Post-diagnosis statin use and breast cancer recurrence in a prospective cohort study of early stage breast cancer survivors

PURPOSE: We examined the association between post-diagnosis statin use (3-hydroxy-3-methylglutaryl-coenzyme A [HMG-CoA] inhibitors) and risk of breast cancer recurrence. MATERIALS AND METHODS: The study included 1945 early stage breast cancer survivors participating in the Life After Cancer Epidemiology (LACE) Study. Women who were diagnosed from 1997 to 2000 and identified from the Kaiser Permanente Northern California (KPNC) Cancer Registry entered the cohort on average 2 years post-diagnosis. Information on statin use was obtained from the KPNC pharmacy database. A total of 210 breast cancer recurrences were reported and verified by medical record review. Cox proportional hazard models were used to estimate rate ratios (RR) and 95% confidence intervals (CI). RESULTS: The mean duration of statin use in the cohort among those who initiated use post-diagnosis was 1.96 years, and lipophilic statins were mainly used (97.8%). Starting statins after diagnosis was suggestive of a decreased risk of breast cancer recurrence (RR = 0.67; 95% CI: 0.39-1.13). Risk of recurrence decreased with increasing duration of statin use after diagnosis (p linear trend = 0.02). CONCLUSION: Our findings provide initial support for an inverse association between post-diagnosis, lipophilic statin use and risk of breast cancer recurrence.     

Mammography screening matters for young women with breast carcinoma: evidence of downstaging among 42-49-year-old women with a history of previous mammography screening

BACKGROUND: Breast carcinoma is the leading cause of death for women between the ages of 40 and 49 years, yet questions linger regarding the effectiveness of screening mammography in reducing mortality rates among women of this age. In the current study, the authors report on the association between cancer stage at diagnosis and a history of mammography screening in a clinical setting that has emphasized informed choice regarding mammography screening for women in this age group. METHODS: Previous mammographic screening for 247 breast cancer patients 42-49 years of age who were diagnosed at Kaiser Permanente Colorado during 1994-2000 was evaluated relative to cancer stage. Cancer stage was dichotomized into early (American Joint Committee on Cancer [AJCC] Stages 0 and I) and late (AJCC Stages II-IV) and previous screening was defined as at least one normal screening mammogram within 24 months before the breast carcinoma diagnosis. RESULTS: Women who were screened were less likely to be diagnosed at a late stage than were women who were not screened (40% vs. 52% late stage, respectively). Adjusted for age, year of diagnosis, and family history, screened women were 0.56 (95% confidence interval = 0.32-0.97) times as likely as unscreened women to be diagnosed at a late stage. CONCLUSIONS: Women 42-49 of years with breast carcinoma who undergo regular screening mammography have a more favorable cancer stage than do women with breast carcinoma who do not undergo regular screening. This downstaging of breast carcinoma is likely to translate into improved breast carcinoma survival resulting from screening mammography for women 40-49 years of age.     

Live birth outcomes after adolescent and young adult breast cancer

Reproductive outcomes are an important survivorship concern for women diagnosed with cancer as adolescents and young adults (AYAs). We examined the incidence of live birth and the prevalence of adverse birth outcomes according to tumor and treatment characteristics among AYAs with breast cancer. Women diagnosed with breast cancer at ages 15–39 during 2000–2013 were identified using the North Carolina Central Cancer Registry (n = 4,978). Cancer registry records were linked to state birth certificate files from 2000 to 2014 to identify births to women with and without a breast cancer history. The breast cancer cohort was followed until live birth, death, age 46, or December 31, 2014, whichever occurred first. For each birth to breast cancer survivors (n = 338), we sampled 20 births to women without a recorded cancer diagnosis, with frequency matching on maternal age and year of delivery. The cumulative incidence of live births after breast cancer was 8% at 10 years. Births were less common among women treated with chemotherapy. Overall, the prevalence of preterm birth, low birth weight, small‐for‐gestational age (SGA) and Cesarean delivery did not differ substantially between births to women with and without breast cancer. However, births to women with ER‐negative disease were more likely to be preterm (PR = 1.84; 95% CI: 1.11–3.06). In this population‐based study, <10% of AYA breast cancer survivors had a live birth within 10 years of their diagnosis. The increase in risk of preterm delivery among ER‐negative survivors in our cohort warrants further investigation in larger studies.     

