{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:10:10Z","timestamp":1787062210880,"version":"build-2736575974"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T00:00:00Z","timestamp":1700611200000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Obesity has been associated with an adverse prognosis and reduced efficacy of endocrine therapy in patients with hormone receptor-positive (HR+) breast cancer (BC). This study determines the prognostic and predictive effect of body mass index (BMI) on the disease-free survival (DFS) of postmenopausal HR+ BC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients were identified from the DATA study (NCT00301457), a randomized controlled trial evaluating the efficacy of 6 vs 3 years of anastrozole after 2 to 3 years of adjuvant tamoxifen in postmenopausal women with HR+ BC. Patients were classified as normal weight (BMI: 18.5\u201324.9\u2009kg\/m2), overweight (25.0\u201329.9\u2009kg\/m2), or obese (\u226530.0\u2009kg\/m2). The primary endpoint was DFS, evaluated from randomization (prognostic analyses) or 3 years after randomization onwards (predictive analyses; aDFS) using multivariable Cox regression analyses. P-values were 2-sided.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study included 678 normal weight, 712 overweight, and 391 obese patients. After a median follow-up of 13.1\u2009years, overweight and obesity were identified as negative prognostic factors for DFS (hazard ratio (HR) = 1.16; 95% confidence interval (CI) = 0.97 to 1.38 and HR\u2009=\u20091.26; 95% CI = 1.03 to 1.54, respectively). The adverse prognostic effect of BMI was observed in women aged younger than 60\u2009years, but not in women aged 60\u2009years or older (P-interaction\u2009=\u2009.009). The effect of extended anastrozole on aDFS was similar in normal weight (HR\u2009=\u20091.00; 95% CI = 0.74 to 1.35), overweight (HR\u2009=\u20090.74; 95% CI = 0.56 to 0.98), and obese patients (HR\u2009=\u20090.97; 95% CI = 0.69 to 1.36) (P-interaction\u2009=\u2009.24).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this study among 1781 HR+ BC patients, overweight and obesity were adverse prognostic factors for DFS. BMI did not impact the efficacy of extended anastrozole.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jncics\/pkad092","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T17:51:25Z","timestamp":1700589085000},"source":"Crossref","is-referenced-by-count":9,"title":["The prognostic and predictive effect of body mass index in hormone receptor-positive breast cancer"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8279-585X","authenticated-orcid":false,"given":"Senna W M","family":"Lammers","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University , Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra M E","family":"Geurts","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University , Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene E G","family":"van Hellemond","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Catharina Hospital , Eindhoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid C P","family":"Swinkels","sequence":"additional","affiliation":[{"name":"Clinical research department, Netherlands Comprehensive Cancer Organisation (IKNL) , Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolien H","family":"Smorenburg","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Netherlands Cancer Institute , Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice J C","family":"van der Sangen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Catharina Hospital , Eindhoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith R","family":"Kroep","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Leiden University Medical Centre , Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiltje","family":"de Graaf","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Medical Centre Leeuwarden , Leeuwarden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aafke H","family":"Honkoop","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Isala Clinics , Zwolle, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans L G","family":"Erdkamp","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Zuyderland Medical Centre Heerlen-Sittard-Geleen , location Sittard-Geleen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfred K","family":"de Roos","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gelderse Vallei Hospital , Ede, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5541-0347","authenticated-orcid":false,"given":"Sabine C","family":"Linn","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Netherlands Cancer Institute , Amsterdam, the Netherlands"},{"name":"Department of Pathology, University Medical Centre Utrecht , Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander L T","family":"Imholz","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Deventer Hospital , Deventer, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolein L","family":"Smidt","sequence":"additional","affiliation":[{"name":"Department of Surgery, Maastricht University Medical Centre, GROW, Maastricht University , Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingeborg J H","family":"Vriens","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University , Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3935-7440","authenticated-orcid":false,"given":"Vivianne C G","family":"Tjan-Heijnen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University , Maastricht, the 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