Lifestyle Intervention on Body Weight and Physical Activity in Patients with Breast Cancer can reduce the Risk of Death in Obese Women: The EMILI Study.

Laura Cortesi,Federica Sebastiani,Luigi Marcheselli,Anna Iannone,Claudia Piombino,Angela Toss,Marta Venturelli,Massimo Federico

doi:10.3390/cancers12071709

Laura Cortesi, Federica Sebastiani + Show 6 more

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https://doi.org/10.3390/cancers12071709

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Abstract

Background obesity and sedentary lifestyle have been shown to negatively affect survival in breast cancer (BC). The purpose of this study was to test the efficacy of a lifestyle intervention on body mass index (BMI) and physical activity (PA) levels among BC survivors in Modena, Italy, in order to show an outcome improvement in obese and overweight patients. Methods: This study is a single-arm experimental design, conducted between November 2009 and May 2016 on 430 women affected by BC. Weight, BMI, and PA were assessed at baseline, at 12 months, and at the end of the study. Survival curves were estimated among normal, overweight, and obese patients. Results: Mean BMI decreased from baseline to the end of the study was equal to 2.9% (p = 0.065) in overweight patients and 3.3% in obese patients (p = 0.048). Mean PA increase from baseline to the end of the study was equal to 125% (p < 0.001) in normal patients, 200% (p < 0.001) in overweight patients and 100% (p < 0.001) in obese patients. After 70 months of follow-up, the 5-year overall survival (OS) rate was 96%, 96%, and 93%, respectively in normal, obese, and overweight patients. Overweight patients had significantly worse OS than normal ones (HR = 3.69, 95%CI = 1.82–4.53 p = 0.027) whereas no statistically significant differences were seen between obese and normal patients (HR 2.45, 95%CI = 0.68–8.78, p = 0.169). Conclusions: A lifestyle intervention can lead to clinically meaningful weight loss and increase PA in patients with BC. These results could contribute to improving the OS in obese patients compared to overweight ones.

Highlights

Breast cancer (BC) is the most common cancer in women worldwide
In a recent study, we evaluated the relationship between body mass index (BMI) and the risk of breast cancer (BC) as well as the outcome in 14,684 women recruited between ages 55 and 69 who resulted eligible to participate in the mammography screening program (MSP) in the province of Modena, Italy
On 31st March 2020, excluding seven patients who left the study during the first year, the median follow-up was equal to 70 months

Summary

Introduction

Breast cancer (BC) is the most common cancer in women worldwide. In Italy, between 2008 and2012, breast cancer reached an age-standardized incidence rate of 126.9 per 100,000 women in northernItaly, 111.2 per 100,000 women in central Italy, and 98.9 per 100,000 women in southern Italy, Sicily, and Sardinia [1]. Breast cancer (BC) is the most common cancer in women worldwide. 2012, breast cancer reached an age-standardized incidence rate of 126.9 per 100,000 women in northern. Since BC prognosis has significantly improved in developed countries due to earlier diagnosis and treatment improvements, BC survivors comprise the largest group of cancer survivors, with a prevalent number of cases equal to 799,196 in Italy. Cancers 2020, 12, 1709 subtypes, based on the expression of diagnostic biomarkers estrogen (ER) and progesterone (PR). Receptor-positive; HER2 positive; and triple-negative (lacking hormone receptors and HER2). A further stratification of the disease includes six intrinsic subtypes (normal, claudin-low, luminals A and B, HER2 enriched and basal) [3] and four triple-negative molecular subtypes (basal-like 1, basal-like 2, mesenchymal and luminal androgen receptor) [4]

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