Maintaining a Stable Weight May Help Breast Cancer Survivors Avoid Hot Flashes

Bette J. Caan, DrPh

Women who have been previously treated for early-stage breast cancer are much less likely to complain of hot flashes if they remain within 10% of their prediagnosis weight, as compared with women who gain 10% or more of their prediagnosis weight, new data show.

Bette J. Caan, DrPh, senior research scientist at Kaiser Permanente Northern California in Oakland, and associates examined the effect of postdiagnosis weight change on hot flash status in 3088 breast cancer survivors. All of the women had been diagnosed with stage I, II, or III invasive breast cancer as defined by the American Joint Committee on Cancer classification (6th edition) and had completed treatment.

The study cohort was drawn from the Women’s Healthy Eating and Living (WHEL) study. The WHEL study, which ended in 2006, found that a diet that was high in vegetables, fruit, and fiber and low in fat did not decrease additional breast cancer events or mortality during a 7.3-year follow-up period among survivors of early-stage breast cancer.

At baseline, 36.1% of women reported moderate-to-severe hot flashes on the Women’s Health Initiative symptom inventory. Hot flashes were considered moderate if they interfered somewhat with usual activities, while hot flashes were deemed severe if patients were unable to perform routine activities.

At 2 years’ postdiagnosis, most women (69.2%) remained within 10% of their prediagnosis weight, while 4.8% lost at least 10%, and 26.0% gained at least 10% of their prediagnosis weight. Of the women who gained at least 10% of their prediagnosis weight, the average weight gain was 26.5 pounds. The average weight loss for women who lost at least 10% of their prediagnosis weight was 27.9 pounds.

Patients who gained at least 10% of their prediagnosis weight had a greater risk of reporting hot flashes than women who remained weight-stable in that same period (odds ratio [OR], 1.33; 95% CI, 1.11-1.60; P = .003). Women who lost at least 10% of their prediagnosis weight had a nonsignificant decreased risk of hot flashes (OR, 0.72; 95% CI, 0.47-1.08; P = .118).

The investigators also documented a significant linear trend for the effect of weight change on reports of hot flashes at baseline whether weight loss was examined categorically (P = .03) or continuously (P <.001).

Caan et al concluded that more research is needed to determine whether intentional weight loss in breast cancer survivors can prevent hot flashes. “For now, prevention of weight (and fat) gain after a breast cancer diagnosis, a modifiable behavior that may have other prognostic benefits, may be a viable intervention for the relief of hot flashes,” they wrote.

Caan BJ, Emond JA, Su HI, et al. Effect of postdiagnosis weight change on hot flash status among early-stage breast cancer survivors. J Clin Oncol. 2012;30(13): 1492-1497.