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Weight gain is associated with increased risk of hot flashes in breast cancer survivors on aromatase inhibitors

  • Epidemiology
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Abstract

Hot flashes in breast cancer survivors (BCS) receiving adjuvant aromatase inhibitor (AI) therapy are common, but risk factors for these symptoms are ill-defined. This study tested if body size is associated with hot flashes in BCS on AI therapy. A cross-sectional study of postmenopausal BCS receiving adjuvant AI therapy was performed. The primary outcome was occurrence of patient-reported hot flashes. The primary exposures of interest were current body size and weight change since breast cancer diagnosis. Three hundred participants were enrolled at a mean age of 61 years (range 33–86) after an average AI exposure of 23 months (range 1 month–9 years). Fifty-nine percent reported hot flashes, 32% reported moderate to severe hot flashes, and 25% reported significant worsening of hot flashes since starting AI therapy. Sixty-one percent experienced weight maintenance (±10 lb), while 27% had weight gain (gained 10 lb or more), and 11% had weight loss (lost 10 lb or more). In multivariable analysis, weight gain was independently associated with hot flash occurrence (OR 2.1, 95% CI 1.1–4.4) and hot flash severity (OR 2.6, 95% CI 1.3–5.0) after adjusting for confounding. Current body size was not associated with hot flash occurrence, severity or change with AI therapy. In an outpatient BCS population on AI therapy, weight gain is a risk factor for hot flash occurrence. Women who gained at least 10 lb since breast cancer diagnosis were two times more likely to have hot flashes than women who maintained or lost weight. These results support the thermoregulatory model of hot flashes and argue against a protective effect of body fat in this population.

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Acknowledgments

This work has been supported by the American Cancer Society (MRSG 08-110-01-CCE [IS], ACS CCDA 08-107-01 [JM]), the National Institutes of Health (NICHD K23HD058799 [IS], NCCAM K23AT004112 [JM]) and the Pennsylvania Department of Aging [JM].

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Authors and Affiliations

  1. Department of Reproductive Medicine, Moores UCSD Cancer Center, University of California, San Diego, 3855 Health Sciences Drive, Dept. 0901, La Jolla, CA, 92093-0901, USA

    H. Irene Su

  2. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA, 19104, USA

    Mary D. Sammel, Angela DeMichele & Jun J. Mao

  3. Department of Obstetrics and Gynecology, University of Pennsylvania, 3701 Market Street, 8th Floor, Philadelphia, PA, 19104, USA

    Erin Springer & Ellen W. Freeman

  4. Department of Psychiatry, University of Pennsylvania, 3701 Market Street, 8th Floor, Philadelphia, PA, 19104, USA

    Ellen W. Freeman

  5. Abramson Cancer Center of the University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA

    Angela DeMichele

  6. Department of Family Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA

    Jun J. Mao

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  1. H. Irene Su
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  2. Mary D. Sammel
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  3. Erin Springer
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  4. Ellen W. Freeman
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  5. Angela DeMichele
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  6. Jun J. Mao
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Correspondence to H. Irene Su.

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Su, H.I., Sammel, M.D., Springer, E. et al. Weight gain is associated with increased risk of hot flashes in breast cancer survivors on aromatase inhibitors. Breast Cancer Res Treat 124, 205–211 (2010). https://doi.org/10.1007/s10549-010-0802-6

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  • DOI: https://doi.org/10.1007/s10549-010-0802-6

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