Alfano, Marian L. Neuhouser, Stephanie M. George, Ashley Wilder Smith, Richard N. Baumgartner, Kathy B. Baumgartner, Leslie Bernstein, Rachel Ballard-Barbash. Weight, inflammation, cancer-related symptoms and health-related quality of life among breast cancer survivors. [abstract]. In: Proceedings of the Eleventh Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2012 Oct 16-19; Anaheim, CA. Philadelphia (PA): AACR; Cancer Prev Res 2012;5(11 Suppl):Abstract nr A08.