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Longitudinal assessment of the impact of higher body mass index on cancer-related fatigue in patients with breast cancer receiving chemotherapy

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Abstract

Purpose

To assess the impact of obesity on cancer-related fatigue (CRF) in patients with breast cancer, through a secondary analysis of a large, longitudinal, nationwide study of breast cancer patients beginning chemotherapy.

Methods

All patients (N = 565; aged 53 ± 10.6) with breast cancer completed the multidimensional fatigue symptom inventory and the symptom inventory to measure CRF symptoms at baseline, post-chemotherapy, and 6 months post-chemotherapy. Height and weight at baseline were used to categorize subjects based on body mass index (BMI): obese (≥ 30.0 kg/m2; n = 294), overweight (25.0–29.9 kg/m2; n = 146), and normal weight (18.5–24.9 kg/m2; n = 125). Multivariate regression models evaluated the relationship of obesity level to CRF over time, controlling for age, menopausal status, race, Karnofsky Performance Status, cancer stage, radiation, and exercise status.

Results

At baseline, the obese had significantly higher CRF symptoms than the normal weight subjects for both the Multidimensional fatigue symptom inventory (MFSI) total (obese = 11.2 vs normal weight = 6.3; p = 0.03) and Symptom Inventory (SI) (obese = 3.5 vs normal weight = 2.9; p = 0.03). Significantly higher SI fatigue scores persisted at post-chemotherapy for the obese (obese = 5.0 vs normal weight = 4.4; p = 0.02). At 6 months post-chemotherapy, the obese patients still had significantly higher SI fatigue scores (obese = 3.5 vs normal weight = 3.0; p = 0.05).

Conclusion

Obese patients suffered greater CRF from pre-chemotherapy through 6 months post-chemotherapy. Recommendations for weight loss or weight maintenance may impact CRF levels in obese breast cancer patients before and after chemotherapy.

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Abbreviations

CRF:

Cancer-related fatigue

BMI:

Body mass index

QOL:

Quality of life

SI:

Symptom inventory

MFSI-SF:

Multidimensional fatigue symptom inventory-short form

KPS:

Karnofsky Performance Status

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Acknowledgments

The authors would like to thank all study participants from NCORP sites involved in this research.

Funding

This study was funded by grants U10CA037420, UG1 CA189961, DP2 CA195765, R25 CA1026185, and K07CA221931 through the National Cancer Institute in the National Institute of Health.

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Authors and Affiliations

  1. Department of Surgery, University of Rochester Medical Center (URMC), 265 Crittenden Blvd, CU 420658, Rochester, NY, 14642, USA

    Julia E. Inglis, Michelle C. Janelsins, Eva Culakova, Karen M. Mustian, Po-Ju Lin, Ian R. Kleckner & Luke J. Peppone

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  1. Julia E. Inglis
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Correspondence to Julia E. Inglis.

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Informed consent was obtained from all individual participants included in the study.

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Furthermore, the authors declare that the protocol herein described complies with the University of Rochester Medical Center and that they obtained institutional review board approval and have been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Inglis, J.E., Janelsins, M.C., Culakova, E. et al. Longitudinal assessment of the impact of higher body mass index on cancer-related fatigue in patients with breast cancer receiving chemotherapy. Support Care Cancer 28, 1411–1418 (2020). https://doi.org/10.1007/s00520-019-04953-4

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