QIM20-125: OBESE: Oncologist Based Emphasis on Survivor Education-Physician Driven Weight Loss Counseling and Outcomes in TNBC

Obesity has an association with triple negative breast cancer (TNBC). Healthy diet, weight loss, and exercise have lead to favorable outcomes (overall survival [OS], progression free survival [PFS],quality of life [QOL])in TNBC. We aim to highlight the importance of lifestyle modifications in TNBC outcomes and predict that oncologist led weight counseling has a positive impact on BMI. This is a retrospective review of TNBC patients in a community practice. Patients in this study belonged to an oncologist who dedicated a significant amount of time on weight loss. A healthy diet and exercise was discussed at all clinical visits. Patients diagnosed with TNBC between 2010-2015 were selected. Data collected included race, age, stage, BMI at initial diagnosis and at every subsequent year, BRCA status, date of last visit, date of progression, and date of death. A total of 50 patients (all female) met the criteria. Table 1 shows the demographics. Ten patients (20%) were deceased; 5 died within the first year; and 13 were lost to follow-up. The remaining 30 were analyzed. Two patients had BRCA1 mutation,1 had BRCA2,10 were BRCA negative, and the rest unknown. Average BMI at diagnosis was 32 and at Year 5 was 30. At diagnosis, 57% were obese. Change in BMI was most remarkable during years 1 & 3 with a P value <0.05. It is important to note, 6 patients had an increase in BMI over 5 years (+1-2 points); all except 1/6 patients had a BMI <30 at diagnosis. The number one cause of death for all women, including breast cancer patients, is cardiovascular disease. With the increased effectiveness of treatment, oncologists are looking to increase QOL and OS. Recent studies have shown the benefit of exercise on PFS but there are no studies on oncologists led efforts on weight loss in TNBC. Ours is the first study to look at this. This study shows that active counseling by oncologists has a positive impact on patients and potentially overall outcomes. The limitation of this study is the size, as it was based on one physician’s practice. Also, given that this is a retrospective chart review other factors may affect BMI. On average, a minimum of 5 minutes was spent at each visit emphasizing diet/exercise. This highlights that despite being in a fast paced setting as oncologists take time to stress weight loss, it benefits patients. Oncologist based emphasis on survivor education regarding lifestyle choices should be implemented as a quality improvement tactic in the future by oncology practices.

Figure 1.
Figure 1.

Change in BMI in Years 1&3, BMI and PFS

Citation: Journal of the National Comprehensive Cancer Network J Natl Compr Canc Netw 18, 3.5; 10.6004/jnccn.2019.7435

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Corresponding Author: Marwah W Farooqui, DO
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