• 1
    Kulie T, Slattengren A, Redmer J, Counts H, Eglash A, Schrager S. Obesity and women's health: an evidence-based review. J Am Board Fam Med. 2011; 24: 75-85.
  • 2
    Friedenreich CM, Courneya KS, Bryant HE. Case-control study of anthropometric measures and breast cancer risk. Int J Cancer. 2002; 99: 445-452.
  • 3
    Lahmann PH, Hoffmann K, Allen N, et al. Body size and breast cancer risk: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC). Int J Cancer. 2004; 111: 762-771.
  • 4
    Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008; 371: 569-578.
  • 5
    van den Brandt PA, Spiegelman D, Yaun SS, et al. Pooled analysis of prospective cohort studies on height, weight, and breast cancer risk. Am J Epidemiol. 2000; 152: 514-527.
  • 6
    Reeves GK, Pirie K, Beral V, Green J, Spencer E, Bull D. Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ. 2007; 335: 1134.
  • 7
    Ahn J, Schatzkin A, Lacey JVJr, et al. Adiposity, adult weight change, and postmenopausal breast cancer risk. Arch Intern Med. 2007; 167: 2091-2102.
  • 8
    Eliassen AH, Colditz GA, Rosner B, Willett WC, Hankinson SE. Adult weight change and risk of postmenopausal breast cancer. JAMA. 2006; 296: 193-201.
  • 9
    Harvie M, Howell A, Vierkant RA, et al. Association of gain and loss of weight before and after menopause with risk of postmenopausal breast cancer in the Iowa women's health study. Cancer Epidemiol Biomarkers Prev. 2005; 14: 656-661.
  • 10
    Lahmann PH, Schulz M, Hoffmann K, et al. Long-term weight change and breast cancer risk: the European prospective investigation into cancer and nutrition (EPIC). Br J Cancer. 2005; 93: 582-589.
  • 11
    Manders P, Pijpe A, Hooning MJ, et al. Body weight and risk of breast cancer in BRCA1/2 mutation carriers. Breast Cancer Res Treat. 2011; 126: 193-202.
  • 12
    Yang XR, Chang-Claude J, Goode EL, et al. Associations of breast cancer risk factors with tumor subtypes: a pooled analysis from the Breast Cancer Association Consortium studies. J Natl Cancer Inst. 2011; 103: 250-263.
  • 13
    American Cancer Society. Cancer Facts and Figures. 2011. Available at: @epidemiologysurveilance/documents/document/acspc-029771.pdf. Accessed July 6, 2011.
  • 14
    Wang Y, Beydoun MA. The obesity epidemic in the United States—gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis. Epidemiol Rev. 2007; 29: 6-28.
  • 15
    Demark-Wahnefried W, Peterson B, McBride C, Lipkus I, Clipp E. Current health behaviors and readiness to pursue life-style changes among men and women diagnosed with early stage prostate and breast carcinomas. Cancer. 2000; 88: 674-684.
  • 16
    Demark-Wahnefried W, Winer EP, Rimer BK. Why women gain weight with adjuvant chemotherapy for breast cancer. J Clin Oncol. 1993; 11: 1418-1429.
  • 17
    Goodwin PJ, Ennis M, Pritchard KI, et al. Fasting insulin and outcome in early-stage breast cancer: results of a prospective cohort study. J Clin Oncol. 2002; 20: 42-51.
  • 18
    Goodwin PJ, Ennis M, Pritchard KI, et al. Adjuvant treatment and onset of menopause predict weight gain after breast cancer diagnosis. J Clin Oncol. 1999; 17: 120-129.
  • 19
    Vance V, Mourtzakis M, McCargar L, Hanning R. Weight gain in breast cancer survivors: prevalence, pattern and health consequences. Obes Rev. 2011; 12: 282-294.
  • 20
    Camoriano JK, Loprinzi CL, Ingle JN, Therneau TM, Krook JE, Veeder MH. Weight change in women treated with adjuvant therapy or observed following mastectomy for node-positive breast cancer. J Clin Oncol. 1990; 8: 1327-1334.
  • 21
    Harvie MN, Campbell IT, Baildam A, Howell A. Energy balance in early breast cancer patients receiving adjuvant chemotherapy. Breast Cancer Res Treat. 2004; 83: 201-210.
