{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T05:49:02Z","timestamp":1777009742357,"version":"3.51.4"},"reference-count":62,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100011641","name":"Office of the Vice President for Research and Economic Development, University of Iowa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011641","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30 CA086862"],"award-info":[{"award-number":["P30 CA086862"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Breast cancer patients with higher body mass index (BMI) experience worsened outcomes, though a knowledge gap remains regarding whether treatment differs by BMI. This study examined how BMI was associated with breast cancer treatment among Iowans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Iowa Cancer Registry data were linked with state driver's license data to calculate BMI. Among those with stage I\u2013III cancers, we assessed differences in breast cancer surgery (BCS), reconstruction, chemotherapy, hormone therapy, and radiation therapy between BMI categories using logistic regression models. We restricted analyses of reconstruction to individuals who received surgery, and hormone therapy to hormone receptor\u2010positive (HR+) patients. We used multinomial models to assess the type of BCS received.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nearly all of the 18,115 included patients received surgery (97%), 63% received chemotherapy, 79% of HR+ patients received hormone therapy, and 63% received radiation therapy. Patients with higher BMI had decreased odds for reconstruction (BMI 25.0\u201329.9\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      aOR\u2009=\u20090.81, 95% CI: 0.71, 0.93; BMI 30.0\u201334.9\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      aOR\u2009=\u20090.62, 95% CI: 0.51, 0.74; BMI 35.0+ kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      aOR\u2009=\u20090.44, 95% CI: 0.34, 0.57), and, among patients with HR+, increased odds of hormone therapy (BMI 25.0\u201329.9\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      aOR\u2009=\u20091.14, 95% CI: 1.03, 1.26; BMI 30.0\u201334.9\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      aOR\u2009=\u20091.15, 95% CI: 1.01, 1.30; BMI 35.0+ kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      aOR\u2009=\u20091.22, 95% CI: 1.04, 1.42). Patients with higher BMI were more likely to receive lumpectomy than unilateral\/bilateral mastectomy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These findings suggest breast cancer treatment differences exist for patients with higher BMI. Future research is warranted to understand mechanisms behind differences, both to ensure breast cancer patients with higher BMIs receive adequate and appropriate cancer care and to understand whether treatment differences contribute to observed survival differences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71831","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T13:05:52Z","timestamp":1776085552000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Population\u2010Based Associations of Body Mass Index and Treatments Received for Breast Cancer in a Rural, Midwestern State"],"prefix":"10.1002","volume":"15","author":[{"given":"Breanna L.","family":"Blaess","sequence":"first","affiliation":[{"name":"Department of Epidemiology University of Iowa College of Public Health  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda R.","family":"Kahl","sequence":"additional","affiliation":[{"name":"Iowa Cancer Registry  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid","family":"Lizarraga","sequence":"additional","affiliation":[{"name":"University of Iowa Health Care  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1043-8140","authenticated-orcid":false,"given":"Mary C.","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Division of Health Services Research University of Iowa College of Pharmacy  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5697-6323","authenticated-orcid":false,"given":"Kathleen M.","family":"Robinson","sequence":"additional","affiliation":[{"name":"University of Iowa Health Care  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary E.","family":"Charlton","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Iowa College of Public Health  Iowa City Iowa USA"},{"name":"Iowa Cancer Registry  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah H.","family":"Nash","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Iowa College of Public Health  Iowa City Iowa USA"},{"name":"Iowa Cancer Registry  Iowa City Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"National Cancer Institute: Surveillance Epidemiology and End Results Program Cancer Stat Facts: Female Breast Cancer 2024 https:\/\/seer.cancer.gov\/statfacts\/html\/breast.html."},{"key":"e_1_2_13_3_1","unstructured":"American Cancer Society \u201cCancer Statistics Center: Explore Cancer Statistics. 2024 Estimated Cancer Deaths 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