Multivitamin use and breast cancer outcomes in women with early-stage breast cancer: the Life After Cancer Epidemiology study

Little is known about the relation of multivitamin use to breast cancer outcomes. 2,236 women diagnosed from 1997 to 2000 with early-stage breast cancer (Stage I ≥ 1 cm, II, or IIIA) were enrolled about 2 years post-diagnosis, primarily from the Kaiser Permanente Northern California Cancer Registry (83%). Multivitamin use pre-diagnosis and post-diagnosis was assessed via mailed questionnaire. Outcomes were ascertained yearly by self-report and verified by medical record review. Delayed-entry Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI), adjusting for sociodemographic, tumor, and lifestyle factors. Overall, 54 and 72% of the cohort reported using multivitamins pre- and post-diagnosis, respectively. A total of 380 recurrences, 212 breast cancer deaths, and 396 total deaths were confirmed. Compared to never use, multivitamin use after diagnosis was not associated with any outcome (recurrence HR = 0.92; 95% CI: 0.71, 1.20; total mortality HR = 0.92; 95% CI: 0.71, 1.19). Compared to never use, persistent use of multivitamins from pre- to post-diagnosis was associated with a non-significant decreased risk of recurrence (HR = 0.76; 95% CI: 0.54, 1.06) and total mortality (HR = 0.79; 95% CI: 0.56, 1.12). The protective associations were limited to women who had been treated by radiation only (P for trend = 0.048 and 0.083 for recurrence and total mortality, respectively) and both radiation and chemotherapy (P for trend = 0.015 and 0.095 for recurrence and total mortality, respectively). In stratified analyses, women who consistently used multivitamins before and after diagnosis and ate more fruits/vegetables (P for trend = 0.008) and were more physically active (P for trend = 0.034) had better overall survival. Multivitamin use along with practice of other health-promoting behaviors may be beneficial in improving breast cancer outcomes in select groups of survivors.     

The Impact of Rehabilitation Support Services on Health-related Quality of Life for Women with Breast Cancer

As the number of women surviving breast cancer increases, with implications for the health system, research into the physical and psychosocial sequelae of the cancer and its treatment is a priority. This research estimated self-reported health-related quality of life (HRQoL) associated with two rehabilitation interventions for breast cancer survivors, compared to a non-intervention group. Women were selected if they received an early home-based physiotherapy intervention (DAART, n = 36) or a group-based exercise and psychosocial intervention (STRETCH, n = 31). Questionnaires on HRQoL, using the Functional Assessment of Cancer Therapy – Breast Cancer plus Arm Morbidity module, were administered at pre-, post-intervention, 6- and 12-months post-diagnosis. Data on a non-intervention group (n = 208) were available 6- and 12-months post-diagnosis. Comparing pre/post-intervention measures, benefits were evident for functional well-being, including reductions in arm morbidity and upper-body disability for participants completing the DAART service at one-to-two months following diagnosis. In contrast, minimal changes were observed between pre/post-intervention measures for the STRETCH group at approximately 4-months post-diagnosis. Overall, mean HRQoL scores (adjusted for age, chemotherapy, hormone therapy, high blood pressure and occupation type) improved gradually across all groups from 6- to 12-months post-diagnosis, and no prominent differences were found. However, this obscured declining HRQoL scores for 20–40% of women at 12 months post-diagnosis, despite receiving supportive care services. Greater awareness and screening for adjustment problems among breast cancer survivors is required throughout the disease trajectory. Early physiotherapy after surgery has the potential for short-term functional, physical and overall HRQoL benefits.     

Change in physical activity during active treatment in a prospective study of breast cancer survivors

Physical activity offers many benefits to breast cancer survivors, yet research on physical activity during the immediate period following a breast cancer diagnosis is limited. In a prospective cohort study of 1,696 women diagnosed with invasive breast cancer in the Kaiser Permanente Northern California Medical Care Program from 2006–2009, we describe change in self-reported physical activity levels from around diagnosis to 6 months post-diagnosis and determine factors associated with change. Participants completed a comprehensive physical activity questionnaire at baseline (2 months post-diagnosis) and at follow-up (8 months post-diagnosis). Predictors of physical activity change were determined by multivariable linear regression. Reductions in all physical activity levels were observed (P < 0.0001); mean (SD) change (h/week) of moderate-vigorous physical activity (MVPA) was −1.28 (4.48) and sedentary behavior was −0.83 (6.95). In fully-adjusted models, overweight and obesity were associated with greater declines in MVPA of −1.58 h/week (SD = 0.92) and −1.29 h/week (SD = 0.93), respectively (P = 0.0079). Receipt of chemotherapy only was also associated with a greater decrease in MVPA (−2.12 h/week; SD = 0.92; P < 0.0001), specifically for recreational activities (−1.62 h/week; SD = 0.64; P = 0.0001). These data suggest challenges in maintaining physical activity levels during active treatment among women with breast cancer. Interventions to encourage physical activity in breast cancer survivors should be pursued.     

