Body Weight Breast Cancer Risk And Menopausal Status
Studies show a link between BMI and breast cancer risk. However, BMI affects risk differently before and after menopause.
- Before menopause, women who are overweight or obese have a modestly decreased risk of breast cancer .
- After menopause, women who are overweight or obese have an increased risk of breast cancer .
Let’s Talk About Carbs
Assuming that youve discussed daily calorie needs with a professional, especially if weight loss is a goal, then the spotlight needs to be on grains. This food group needs special attention because processed carbohydrates have overwhelmed the American diet. Choose whole grains as the primary ingredient and make sure the ingredient list is short. Labels should say 100 percent whole wheat or the unprocessed grain should be the first and primary ingredient. Use portion control and decide how many portions to have daily.
Keep As Active As Possible
Fatigue is such a prevalent side effect of many cancer treatments that patients may find it difficult to get off the couch on some days, much less head outside for a walk. But staying physically active is important for weight management regardless of whether weight loss or gain is desired because regular movement helps maintain lean muscle mass.
We really want patients to hold on to their muscle mass because research has told us there are poorer prognoses for patients who lose their lean body mass at a very rapid rate, Ms. Stella says.
If youre looking for a class, take a look at the fitness and yoga classes on offer at MSKs Bendheim Integrative Medicine Center. Anyone can join.
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Measures Of Exposure And Outcome
Studies were evaluated for clinical relevance including magnitude and precision of outcome estimates. Outcomes were assessed as dichotomous . Effect measures included hazard ratio or relative risk reported with 95% confidence intervals. Both median survival and survival curves were considered in assessment of survival.
Put The Brakes On Supplement Use
Eating whole foods, and getting the nutrients your body needs from them, is the gold standard of nutrition. In fact, vitamins and other supplements which arent regulated by the US Food and Drug Administration or any agency can actually interfere with certain cancer treatments and medications.
It depends on what treatment youre on and what supplement youre taking, Ms. Gerdes says, but supplements are definitely something we want our patients to avoid most of the time because theyre taking so many medications, we dont know whats going to interact with them.
Be honest with your medical team about vitamins or herbal supplements youve been taking in any form, whether pills, shakes, or powders. To educate yourself on herbs and potential adverse reactions or interactions with treatment, visit MSKs About Herbs webpage.
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How Can Weight Gain From Fluid Retention Be Managed
Fluid retention or edema is swelling caused by the buildup of fluid in the body. If you have edema, you might feel like your clothes, rings, or shoes are too tight. People with edema can also have less flexibility in their hands, elbows, wrists, fingers, or legs. Swollen arms or legs, especially around the wrists or ankles, are also a sign of edema. The fluid buildup collects under the skin, so your skin might feel puffy or stiff. Pressing on your skin might leave small indentations.
Talk to your health care team about any of these symptoms so they can diagnose and treat edema. Some of the ways edema can be managed include:
Medication. Your doctor can prescribe a diuretic to remove excess water.
Lower the amount of salt in your diet.
Avoid standing for long periods.
Elevate your feet as often as possible.
Avoid crossing your legs, which restricts blood flow.
Weigh yourself at the same time every day to keep track of changes. This can help your health care team see any fluctuations in your weight that might be caused by edema. Bring this log with you to appointments for your health care team to evaluate.
Avoid tight clothing and footwear.
Ask your health care team if wearing support or compression socks may help.
Continue To Live Continue To Thrive
Theres a saying in medicine: Your condition does not define you. You are living with MBC, and that may mean some difficult, even brutal treatment and recovery periods. Following the recommendations in this slideshow can help you prioritize certain behaviors that require daily commitment. You should feel encouraged to embrace these habits at whatever pace feels comfortable. Value support and ask for it. Find a buddy or group who can share your journey to protect and improve your health.
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A Flattening Or Indentation Of The Breast
We all know that breasts can seemingly deflate with age, however if you notice that one of your breasts seems suddenly flat or you see an indentation in your breast tissue, you should make an appointment with your doctor. This type of change in your breast tissue “may indicate a tumor that cannot be seen or felt.”
If You Want To Try To Stop Gaining Weight
- Ask if you need to limit fluid if your ankles are swollen. If you have swelling in your abdomen , limiting fluids may not help and you should call your cancer care team.
- Choose healthier, lower calorie foods.
- Cut back on sugar-sweetened beverages.
- Limit your salt intake.
- Limit food portions especially with high-calorie foods.
- Read food labels to become more aware of portion sizes and calories. Be aware that low-fat or non-fat doesnt always mean low-calorie.
- Try to walk daily if you can and if its OK with your doctor. Talk with your cancer care team about referral to a physical therapist to help you safely increase activity levels.