  • 22
    Ingram C, Brown JK. Patterns of weight and body composition change in premenopausal women with early stage breast cancer: has weight gain been overestimated? Cancer Nurs. 2004; 27: 483-490.
  • 23
    Irwin ML, McTiernan A, Baumgartner RN, et al. Changes in body fat and weight after a breast cancer diagnosis: influence of demographic, prognostic, and lifestyle factors. J Clin Oncol. 2005; 23: 774-782.
  • 24
    McInnes JA, Knobf MT. Weight gain and quality of life in women treated with adjuvant chemotherapy for early-stage breast cancer. Oncol Nurs Forum. 2001; 28: 675-684.
  • 25
    Makari-Judson G, Judson CH, Mertens WC. Longitudinal patterns of weight gain after breast cancer diagnosis: observations beyond the first year. Breast J. 2007; 13: 258-265.
  • 26
    Demark-Wahnefried W, Hars V, Conaway MR, et al. Reduced rates of metabolism and decreased physical activity in breast cancer patients receiving adjuvant chemotherapy. Am J Clin Nutr. 1997; 65: 1495-1501.
  • 27
    Aslani A, Smith RC, Allen BJ, Levi JA. Changes in body composition during adjuvant chemotherapy for breast cancer. Appl Radiat Isot. 1998; 49: 637-638.
  • 28
    Campbell KL, Lane K, Martin AD, Gelmon KA, McKenzie DC. Resting energy expenditure and body mass changes in women during adjuvant chemotherapy for breast cancer. Cancer Nurs. 2007; 30: 95-100.
  • 29
    Del RG, Zironi S, Valeriani L, et al. Weight gain in women with breast cancer treated with adjuvant cyclophosphomide, methotrexate and 5-fluorouracil. Analysis of resting energy expenditure and body composition. Breast Cancer Res Treat. 2002; 73: 267-273.
  • 30
    Demark-Wahnefried W, Peterson BL, Winer EP, et al. Changes in weight, body composition, and factors influencing energy balance among premenopausal breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol. 2001; 19: 2381-2389.
  • 31
    Francini G, Petrioli R, Montagnani A, et al. Exemestane after tamoxifen as adjuvant hormonal therapy in postmenopausal women with breast cancer: effects on body composition and lipids. Br J Cancer. 2006; 95: 153-158.
  • 32
    Freedman RJ, Aziz N, Albanes D, et al. Weight and body composition changes during and after adjuvant chemotherapy in women with breast cancer. J Clin Endocrinol Metab. 2004; 89: 2248-2253.
  • 33
    Kroenke CH, Chen WY, Rosner B, Holmes MD. Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol. 2005; 23: 1370-1378.
  • 34
    Kutynec CL, McCargar L, Barr SI, Hislop TG. Energy balance in women with breast cancer during adjuvant treatment. J Am Diet Assoc. 1999; 99: 1222-1227.
  • 35
    Gu K, Chen X, Zheng Y, et al. Weight change patterns among breast cancer survivors: results from the Shanghai breast cancer survival study. Cancer Causes Control. 2010; 21: 621-629.
  • 36
    Cheney CL, Mahloch J, Freeny P. Computerized tomography assessment of women with weight changes associated with adjuvant treatment for breast cancer. Am J Clin Nutr. 1997; 66: 141-146.
  • 37
    Demark-Wahnefried W, Kenyon AJ, Eberle P, Skye A, Kraus WE. Preventing sarcopenic obesity among breast cancer patients who receive adjuvant chemotherapy: results of a feasibility study. Clin Exerc Physiol. 2002; 4: 44-49.
  • 38
    Nissen MJ, Shapiro A, Swenson KK. Changes in weight and body composition in women receiving chemotherapy for breast cancer. Clin Breast Cancer. 2011; 11: 52-60.
  • 39
    Doyle C, Kushi LH, Byers T, et al. Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin. 2006; 56: 323-353.
  • 40
    Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009; 9: 88.
  • 41
    Batist G, Ramakrishnan G, Rao CS, et al. Reduced cardiotoxicity and preserved antitumor efficacy of liposome-encapsulated doxorubicin and cyclophosphamide compared with conventional doxorubicin and cyclophosphamide in a randomized, multicenter trial of metastatic breast cancer. J Clin Oncol. 2001; 19: 1444-1454.
