Body mass index as a prognostic feature in operable breast cancer: The International Breast Cancer Study Group experience

Gilles Berclaz, S. Li, K. N. Price, A. S. Coates, M. Castiglione-Gertsch, C. M. Rudenstam, S. B. Holmberg, J. Lindtner, D. Eržen, J. Collins, R. Snyder, B. Thürlimann, M. F. Fey, C. Mendiola, I. Dudley Werner, E. Simoncini, D. Crivellari, R. D. Gelber, A. Goldhirsch

Research output: Contribution to journalArticlepeer-review


Background: Current information on the prognostic importance of body mass index (BMI) for patients with early breast cancer is based on a variety of equivocal reports. Few have data on BMI in relationship to systemic treatment. Patients and methods: Patients (6792) were randomized to International Breast Cancer Study Group trials from 1978 to 1993, studying chemotherapy and endocrine therapy. BMI was evaluated with eight other factors: menopausal status, nodal status, estrogen receptor status, progesterone receptor status, tumor size, vessel invasion, tumor grade and treatment. BMI was categorized as normal (≤24.9), intermediate (25.0-29.9) or obese (≥30.0). Results: Patients with normal BMI had significantly longer overall survival (OS) and disease-free survival (DFS) than patients with intermediate or obese BMI in pairwise comparisons adjusted for other factors. Subset analyses showed the same effect in pre- and perimenopausal patients and in those receiving chemotherapy alone. When assessed globally and adjusted for other factors, BMI significantly influenced OS (P = 0.03) but not DFS (P = 0.12). Conclusions: BMI is an independent prognostic factor for OS in patients with breast cancer, especially among pre-/perimenopausal patients treated with chemotherapy without endocrine therapy.

Original languageEnglish
Pages (from-to)875-884
Number of pages10
JournalAnnals of Oncology
Issue number6
Publication statusPublished - Jun 2004


  • Body mass index
  • Breast cancer
  • Obesity
  • Prognostic factor
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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