Arm/hand swelling and perceived functioning among breast cancer survivors 12 years post-diagnosis: CALGB 79804

Introduction  Lymphedema is an under-reported and debilitating consequence of axillary node dissection among breast cancer survivors. This study describes the characteristics of arm and hand swelling in relation to perceived physical and mental health functioning among breast cancer survivors 9–16 years post-diagnosis who previously participated in a clinical trial coordinated by the Cancer and Leukemia Group B (CALGB 8541). Methods  Eligible survivors of CALGB 8541 completed questionnaires assessing demographics, arm/hand swelling, perceived physical functioning, and mental health. Results  Two hundred forty-five women (94% white, mean age = 63, on average 12.4 years post-diagnosis) completed questionnaires (participation rate = 78%). Seventy-five women (31%) reported arm/hand swelling since their surgery. Of these women, 76% reported current swelling and half reported constant swelling, mainly in the upper arm. Swelling was reported as mild or moderate in 88% of the women. Women who reported severe swelling had significantly worse physical functioning and trended toward worse depressive symptoms and poorer mental health (lower mental SF-36 scores) as well. Activity-limiting swelling was also significantly associated with worse physical functioning. Although swelling interfered with wearing clothing (36%) and perceptions about general appearance (32%), only 37% of women sought treatment for swelling. Conclusions  Arm/hand swelling is a chronic problem for a subgroup of long-term survivors of breast cancer, negatively affecting physical functioning. Implications for cancer survivors  Educational efforts are needed as part of a comprehensive survivorship care plan to raise awareness about lymphedema so that survivors may identify this complication, seek treatment early, and potentially improve their physical functioning. A portion of these study results were presented at the 8th World Congress of Psycho-Oncology, Venice, Italy, October 21, 2006, and the 135th Annual Meeting of the American Public Health Association, Washington, D.C., November 5, 2007. Jill M. Oliveri, Catherine M. Alfano, Mira L. Katz, Marisa A. Bittoni, and Electra D. Paskett were supported by CA77658. Jeannette M. Day², James E. Herndon II, and Kathleen Donohue² were supported by CA33601.     

Cervical cancer screening research in the PROSPR I consortium: Rationale,methods and baseline findings from a US cohort

Little is known about the effect of evolving risk-based cervical cancer screening and management guidelines on United States (US) clinical practice and patient outcomes. We describe the National Cancer Institute's Population-based Research Optimizing Screening through Personalized Regimens (PROSPR I) consortium, methods and baseline findings from its cervical sites: Kaiser Permanente Washington, Kaiser Permanente Northern California, Kaiser Permanente Southern California, Parkland Health & Hospital System/University of Texas Southwestern (Parkland-UTSW) and New Mexico HPV Pap Registry housed by University of New Mexico (UNM-NMHPVPR). Across these diverse healthcare settings, we collected data on human papillomavirus (HPV) vaccinations, screening tests/results, diagnostic and treatment procedures/results and cancer diagnoses on nearly 4.7 million women aged 18–89 years from 2010 to 2014. We calculated baseline (2012 for UNM-NMHPVPR; 2010 for other sites) frequencies for sociodemographics, cervical cancer risk factors and key screening process measures for each site's cohort. Healthcare delivery settings, cervical cancer screening strategy, race/ethnicity and insurance status varied among sites. The proportion of women receiving a Pap test during the baseline year was similar across sites (26.1–36.1%). Most high-risk HPV tests were performed either reflexively or as cotests, and utilization pattern varied by site. Prevalence of colposcopy or biopsy was higher at Parkland-UTSW (3.6%) than other sites (1.3–1.4%). Incident cervical cancer was rare. HPV vaccination among age-eligible women not already immunized was modest across sites (0.1–7.2%). Cervical PROSPR I makes available high-quality, multilevel, longitudinal screening process data from a large and diverse cohort of women to evaluate and improve the effectiveness of US cervical cancer screening delivery.     