  • 42
    Rock CL, Demark-Wahnefried W. Nutrition and survival after the diagnosis of breast cancer: a review of the evidence. J Clin Oncol. 2002; 20: 3302-3316.
  • 43
    Hanrahan EO, Gonzalez-Angulo AM, Giordano SH, et al. Overall survival and cause-specific mortality of patients with stage T1a,bN0M0 breast carcinoma. J Clin Oncol. 2007; 25: 4952-4960.
  • 44
    Protani M, Coory M, Martin JH. Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat. 2010; 123: 627-635.
  • 45
    Thivat E, Therondel S, Lapirot O, et al. Weight change during chemotherapy changes the prognosis in non metastatic breast cancer for the worse. BMC Cancer. 2010; 10: 648.
  • 46
    Nichols HB, Trentham-Dietz A, Egan KM, et al. Body mass index before and after breast cancer diagnosis: associations with all-cause, breast cancer, and cardiovascular disease mortality. Cancer Epidemiol Biomarkers Prev. 2009; 18: 1403-1409.
  • 47
    Caan BJ, Kwan ML, Hartzell G, et al. Pre-diagnosis body mass index, post-diagnosis weight change, and prognosis among women with early stage breast cancer. Cancer Causes Control. 2008; 19: 1319-1328.
  • 48
    Caan BJ, Emond JA, Natarajan L, et al. Post-diagnosis weight gain and breast cancer recurrence in women with early stage breast cancer. Breast Cancer Res Treat. 2006; 99: 47-57.
  • 49
    Chen X, Lu W, Zheng W, et al. Obesity and weight change in relation to breast cancer survival. Breast Cancer Res Treat. 2010; 122: 823-833.
  • 50
    Ballard-Barbash R, Hunsberger S, Alciati MH, et al. Physical activity, weight control, and breast cancer risk and survival: clinical trial rationale and design considerations. J Natl Cancer Inst. 2009; 101: 630-643.
  • 51
    Information and access to breast reconstructive surgery. Available at: Accessed July 6, 2011.
  • 52
    Schuster JM, Rechtine G, Norvell DC, Dettori JR. The influence of perioperative risk factors and therapeutic interventions on infection rates after spine surgery: a systematic review. Spine (Phila Pa 1976). 2010; 35( 9 suppl): S125-S137.
  • 53
    Anaya DA, Dellinger EP. The obese surgical patient: a susceptible host for infection. Surg Infect (Larchmt). 2006; 7: 473-480.
  • 54
    Poirier P, Alpert MA, Fleisher LA, et al. Cardiovascular evaluation and management of severely obese patients undergoing surgery: a science advisory from the American Heart Association. Circulation. 2009; 120: 86-95.
  • 55
    Chen CL, Shore AD, Johns R, Clark JM, Manahan M, Makary MA. The impact of obesity on breast surgery complications. Plast Reconstr Surg. 2011; 128: 395e-402e.
  • 56
    McCarthy CM, Mehrara BJ, Riedel E, et al. Predicting complications following expander/implant breast reconstruction: an outcomes analysis based on preoperative clinical risk. Plast Reconstr Surg. 2008; 121: 1886-1892.
  • 57
    Selber JC, Kurichi JE, Vega SJ, Sonnad SS, Serletti JM. Risk factors and complications in free TRAM flap breast reconstruction. Ann Plast Surg. 2006; 56: 492-497.
  • 58
    Paskett ED, Naughton MJ, McCoy TP, Case LD, Abbott JM. The epidemiology of arm and hand swelling in premenopausal breast cancer survivors. Cancer Epidemiol Biomarkers Prev. 2007; 16: 775-782.
  • 59
    Helyer LK, Varnic M, Le LW, Leong W, McCready D. Obesity is a risk factor for developing postoperative lymphedema in breast cancer patients. Breast J. 2010; 16: 48-54.
  • 60
    Kwan ML, Darbinian J, Schmitz KH, et al. Risk factors for lymphedema in a prospective breast cancer survivorship study: the Pathways Study. Arch Surg. 2010; 145: 1055-1063.
