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September 18, 2020  
FIBROIDS1 NEWS: Feature Story

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  • Undertreatment of Breast Cancer in Obese Women

    Undertreatment of Breast Cancer in Obese Women May Be Detrimental


    September 19, 2005

    By Jennifer Jope for Fibroids1

    Although there have been opinions or “folklore,” as one doctor calls it, in the medical field stating chemotherapy should be reduced in obese patients with breast cancer, a recent study says a reduction in chemotherapy in obese women should be avoided and could actually be detrimental.
    Take Action
    According to the American Breast Cancer Foundation keeping in good health will reduce your risk for breast cancer.

    Eat less animal and dairy saturated fats.

    Exercise and maintain a healthy body weight.

    Drink alcohol in moderation and avoid hard liquor.

    Don't smoke.


    According to the International Breast Cancer Study Group, which conducted the study, doctors often lower chemotherapy doses when treating obese patients due to fear of overdosing.

    The study evaluated dose response according to body-mass index and estrogen receptor expression of a primary cancer tumor. The patients were pre-menopausal with node-positive breast cancer.

    The results of the study found that 39 percent of obese patients were significantly more likely to receive a lower dose of chemotherapy – less than 85 percent of the expected dose in the first course – compared to 16 percent of those with normal or intermediate body mass index.

    The researchers also noted that for both obese patients and the total population with estrogen receptor-negative tumors (cancer cells that do not need estrogen to grow), reducing the dose of chemotherapy created a significantly worse outcome for disease-free survival and overall survival.

    “Our findings suggest that for women with [estrogen receptor]-absent or [estrogen receptor]-low tumors, reduction in chemotherapy dose should be avoided,” the researchers said.

    In June, researchers from the University of Rochester conducted a similar study comparing chemotherapy doses administered to normal weight women and obese women. They found that the heavier the women, the more likely a reduced dosage was given. Twenty percent of obese women and 37 percent of severely obese women received lower chemotherapy doses compared to 9 percent of normal weight patients. This study also found that the women being undertreated typically had other medical problems, were older than age 60 and were treated earlier in the study period, according to www.breastcancer.org. However, the study points out that an obese woman was still more likely to receive a reduced dose even with no medical problems, being under age 60 and not treated earlier.

    Last year, Fox Chase Cancer Center in Philadelphia researched the connection between obesity and breast cancer. The researchers at the cancer center found that women who are obese when they are diagnosed with early-stage breast cancer are at a greater risk of dying than women of normal weight. While most early-stage breast cancer is commonly cured, Fox Chase Cancer Center found that obese women often developed metastatic disease and more often died. The influence of obesity on breast cancer outcome, the center said, has been uncertain. Nonetheless, national associations like the American Cancer Society suggest engaging in vigorous activity for at least four hours per week and reducing lifetime weight gain through regular exercise and a healthy diet.

    Dr. Rulla Tamimi, of Brigham & Women’s Hospital in Boston and an instructor in medicine at Harvard Medical School, said the most recent study from the International Breast Cancer Study Group didn’t take other factors into account when looking at the prognosis of a breast cancer patient. She suggested that diet and exercise may be factors to be considered when looking at survival rates. This study, she said, reviewed only body mass index, dosage and stage of the cancer. She suggested other studies should be considered before making a final judgment call.

    “It is still too early to tell,” Tamimi said.

    Last updated: 19-Sep-05

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