Factors associated with long-term adherence to annual surveillance mammography among breast cancer survivors

Clinical practice guidelines recommend yearly surveillance mammography for breast cancer survivors, yet many women do not receive this service. The objective of this study was to evaluate factors related to long-term surveillance mammography adherence among breast cancer survivors. We conducted a retrospective cohort study among women ≥18 years, diagnosed with incident stage I or II breast cancer between 1990 and 2008. We used medical record and administrative health plan data to ascertain covariates and receipt of surveillance mammography for up to 10 years after completing breast cancer treatment. Surveillance included post-diagnosis screening exams among asymptomatic women. We used multivariable repeated measures generalized estimating equation regression models to estimate odds ratios and robust 95 % confidence intervals to examine factors related to the annual receipt of surveillance mammography. The analysis included 3,965 women followed for a median of six surveillance years; 79 % received surveillance mammograms in year 1 but decreased to 63 % in year 10. In multivariable analyses, women, who were <40 years or 80+ years of age (compared to 50–59 years), current smokers, had greater comorbidity, were diagnosed more recently, had stage II cancer, or were treated with mastectomy or breast conserving surgery without radiation, were less likely than other women to receive surveillance mammography. Women with outpatient visits during the year to primary care providers, oncologists, or both were more likely to undergo surveillance. In this large cohort study of women diagnosed with early-stage invasive breast cancer, we found that important subgroups of women are at high risk for non-adherence to surveillance recommendations, even among younger breast cancer survivors. Efforts should be undertaken to actively engage breast cancer survivors in managing long-term surveillance care.     

Exploring the economic impact of breast cancers during the 18 months following diagnosis

The economic impact on individuals with breast cancer is not well understood. We sought to identify and describe the direct and indirect economic losses to breast cancer survivors in Australia. A longitudinal, population-based study of 287 women was used to explore economic outcomes (costs and lost income) for women with breast cancer 0-18 months post-diagnosis. Survey methods collected data on out-of-pocket costs, care-giving support, paid and unpaid work reductions, and perceptions from participants on these financial impacts. Bootstrapping was used to estimate 95% confidence intervals around means. Data were sub-grouped by cost type, age category and disease severity. Lost income, health service expenditures and lost unpaid work were the greatest sources of economic burden. Women with positive lymph nodes reported significantly higher costs than those with negative lymph nodes (US$6674 versus US$3533, p<0.001), and younger women (< or =50 years) with positive lymph nodes experienced costs 80% greater than older women (US$8880 versus US$4937, p<0.001). Economic costs related to breast cancer may continue to affect women 18 months post-diagnosis. Economic research adds an important dimension for understanding the impact of breast cancer, and findings may be used to help improve supportive care services for women and families confronted by this disease.     

Pre- to post-diagnosis weight change and associations with physical functional limitations in breast cancer survivors

Purpose

We investigated pre- to post-diagnosis weight change and functional limitations in a cohort of breast cancer survivors.

Methods

A cohort of 1,841 early-stage breast cancer survivors provided information on pre- and post-diagnosis weight and physical function on average 2 years post-diagnosis. The mean number of limitations for each BMI category and each weight change category were compared using the Wilcoxon test. Cross-sectional associations between weight change, from 1 year prior to diagnosis to 2 years post-diagnosis, and functional limitations were determined using logistic regression.

Results

Women with BMI?≥?30 kg/m² had significantly higher physical limitations compared to women with BMI?2 (2.06 vs 0.96 for moderate/severe limitations, 3.92 vs 3.27 for mild limitations, 1.31 vs 0.47 for lower body limitations, and 0.76 vs 0.49 for all other limitations; P?Conclusions Large weight gain was associated with a higher risk of physical functional limitations, but associations between weight loss and functional limitations may depend on initial BMI and comorbidity status.

Implications for Cancer Survivors

In this study we found that both weight loss and weight gain among breast cancer survivors were associated with a higher risk of physical functional limitations. Weight maintenance, therefore, may be an important factor in preventing and/or reducing the risk of functional decline in breast cancer survivors.     

