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Open AccessArticle

Lifestyle Intervention on Body Weight and Physical Activity in Patients with Breast Cancer Can Reduce the Risk of Death in Obese Women: The EMILI Study

1
Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, 41124 Modena, Italy
2
Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, 41124 Modena, Italy
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(7), 1709; https://doi.org/10.3390/cancers12071709
Received: 1 May 2020 / Revised: 20 June 2020 / Accepted: 22 June 2020 / Published: 27 June 2020
(This article belongs to the Special Issue How Does Obesity Cause Cancer?)
Background obesity and sedentary lifestyle have been shown to negatively affect survival in breast cancer (BC). The purpose of this study was to test the efficacy of a lifestyle intervention on body mass index (BMI) and physical activity (PA) levels among BC survivors in Modena, Italy, in order to show an outcome improvement in obese and overweight patients. Methods: This study is a single-arm experimental design, conducted between November 2009 and May 2016 on 430 women affected by BC. Weight, BMI, and PA were assessed at baseline, at 12 months, and at the end of the study. Survival curves were estimated among normal, overweight, and obese patients. Results: Mean BMI decreased from baseline to the end of the study was equal to 2.9% (p = 0.065) in overweight patients and 3.3% in obese patients (p = 0.048). Mean PA increase from baseline to the end of the study was equal to 125% (p < 0.001) in normal patients, 200% (p < 0.001) in overweight patients and 100% (p < 0.001) in obese patients. After 70 months of follow-up, the 5-year overall survival (OS) rate was 96%, 96%, and 93%, respectively in normal, obese, and overweight patients. Overweight patients had significantly worse OS than normal ones (HR = 3.69, 95%CI = 1.82–4.53 p = 0.027) whereas no statistically significant differences were seen between obese and normal patients (HR 2.45, 95%CI = 0.68–8.78, p = 0.169). Conclusions: A lifestyle intervention can lead to clinically meaningful weight loss and increase PA in patients with BC. These results could contribute to improving the OS in obese patients compared to overweight ones. View Full-Text
Keywords: obesity; BMI loss; breast cancer; diet; physical activity; overall survival obesity; BMI loss; breast cancer; diet; physical activity; overall survival
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Cortesi, L.; Sebastiani, F.; Iannone, A.; Marcheselli, L.; Venturelli, M.; Piombino, C.; Toss, A.; Federico, M. Lifestyle Intervention on Body Weight and Physical Activity in Patients with Breast Cancer Can Reduce the Risk of Death in Obese Women: The EMILI Study. Cancers 2020, 12, 1709.

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