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The Impact of BMI Class on Longitudinal Weight Change Following Breast Reconstruction
Eva Roy, BS; Jennifer A. Hall, BS; Xiao Zhu, MD; Francesco Egro, MBChB, MSc, MRCS; Carolyn De La Cruz, MD
University of Pittsburgh Medical Center
2021-01-31
Presenter: Eva Roy
Affidavit:
Eva Roy completed 50% of the project, helping with conception, data collection, analysis, and writing.
Director Name: Vu T Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Abstract
Background: Weight gain is a common occurrence in breast cancer patients increasing the risks of recurrence. Causative factors have not been well described. The aim of this study was to determine baseline BMI class impact on longitudinal weight and BMI change following breast reconstruction.
Methods: Single-center retrospective cohort study of 722 patients who underwent total mastectomy followed by breast reconstruction by one surgeon from 2008-2017. Patients were categorized by WHO BMI classification and then stratified by breast reconstruction type and vice versa.
Results: In the implant group, normal weight (1.3%/year, p<0.001) and overweight (0.5%/year, p=0.005) had a significant increase in BMI over time while obese patients had a significant decrease in BMI over time (-0.3%/year, p<0.001). In the autologous-based reconstruction group, normal weight (1.35%/year, p=0.414) had no significant change in weight over time, while overweight (0.19%/year, p=0.002) and obese (0.3%/year, p=0.007) had a significant increase in BMI over time. Overall, normal weight patients had a significant increase in BMI over time (0.8%/year, p=0.047), overweight patients had no significant change in BMI over time (0.3%/year, p=0.351), and obese patients had a significant decrease in BMI over time (0.4%/year, p=0.001).
Conclusion: Risk of weight gain after breast reconstruction may be correlated to baseline BMI. Normal BMI trended towards increased weight gain over time. Conversely, obese patient trended towards weight loss for implant based groups. This study can guide physicians in stratifying patients using baseline BMI so that patients can be appropriately counselled on the optimal reconstruction option.