Long-term risk of medical conditions associated with breast cancer treatment

Early and late effects of cancer treatment are of increasing concern with growing survivor populations, but relevant data are sparse. We sought to determine the prevalence and hazard ratio of such effects in breast cancer cases. Women with invasive breast cancer and women with no cancer history recruited for a cancer research cohort completed a mailed questionnaire at a median of 10 years post-diagnosis or matched reference year (for the women without cancer). Reported medical conditions including lymphedema, osteopenia, osteoporosis, and heart disease (congestive heart failure, myocardial infarction, coronary heart disease) were assessed in relation to breast cancer therapy and time since diagnosis using Cox regression. The proportion of women currently receiving treatment for these conditions was calculated. Study participants included 2,535 women with breast cancer and 2,428 women without cancer (response rates 66.0 % and 50.4 %, respectively) Women with breast cancer had an increased risk of lymphedema (Hazard ratio (HR) 8.6; 95 % confidence interval (CI) 6.3–11.6), osteopenia (HR 2.1; 95 % CI 1.8–2.4), and osteoporosis (HR 1.5; 95 % CI 1.2–1.9) but not heart disease, compared to women without cancer Hazard ratios varied by treatment and time since diagnosis. Overall, 49.3 % of breast cancer cases reported at least one medical condition, and at 10 or more years post-diagnosis, 37.7 % were currently receiving condition-related treatment. Responses from survivors a decade following cancer diagnosis demonstrate substantial treatment-related morbidity, and emphasize the need for continued medical surveillance and follow-up care into the second decade post-diagnosis.     

The Pathways Study: a prospective study of breast cancer survivorship within Kaiser Permanente Northern California

Objective  With 2.3 million breast cancer survivors in the US today, identification of modifiable factors associated with breast cancer recurrence and survival is increasingly important. Only recently new studies have been designed to examine the impact of lifestyle factors on prognosis, including Pathways, a prospective study of women with breast cancer in Kaiser Permanente Northern California (KPNC). Methods  Pathways aims to examine the effect on recurrence and survival of (1) lifestyle factors such as diet, physical activity, quality of life, and use of alternative therapies and (2) molecular factors such as genetic polymorphisms involved in metabolism of chemotherapeutic agents. Eligibility includes any woman diagnosed with invasive breast cancer within KPNC, no previous diagnosis of other invasive cancer, age 21 years or older, and ability to speak English, Spanish, Cantonese, or Mandarin. Newly diagnosed patients are identified daily from electronic pathology records and are enrolled within two months of diagnosis. An extensive baseline interview is conducted, blood and saliva samples are collected, and body measurements are taken. Women are followed for lifestyle updates, treatment, and outcomes by self-report and query of KPNC databases. Results  Recruitment began in 9 January, 2006, and as of 16 January, 2008, 1,539 women have been enrolled along with collection of 1,323 blood samples (86%) and 1,398 saliva samples (91%). Conclusions  The Pathways Study will become a rich resource to examine behavioral and molecular factors and breast cancer prognosis.     

Health-related quality of life before and after a breast cancer diagnosis

While many reports describe health-related quality of life (QOL) among breast cancer survivors, few compare QOL before and after diagnosis and whether changes in QOL substantially differ from changes experienced by all women during aging. QOL was examined in a cohort of female residents of Beaver Dam, Wisconsin, aged 43-86 years at the time of a 1988-1990 baseline examination (N = 2,762; 83% of eligible). Participants were re-contacted four times through 2002 to ascertain QOL using the 36-item Short Form Health Survey (SF-36). QOL data for 114 incident breast cancer cases identified by data linkage with the statewide cancer registry were compared with data for 2,527 women without breast cancer. Women with breast cancer averaged 4.5 (95% CI: 1.6, 7.3) points lower than control women on the SF-36 Physical Component Summary (PCS) scale, regardless of time since diagnosis (up to 13 years). Women with breast cancer also reported lower scores on the SF-36 Mental Component Summary (MCS) scale within two years after diagnosis, but not at more distant times. In longitudinal analyses, 26 women who completed the SF-36 before and after breast cancer diagnosis experienced larger declines than age-matched controls in seven of the eight SF-36 health domains (all but role-emotional) and reported relative declines of -7.0 (95% CI: -11.5, -2.6) and -2.9 (95% CI: -6.3, 0.6) on the PCS and MCS scales, respectively. These results suggest that breast cancer survivors experience relative declines in health-related QOL across a broad spectrum of domains, even many years after diagnosis.     

