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Being overweight increases risks for most common breast cancer

This article first appeared in the St. Louis Beacon, Sept. 17, 2012 - A local cancer specialist is urging women to pay even closer attention to body fat in light of a new study showing that those who are overweight or obese at the time of being diagnosed with breast cancer have a higher risk of dying prematurely from the disease.

Dr. Aislinn Vaughan, medical director of SSM Breast Care, says the study is important because it shows that extra body fat can cause hormonal changes that exacerbate the most common form of breast cancer. About 80 percent of breast cancers involve what’s called estrogen receptor or progesterone receptor positive tumors, commonly referred to as ER or PR positive.

“Those cancers are stimulated or fed by female hormones,” Vaughan says. ”Women who are overweight or obese have higher estrogen levels. This study shows that women who have cancers that are ER or PR positive (face) increased risk of the negative effects of overweight or obesity. We’ve known that (body fat) increases the risk of breast cancer coming back. But we weren’t certain that it was based on this estrogen receptor issue.”

The study’s leader was Dr. Joseph Sparano of Albert Einstein College of Medicine in Bronx, N.Y. In a statement, he said the study “found that obesity at diagnosis of breast cancer is associated with about a 30 percent higher risk of recurrence and a nearly 50 percent higher risk of death despite optimal treatment,” such as chemotherapy and hormonal therapy. His findings were reported in CANCER, an online journal of the American Cancer Society.

Vaughan says the findings will prompt doctors to emphasize the importance of women giving added attention to body mass index, or BMI,  to achieve or maintain a healthy weight. The BMI is calculated on the basis of a weight and height. The National Institutes of Health offers a BMI calculator on its website.

“The advice is for women to look at their weight and figure out where they are in the spectrum of overweight versus obese. Particularly if you are diagnosed with breast cancer, you want to be very conscious of not gaining any weight.”

An index of 20 to 25 suggests a normal weight, 25 to 30 signals overweight, and 30 to 40 means you’re obese, she says.

She’s concerned about the growing rate of obesity in Missouri and its potential impact on breast cancer. “Obesity is increasing everywhere across the country, so, yes, I think that states with higher obesity rates are likely to end up seeing higher breast cancer rates. But our obesity rates have gradually worsened. It’s not like it happened overnight, so I think the breast cancer rate will sort of gradually increase.”

She adds that a healthy weight also makes good health sense because obesity is a major cause of diabetes and contributes to blood clots, stroke and many other serious illnesses.

In addition to maintaining a healthy body weight, she urges women to get mammograms.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.