Central obesity associated with poor outcomes for Black breast cancer survivors

Reviewed by Emily Henderson, B.Sc.Sep 24 2021

Findings from a recent population based cohort study show that Black women diagnosed with breast cancer who also have central obesity, which means excess body fat in the abdominal area, were more likely to die from breast cancer or any other cause than similar women who didn't have central obesity. Elisa V. Bandera, MD, PhD, chief of Cancer Epidemiology and Health Outcomes and co-leader of the Cancer Prevention and Control Program at Rutgers Cancer Institute of New Jersey, professor of medicine at Rutgers Robert Wood Johnson Medical School, and professor of epidemiology at Rutgers School of Public Health, is lead author of the study and shares more about the findings published online in JAMA Oncology (doi:10.1001/jamaoncol.2021.1499).

Why is this topic important to explore?

Obesity is very common, particularly among Black women, and has been shown to have a major impact on cancer risk and survival. The majority of previous studies based the assessment of obesity on body mass index (BMI), a measure calculated from weight and height. However, we know that BMI is not a perfect tool because it does not capture body fat distribution or body composition. For example, where fat accumulates in the body is important, and women who have higher waist circumference (i.e., central obesity), have higher cardiometabolic risk. However, few studies have evaluated associations of central adiposity and percent body fat with mortality after a breast cancer diagnosis among Black women.

Describe the work and tell us what the team discovered?

This is the first study focused on evaluating the impact of measures of body fat distribution and body composition on mortality outcomes specifically among Black breast cancer survivors, who have disproportionate prevalence of excess body fat and increased risk of more aggressive disease and breast cancer mortality. We found that central obesity and higher body fatness approximately 10 months after diagnosis was associated with significantly worse overall and breast cancer-specific survival among Black women.

What are the implications of these findings?

Our findings are important because they show that simple measures of body fat distribution such as waist and hip circumferences, easy to obtain with a tape measure, can identify breast cancer survivors at higher risk of mortality. This could guide health providers and breast cancer survivors to monitor risk and help to improve survival after a breast cancer diagnosis.