Comorbidities and breast cancer survival: a report from the Shanghai Breast Cancer Survival Study

We investigated the association of major comorbidities with breast cancer outcomes using the Shanghai Breast Cancer Survival Study, a population-based, prospective cohort study of Chinese women diagnosed with breast cancer. Analyses included 4,664 women diagnosed with stage I–III incident breast cancer aged 20–75 years (median age = 51) during 2002–2006. Women were interviewed at 3–11 months post-diagnosis (median = 6.4) and followed up by in-person interviews and linkage with the vital statistics registry. Multivariable hazard ratios (HRs) and (95 % confidence intervals (CIs)) for the associations of comorbidities with breast cancer outcomes were estimated using Cox regression models. After a median follow-up of 5.3 years (range: 0.64–8.9), 647 women died (516 from breast cancer) and 632 recurrence/metastases were documented. The main comorbidities reported included: hypertension (22.4 %), chronic gastritis (14.3 %), diabetes mellitus (6.2 %), chronic bronchitis/asthma (5.8 %), coronary heart disease (5.0 %), and stroke (2.2 %). Diabetes was associated with increased risk of total mortality (adjusted HR: 1.40 (1.06–1.85)) and non-breast cancer mortality (adjusted HR: 2.64 (1.63–4.27)), but not breast cancer-specific mortality (adjusted HR: 0.98 (0.68–1.41)), adjusting for socio-demographics, clinical characteristics, selected lifestyle factors, and other comorbidities. Women with a history of stroke had a non-significant increased risk of total mortality (adjusted HR: 1.42 (0.91–2.22)) and a significant increased risk of non-breast cancer mortality (adjusted HR: 2.52 (1.33–4.78)), but not breast cancer-specific mortality (adjusted HR: 0.78 (0.38–1.62)). Overall, none of the comorbidities investigated were significantly associated with recurrence. In this large prospective cohort of breast cancer survivors, diabetes was significantly associated with increased risk of total and non-breast cancer mortality, and history of stroke was associated with increased risk of non-breast cancer mortality.     

Physical activity and breast cancer risk in the College Alumni Health Study (United States)

Objectives: It is unclear whether physical activity is associated with a reduced risk of breast cancer. Some studies also suggest different effects between pre- and postmenopausal women, and lean and heavy women.Methods: We followed 1,566 University of Pennsylvania alumnae (mean age, 45.5 years), initially free of breast cancer, from 1962 until 1993. Physical activity at baseline was assessed by asking women about stairs climbed, blocks walked, and sports played. We estimated energy expenditure and categorized women into approximate thirds (< 500, 500-999, 1,000+ kcal/wk). We identified 109 breast cancer cases during 35,365 person-years from follow-up questionnaires or from death certificates.Results: After adjustment for age and body mass index (BMI) (kg/m2), the relative risk (RR) of breast cancer was 0.92 (95 percent confidence interval [CI]=0.58-1.45) among women expending 500-999 kcal/wk and 0.73 (CI=0.46-1.14) for those expending 1,000+ kcal/wk, compared with women expending < 500 kcal/wk (P trend=0.17). This association was modified by menopausal status, but not BMI. For postmenopausal women, corresponding RRs were 0.95 (CI=0.58-1.57) and 0.49 (CI=0.28-0.86), respectively (P trend=0.015). Increased physical activity in premenopausal women was not significantly associated with decreased risk of breast cancer.Conclusions: These data support an inverse association between physical activity and breast cancer among postmenopausal women. Cancer Causes and Control 1998, 9, 433–439     

Weight change patterns among breast cancer survivors: results from the Shanghai breast cancer survival study

In a population-based cohort study of 5,014 women with stage 0–III breast cancer, we evaluated weight change patterns from diagnosis to 6, 18, and 36 months post-diagnosis. Patients were recruited to the study approximately 6 months after cancer diagnosis between 2002 and 2006 and followed through 36 months post-diagnosis. The medians of weight change from diagnosis to 6, 18, and 36 months post-diagnosis were 1.0, 2.0, and 1.0 kg, respectively. Approximately, 26% of survivors gained ≥5% of their at-diagnosis body weight during the first 6 months after diagnosis, while 37% and 33% of women gained the same percentage of weight at 18 and 36 months post-diagnosis. More weight gain was observed among women who had a more advanced disease stage, were younger, had lower body mass index at diagnosis, were premenopausal, or received chemotherapy or radiotherapy during the first 6 months after cancer diagnosis. Multivariate analyses indicated that age at diagnosis, body size, comorbidity, and disease stage independently predicted weight gain from diagnosis to 36 months post-diagnosis. In summary, weight gain is common over the first 3 years after breast cancer diagnosis among Chinese women. More research is needed to investigate measures to prevent weight gain in breast cancer survivors.