% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Bonet:274571,
      author       = {C. Bonet and M. Crous-Bou and K. K. Tsilidis and M. J.
                      Gunter and R. Kaaks$^*$ and M. B. Schulze and R. T.
                      Fortner$^*$ and C. S. Antoniussen and C. C. Dahm and L.
                      Mellemkjær and A. Tjønneland and P. Amiano and E. Ardanaz
                      and S. M. Colorado-Yohar and M. Rodriguez-Barranco and S.
                      Tin Tin and C. Agnoli and G. Masala and S. Panico and C.
                      Sacerdote and A. M. May and K. B. Borch and C. Rylander and
                      G. Skeie and S. Christakoudi and D. Aune and E. Weiderpass
                      and L. Dossus and E. Riboli and A. Agudo},
      title        = {{T}he association between body fatness and mortality among
                      breast cancer survivors: results from a prospective cohort
                      study.},
      journal      = {European journal of epidemiology},
      volume       = {38},
      number       = {5},
      issn         = {0393-2990},
      address      = {Dordrecht [u.a.]},
      publisher    = {Springer Science + Business Media B.V.},
      reportid     = {DKFZ-2023-00648},
      pages        = {545-557},
      year         = {2023},
      note         = {2023 May;38(5):545-557},
      abstract     = {Evidence 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.},
      keywords     = {Body fatness (Other) / Breast cancer survivors (Other) /
                      Breast cancer-specific mortality (Other) / Mortality (Other)
                      / Prospective study (Other) / Weight change (Other)},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:36988840},
      doi          = {10.1007/s10654-023-00979-5},
      url          = {https://inrepo02.dkfz.de/record/274571},
}