Body mass index and persistent pain after breast cancer surgery: findings from the women's healthy eating and living study and a meta-analysis

Yuan-Yuan Ding, Peng Yao _, Lang Wu, Zhen-Kai Han, Tao Hong, Yong-Qiang Zhu and Hong-Xi Li

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Oncotarget. 2017; 8:43332-43343. https://doi.org/10.18632/oncotarget.17948

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Yuan-Yuan Ding1, Peng Yao1, Lang Wu2, Zhen-Kai Han1, Tao Hong1, Yong-Qiang Zhu1 and Hong-Xi Li1

1Department of Pain Management, Shengjing Hospital of China Medical University, Shenyang, China

2Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA

Correspondence to:

Peng Yao, email: [email protected]

Keywords: body mass index, persistent pain, breast cancer, prospective study, meta-analysis

Received: March 04, 2017     Accepted: April 11, 2017     Published: May 17, 2017


The purpose of this study is to evaluate the association between body mass index (BMI) and persistent pain after breast cancer surgery in a prospective study and synthesize available evidence through a meta-analysis. In the Women's Healthy Eating and Living (WHEL) Study, 3,088 women diagnosed of breast cancer were enrolled and assessed. After 4 years, a subgroup of 2,131 women was re-assessed for the pain information. Logistic regression models were used to assess the associations of baseline BMI and BMI change between baseline and 4 years of follow-up with general pain symptoms at 4 years of follow-up. We further synthesized all available evidence from observational studies by searching PubMed and Embase up to February 2017. In the WHEL study, baseline BMI was linearly associated with an increased risk of persistent pain at 4 years of follow-up (odds ratio (OR) (95% confidence interval (CI)): 1.07 (1.05-1.10)). After adjusting for baseline BMI, BMI change since baseline was associated with persistent pain (OR (95% CI) for every unit increase: 1.10 (1.04-1.16)). After searching the literature, additional eight studies were eligible to be included in the meta-analysis. After pooling estimates from all nine studies, there was a positive association with persistent pain development comparing obesity or overweight with normal weight. Available data suggested a linear relationship between BMI and persistent pain (OR (95% CI) for every one unit increment of BMI: 1.04 (1.02-1.07)). Overall, our analyses suggested that BMI might be positively associated with risk of persistent pain after breast cancer surgery.

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