- Ask about meeting with a dietitian.
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What Are The Risks Of Gaining Or Losing Pounds
Weight gain can raise your risk for getting high blood pressure, heart disease, and diabetes. Being overweight also puts you at risk for getting other types of cancers. Research has also shown that carrying around extra pounds can raise your risk of breast cancer recurring.
Weight loss can cause you to lose energy, and poor nutrition can make it harder for you to recover.
Lifestyle Changes For Mbc
Lifestyle changes involve diet, exercise, stress reduction, and sleep behaviors. If the goal is weight loss, tailor your plan to the other treatments you receive, since there will likely be appetite fluctuations and days where you feel energized and days or possibly fatigued. Any program you set up should factor in your age, the impact of drugs, radiation, and surgery. Consider working with a dietician and personal trainer experienced with handling MBC. Clear diet and exercise with your doctor.
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Changes In Bowel Movements
If you’re finding yourself suddenly constipated, be sure to take note of any other symptoms. A study back in the ’80s found an association between women who are constipated and an increased risk of breast cancer. Then, a study in 2008 found that women who had three or more bowel movements per day had a 46 percent decreased risk of developing breast cancer compared to women who had only one bowel movement per day.
While there hasn’t been much conclusive research since then to determine if constipation was a symptom of breast cancer or if something else in the body is related to both frequent constipation and breast cancer, if you’re noticing changes in how often you go to the bathroom, talk to your doctor.
Rule Out Other Causes
Nothing is scarier than a potential cancer diagnosis. The possible symptoms outlined here are especially terrifying given that they can all be symptoms of something else entirely . This process of determining whether your symptoms might be related to something else is called “differential diagnosis” and for breast cancer symptoms these can include a benign breast disease such as cysts, or eczema or another rash, among many other things.
While you should absolutely talk to your doctor if you’re having concerning symptoms, remember that as we get older our bodies naturally change and start doing different things. Perform your monthly breast self exams and keep track of them in a journal. Note any odd things you find, or other symptoms you’re having, and talk to your doctor if you notice something truly out of the ordinary.
The only real way to know whether what you’re experiencing is breast cancer is to see your doctor. While you are your own best advocate for getting the care you need, and for noticing changes in your body, you can’t diagnose breast cancer alone. Seek out professional expertise to determine what’s going on with your body and what your next steps may be.
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Body Weight And Breast Cancer Risk After Menopause
Women who are overweight or obese after menopause have a 20-60 percent higher breast cancer risk than those who are lean .
Hormone receptor status
Being overweight after menopause may be more strongly linked to an increased risk of estrogen receptor-positive breast cancers than the risk of estrogen receptor-negative cancers .
One large study found postmenopausal women who were overweight had a 10-30 percent greater risk of estrogen receptor-positive breast cancer compared to those who were lean . Those who were obese had a 20-80 percent greater risk of estrogen receptor-positive breast cancer .
This study also found, in general, women who were overweight or obese had an increased risk of estrogen receptor-negative breast cancers .
For a summary of research studies on body weight and breast cancer, visit the Breast Cancer Research Studies section.
If Youre Overweight Aim For Controlled Weight Loss
With two-thirds of the American population classified as overweight or obese, many newly diagnosed cancer patients who fall into those categories consider the prospect of treatment-related weight loss to be a silver lining. But its not your ticket to become the Biggest Loser, Ms. Stella and Ms. Gerdes say.
We want to make sure theyre not losing in an uncontrolled manner, Ms. Gerdes says, noting that rapid weight loss usually involves the loss of lean muscle mass, which is needed to maintain strength. Losing five to six pounds a week would be concerning.
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How Is Breast Cancer Treated
If the tests find cancer, you and your doctor will develop a treatment plan to eradicate the breast cancer, to reduce the chance of cancer returning in the breast, as well as to reduce the chance of the cancer traveling to a location outside of the breast. Treatment generally follows within a few weeks after the diagnosis.
The type of treatment recommended will depend on the size and location of the tumor in the breast, the results of lab tests done on the cancer cells, and the stage, or extent, of the disease. Your doctor will usually consider your age and general health as well as your feelings about the treatment options.
Breast cancer treatments are local or systemic. Local treatments are used to remove, destroy, or control the cancer cells in a specific area, such as the breast. Surgery and radiation treatment are local treatments. Systemic treatments are used to destroy or control cancer cells all over the body. Chemotherapy and hormone therapy are systemic treatments. A patient may have just one form of treatment or a combination, depending on her individual diagnosis.
Demographic Clinical And Lifestyle Characteristics
Information on demographic and clinical characteristics was obtained through medical record review. Data included age at diagnosis, time between diagnosis and clinic visit, type of surgery, history of adjuvant treatment , pathologic stage, histologic type of tumor, and hormone receptor status. Pathologic stage was calculated according to the American Joint Committee on Cancer .