  • 61
    Meeske KA, Sullivan-Halley J, Smith AW, et al. Risk factors for arm lymphedema following breast cancer diagnosis in black women and white women. Breast Cancer Res Treat. 2009; 113: 383-391.
  • 62
    Ridner SH, Dietrich MS, Stewart BR, Armer JM. Body mass index and breast cancer treatment-related lymphedema. Support Care Cancer. 2011; 19: 853-857.
  • 63
    de Azambuja E, McCaskill-Stevens W, Francis P, et al. The effect of body mass index on overall and disease-free survival in node-positive breast cancer patients treated with docetaxel and doxorubicin-containing adjuvant chemotherapy: the experience of the BIG 02-98 trial. Breast Cancer Res Treat. 2010; 119: 145-153.
  • 64
    Francis WP, Abghari P, Du W, Rymal C, Suna M, Kosir MA. Improving surgical outcomes: standardizing the reporting of incidence and severity of acute lymphedema after sentinel lymph node biopsy and axillary lymph node dissection. Am J Surg. 2006; 192: 636-639.
  • 65
    Hayes SC, Janda M, Cornish B, Battistutta D, Newman B. Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function. J Clin Oncol. 2008; 26: 3536-3542.
  • 66
    Lucci A, McCall LM, Beitsch PD, et al. Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011. J Clin Oncol. 2007; 25: 3657-3663.
  • 67
    Shaw C, Mortimer P, Judd PA. A randomized controlled trial of weight reduction as a treatment for breast cancer-related lymphedema. Cancer. 2007; 110: 1868-1874.
  • 68
    Reinertsen KV, Cvancarova M, Loge JH, Edvardsen H, Wist E, Fossa SD. Predictors and course of chronic fatigue in long-term breast cancer survivors. J Cancer Surviv. 2010; 4: 405-414.
  • 69
    Gerber LH, Stout N, McGarvey C, et al. Factors predicting clinically significant fatigue in women following treatment for primary breast cancer. Support Care Cancer. 2011; 19: 1581-1591.
  • 70
    Taylor DL, Nichols JF, Pakiz B, Bardwell WA, Flatt SW, Rock CL. Relationships between cardiorespiratory fitness, physical activity, and psychosocial variables in overweight and obese breast cancer survivors. Int J Behav Med. 2010; 17: 264-270.
  • 71
    Andrykowski MA, Donovan KA, Laronga C, Jacobsen PB. Prevalence, predictors, and characteristics of off-treatment fatigue in breast cancer survivors. Cancer. 2010; 116: 5740-5748.
  • 72
    Blagojevic M, Jinks C, Jeffery A, Jordan KP. Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2010; 18: 24-33.
  • 73
    Mao JJ, Stricker C, Bruner D, et al. Patterns and risk factors associated with aromatase inhibitor-related arthralgia among breast cancer survivors. Cancer. 2009; 115: 3631-3639.
  • 74
    Crew KD, Greenlee H, Capodice J, et al. Prevalence of joint symptoms in postmenopausal women taking aromatase inhibitors for early-stage breast cancer. J Clin Oncol. 2007; 25: 3877-3883.
  • 75
    Sestak I, Cuzick J, Sapunar F, et al. Risk factors for joint symptoms in patients enrolled in the ATAC trial: a retrospective, exploratory analysis. Lancet Oncol. 2008; 9: 866-872.
  • 76
    Guthrie JR, Ebeling PR, Dennerstein L, Wark JD. Risk factors for osteoporosis: prevalence, change, and association with bone density. Medscape Womens Health. 2000; 5: E2.
  • 77
    De LC, Kanis JA, Oden A, et al. Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int. 2005; 16: 1330-1338.
  • 78
    Waltman NL, Ott CD, Twiss JJ, Gross GJ, Lindsey AM, Moore TE. Bone mineral density and bone turnover in postmenopausal women treated for breast cancer. Cancer Nurs. 2008; 31: 182-190.
  • 79
    Hadji P, Body JJ, Aapro MS, et al. Practical guidance for the management of aromatase inhibitor-associated bone loss. Ann Oncol. 2008; 19: 1407-1416.
  • 80
    Michaud LB. Managing cancer treatment-induced bone loss and osteoporosis in patients with breast or prostate cancer. Am J Health Syst Pharm. 2010; 67: S20-S30.
