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000274571 041__ $$aEnglish
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000274571 1001_ $$aBonet, Catalina$$b0
000274571 245__ $$aThe association between body fatness and mortality among breast cancer survivors: results from a prospective cohort study.
000274571 260__ $$aDordrecht [u.a.]$$bSpringer Science + Business Media B.V.$$c2023
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000274571 500__ $$a2023 May;38(5):545-557
000274571 520__ $$aEvidence linking body fatness to breast cancer (BC) prognosis is limited. While it seems that excess adiposity is associated with poorer BC survival, there is uncertainty over whether weight changes reduce mortality. This study aimed to assess the association between body fatness and weight changes pre- and postdiagnosis and overall mortality and BC-specific mortality among BC survivors. Our study included 13,624 BC survivors from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, with a mean follow-up of 8.6 years after diagnosis. Anthropometric data were obtained at recruitment for all cases and at a second assessment during follow-up for a subsample. We measured general obesity using the body mass index (BMI), whereas waist circumference and A Body Shape Index were used as measures of abdominal obesity. The annual weight change was calculated for cases with two weight assessments. The association with overall mortality and BC-specific mortality were based on a multivariable Cox and Fine and Gray models, respectively. We performed Mendelian randomization (MR) analysis to investigate the potential causal association. Five-unit higher BMI prediagnosis was associated with a 10% (95% confidence interval: 5-15%) increase in overall mortality and 7% (0-15%) increase in dying from BC. Women with abdominal obesity demonstrated a 23% (11-37%) increase in overall mortality, independent of the association of BMI. Results related to weight change postdiagnosis suggested a U-shaped relationship with BC-specific mortality, with higher risk associated with losing weight or gaining > 2% of the weight annually. MR analyses were consistent with the identified associations. Our results support the detrimental association of excess body fatness on the survival of women with BC. Substantial weight changes postdiagnosis may be associated with poorer survival.
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000274571 650_7 $$2Other$$aBody fatness
000274571 650_7 $$2Other$$aBreast cancer survivors
000274571 650_7 $$2Other$$aBreast cancer-specific mortality
000274571 650_7 $$2Other$$aMortality
000274571 650_7 $$2Other$$aProspective study
000274571 650_7 $$2Other$$aWeight change
000274571 7001_ $$aCrous-Bou, Marta$$b1
000274571 7001_ $$aTsilidis, Konstantinos K$$b2
000274571 7001_ $$aGunter, Marc J$$b3
000274571 7001_ $$0P:(DE-He78)4b2dc91c9d1ac33a1c0e0777d0c1697a$$aKaaks, Rudolf$$b4$$udkfz
000274571 7001_ $$aSchulze, Matthias B$$b5
000274571 7001_ $$0P:(DE-He78)74a6af8347ec5cbd4b77e562e10ca1f2$$aFortner, Renée T$$b6$$udkfz
000274571 7001_ $$aAntoniussen, Christian S$$b7
000274571 7001_ $$aDahm, Christina C$$b8
000274571 7001_ $$aMellemkjær, Lene$$b9
000274571 7001_ $$aTjønneland, Anne$$b10
000274571 7001_ $$aAmiano, Pilar$$b11
000274571 7001_ $$aArdanaz, Eva$$b12
000274571 7001_ $$aColorado-Yohar, Sandra M$$b13
000274571 7001_ $$aRodriguez-Barranco, Miguel$$b14
000274571 7001_ $$aTin Tin, Sandar$$b15
000274571 7001_ $$aAgnoli, Claudia$$b16
000274571 7001_ $$aMasala, Giovanna$$b17
000274571 7001_ $$aPanico, Salvatore$$b18
000274571 7001_ $$aSacerdote, Carlotta$$b19
000274571 7001_ $$aMay, Anne M$$b20
000274571 7001_ $$aBorch, Kristin Benjaminsen$$b21
000274571 7001_ $$aRylander, Charlotta$$b22
000274571 7001_ $$aSkeie, Guri$$b23
000274571 7001_ $$aChristakoudi, Sofia$$b24
000274571 7001_ $$aAune, Dagfinn$$b25
000274571 7001_ $$aWeiderpass, Elisabete$$b26
000274571 7001_ $$aDossus, Laure$$b27
000274571 7001_ $$aRiboli, Elio$$b28
000274571 7001_ $$00000-0001-9900-5677$$aAgudo, Antonio$$b29
000274571 773__ $$0PERI:(DE-600)2004992-4$$a10.1007/s10654-023-00979-5$$n5$$p545-557$$tEuropean journal of epidemiology$$v38$$x0393-2990$$y2023
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