Data on lifestyle characteristics were obtained from medical records, recorded by the attending physician at the clinic visit. Patients were asked about the type, duration, and frequency of usual physical activities for the month prior to the clinic visit. Intensity of each activity was assessed using the classification made by Ainsworth et al . Physical activity level was dichotomized as sufficient or insufficient according to the American College of Sports Medicine and American Heart Associations recommendations . Smoking status was categorized as no or yes . Drinking was defined as having drunk any alcohol more than three drinks per day or more than seven drinks per week according to the National Institute on Alcohol Abuse and Alcoholisms definition of heavy drinking .
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Unexplained Loss Is Often The First Sign Of Disease
Many people would consider a weight loss without dieting or exercise a pleasant surprise. But when the loss is sudden and unexplained, it could be the first warning sign of a serious health issue. This is especially true for those experiencing loss of more than five percent of body weight over the course of several months.
Weight loss is common among people with cancer and often the very first sign of the disease. On its own, it cannot diagnose cancer but will often suggest to doctors that tests be performed to, at the very least, exclude cancer as a cause.
What Are The Stages Of Breast Cancer
There are two different staging systems for breast cancer. One is called anatomic staging while the other is prognostic staging. The anatomic staging is defined by the areas of the body where the breast cancer is found and helps to define appropriate treatment. The prognostic staging helps medical professionals communicate how likely a patient is to be cured of the cancer assuming that all appropriate treatment is given.
The anatomic staging system is as follows:
Stage 0 breast disease is when the disease is localized to the milk ducts .
Stage I breast cancer is smaller than 2 cm across and hasn’t spread anywhere including no involvement in the lymph nodes.
Stage II breast cancer is one of the following:
- The tumor is less than 2 cm across but has spread to the underarm lymph nodes .
- The tumor is between 2 and 5 cm .
- The tumor is larger than 5 cm and has not spread to the lymph nodes under the arm .
Stage III breast cancer is also called “locally advanced breast cancer.” The tumor is any size with cancerous lymph nodes that adhere to one another or to surrounding tissue . Stage IIIB breast cancer is a tumor of any size that has spread to the skin, chest wall, or internal mammary lymph nodes .
Stage IV breast cancer is defined as a tumor, regardless of size, that has spread to areas away from the breast, such as bones, lungs, liver or brain.
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Does Cancer Treatment Cause Unwanted Weight Gain
Weight loss is a common side effect of some cancer treatments. But sometimes, the opposite happens and patients end up packing on the pounds instead of losing them.
So, what causes involuntary weight gain in some cancer patients? And what can patients and their physicians do to counteract this unexpected side effect?
We spoke with integrative medicine specialist Wenli Liu, M.D., to learn more. Heres what she had to say.
What are the most common causes of involuntary weight gain during cancer treatment?
There are actually several, but the biggest is probably steroids. These are prescribed to prevent inflammatory and anaphylactic reactions to chemotherapy, to reduce swelling in patients with brain tumors, and as a cancer-fighting agent used to treat cancers such as lymphoma/myeloma. The downside is that steroids also act as a major appetite stimulant, which can spur overeating.
Another common cause of involuntary weight gain is hormone-suppressing treatments, such as those received by patients with breast cancer or prostate cancer. Hormones have a tremendous effect on metabolism. Hormonal treatments for breast and prostate cancer can result in involuntary weight gain.
The third example is fear: the fear of losing weight. Sometimes, patients are so afraid that theyll become emaciated or unable to eat that they force themselves to do so while they still can, even when theyre not losing weight at all. Over time, that can lead to weight gain, too.
When To Connect With Your Care Team
Some weight gain may be a side effect of cancer treatment or chemotherapy. But there are times when youll want to inform your doctor about weight gain, including if youre:
- Putting on 5 pounds or more a week
- Experiencing new onset shortness of breath
- Feeling dizzy or confused
- Having new signs of fluid retention, such as new arm or leg swelling, jewelry that fits tighter than it used to, or less flexibility
- Finding the weight gain concerning for any other reason
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Weight Gain During Chemotherapy
Its not uncommon to experience weight changes when you have cancer or when you receive chemotherapy. Minor weight gain is not a cause for concern. However, significant weight gain is something to monitor because it puts you at higher risk for health problems such as diabetes and heart disease.
Weight gain is more common during chemotherapy treatment for certain kinds of cancer, including breast cancer, ovarian cancer and prostate cancer. This may result from the combination of chemotherapy along with hormone therapy and other medications typically used to treat these cancer types.
Weight gain during cancer treatment is associated with a lower chance of recovery.