  • 81
    Winters-Stone KM, Dobek J, Nail L, et al. Strength training stops bone loss and builds muscle in postmenopausal breast cancer survivors: a randomized, controlled trial. Breast Cancer Res Treat. 2011; 127: 447-456.
  • 82
    Su HI, Sammel MD, Springer E, Freeman EW, DeMichele A, Mao JJ. Weight gain is associated with increased risk of hot flashes in breast cancer survivors on aromatase inhibitors. Breast Cancer Res Treat. 2010; 124: 205-211.
  • 83
    Daley A, Stokes-Lampard H, Macarthur C. Exercise for vasomotor menopausal symptoms. Cochrane Database Syst Rev. 2011;( 5): CD006108.
  • 84
    Umland EM. Treatment strategies for reducing the burden of menopause-associated vasomotor symptoms. J Manag Care Pharm. 2008; 14: 14-19.
  • 85
    Smith LA, Cornelius VR, Plummer CJ, et al. Cardiotoxicity of anthracycline agents for the treatment of cancer: systematic review and meta-analysis of randomised controlled trials. BMC Cancer. 2010; 10: 337.
  • 86
    World Cancer Research Fund American Institute of Cancer Research. Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective. 2007. Available at: Accessed July 6, 2011.
  • 87
    Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. 1998. Available at: Accessed July 6, 2011.
  • 88
    Saquib N, Natarajan L, Rock CL, et al. The impact of a long-term reduction in dietary energy density on body weight within a randomized diet trial. Nutr Cancer. 2008; 60: 31-38.
  • 89
    Demark-Wahnefried W, Case LD, Blackwell K, et al. Results of a diet/exercise feasibility trial to prevent adverse body composition change in breast cancer patients on adjuvant chemotherapy. Clin Breast Cancer. 2008; 8: 70-79.
  • 90
    Loprinzi CL, Athmann LM, Kardinal CG, et al. Randomized trial of dietician counseling to try to prevent weight gain associated with breast cancer adjuvant chemotherapy. Oncology. 1996; 53: 228-232.
  • 91
    Goodwin P, Esplen MJ, Butler K, et al. Multidisciplinary weight management in locoregional breast cancer: results of a phase II study. Breast Cancer Res Treat. 1998; 48: 53-64.
  • 92
    Mefferd K, Nichols JF, Pakiz B, Rock CL. A cognitive behavioral therapy intervention to promote weight loss improves body composition and blood lipid profiles among overweight breast cancer survivors. Breast Cancer Res Treat. 2007; 104: 145-152.
  • 93
    de Waard F, Ramlau R, Mulders Y, de Vries T, van Waveren S. A feasibility study on weight reduction in obese postmenopausal breast cancer patients. Eur J Cancer Prev. 1993; 2: 233-238.
  • 94
    Djuric Z, DiLaura NM, Jenkins I, et al. Combining weight-loss counseling with the Weight Watchers plan for obese breast cancer survivors. Obes Res. 2002; 10: 657-665.
  • 95
    Jen KL, Djuric Z, DiLaura NM, et al. Improvement of metabolism among obese breast cancer survivors in differing weight loss regimens. Obes Res. 2004; 12: 306-312.
  • 96
    Pakiz B, Flatt SW, Bardwell WA, Rock CL, Mills PJ. Effects of a weight loss intervention on body mass, fitness, and inflammatory biomarkers in overweight or obese breast cancer survivors. Int J Behav Med. 2011; 18: 333-341.
  • 97
    Djuric Z, Mirasolo J, Kimbrough L, et al. A pilot trial of spirituality counseling for weight loss maintenance in African American breast cancer survivors. J Natl Med Assoc. 2009; 101: 552-564.
  • 98
    Stolley MR, Sharp LK, Oh A, Schiffer L. A weight loss intervention for African American breast cancer survivors, 2006. Prev Chronic Dis. 2009; 6: A22.
  • 99
    Morey MC, Snyder DC, Sloane R, et al. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. JAMA. 2009; 301: 1883-1891.
  • 100
    Djuric Z, Ellsworth JS, Weldon AL, et al. A diet and exercise intervention during chemotherapy for breast cancer. Open Obes J. 2011; 3: 87-97.