Multilevel Factors Related to Changes in Body Adiposity in Black Survivors of Breast Cancer

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In a study reported in the Journal of Clinical Oncology, Qin et al found that gains in body weight and body fat were common in a prospective cohort of Black breast cancer survivors. The researchers also identified factors associated with these changes.

As stated by the investigators, “Unfavorable weight change after breast cancer diagnosis increases the risk of mortality, but individual and neighborhood risk factors affecting postdiagnosis weight and body fat changes are unclear among Black women, who have higher rates of obesity and mortality than any other racial/ethnic group.”

Study Details

Adiposity changes during the period of approximately 10 to 24 months after diagnosis of breast cancer were evaluated among 785 women diagnosed between 2012 and 2018 and enrolled in the Women’s Circle of Health Follow-Up Study, a population-based prospective cohort of Black breast cancer survivors in New Jersey. Weight and fat mass gain or loss was defined as a relative difference of ≥ 3%.

Overall, 86% of survivors had overweight or obesity at baseline. Over a median follow-up of 12 months, 28% had weight gain and 47% had body fat gain.

On multivariate analysis, significant risk factors for fat mass gain included receipt of chemotherapy (relative risk ratio [RRR] = 1.59, 95% confidence interval [CI] = 1.08–2.33) and residence in neighborhoods with a greater density of fast-food restaurants (RRR for highest- vs lowest-density tertile = 2.18, 95% CI = 1.38–3.46).

Factors significantly associated with weight gain included receipt of chemotherapy (RRR = 1.58, 95% CI = 1.12–2.24); disease stage I (RRR = 2.28, 95% CI = 1.37–3.80) or II (RRR = 2.42, 95% CI = 1.43–4.10) vs 0; residence in neighborhoods with middle vs lowest tertile socioeconomic status (RRR = 1.81, 95% CI = 1.17–2.81); and residence in neighborhoods with highest vs lowest tertile density of fast-food restaurants (RRR = 1.82, 95% CI = 1.16–2.85). Overall, 9% of survivors had intentional weight loss.

The investigators concluded, “Both individual and neighborhood factors were associated with adiposity change among Black breast cancer survivors. Residential environment characteristics may offer clinically meaningful information to identify cancer survivors at higher risk for unfavorable weight change and to address barriers to postdiagnosis weight management.”

Bo Qin, PhD, of Rutgers Cancer Institute of New Jersey, New Brunswick, is the corresponding author for the Journal of Clinical Oncology article.

Disclosure: The study was supported by grants from the National Institute on Minority Health and Health Disparities, National Cancer Institute, and others. For full disclosures of the study authors, visit

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.