Evidence map›Paper›PMID 14519753›Full record

Trial reportJournal of the National Cancer Institute2003

Obesity, tamoxifen use, and outcomes in women with estrogen receptor-positive early-stage breast cancer.

James J Dignam, Kelly Wieand, Karen A Johnson, Bernard Fisher, Lei Xu, Eleftherios P Mamounas

Registry-linked trialOpen access · bronzeAbstract readClinical TrialMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the National Cancer Institute, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02037542 (A Study of Lifestyle Intervention in Overweight or Obese Women With Early Stage Breast Cancer), which is not on this map. Cited by 85 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
85citing papers in PubMed, 6 pooled it
4.6field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02037542 nacompletednot on this mapstarted 2013, after this paper: background citation

A Study of Lifestyle Intervention in Overweight or Obese Women With Early Stage Breast Cancer

TypeinterventionalSponsorBaptist Health South FloridaRan2013 to 2016Enrolled100ConditionsWeightArmsDiet and exercise
3 · Its place in the literature

Who cites it

85 citing papers in PubMed, 6 syntheses or guidelines pooled it, 224 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Body weight management in overweight and obese breast cancer survivors.The Cochrane database of systematic reviews · 2020
    Pooled it
  4. Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies.Annals of oncology : official journal of the European Society for Medical Oncology · 2014
    Pooled it
  5. Obesity in cancer survival.Annual review of nutrition · 2012
    Pooled it
  6. Pooled it
  7. Trial
  8. Body Mass Index at Diagnosis and Breast Cancer Survival Prognosis in Clinical Trial Populations from NRG Oncology/NSABP B-30, B-31, B-34, and B-38.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2016
    Trial
  9. Trial
  10. Trial
  11. Trial
  12. Obesity and risk of recurrence or death after adjuvant endocrine therapy with letrozole or tamoxifen in the breast international group 1-98 trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2012
    Trial
  13. Reduced-calorie dietary weight loss, exercise, and sex hormones in postmenopausal women: randomized controlled trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2012
    Trial
  14. Trial
  15. Trial
  16. Article
  17. Article
  18. Article
  19. The Microenvironment in DCIS and Its Role in Disease Progression.Advances in experimental medicine and biology · 2025
    Review
  20. Review

25 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

James J DignamDepartment of Health Studies and Cancer Research Center, The University of Chicago, Chicago, IL 60637, USA. jdignam@health.bsd.uchicago.edu
Kelly Wieand
Karen A Johnson
Bernard Fisher
Lei Xu
Eleftherios P Mamounas
University of Chicago · US

Funding

VIRAL ONCOLOGY CORE FACILITYP30CA014599 · NCI · UNIVERSITY OF CHICAGO · PI CHIEN-MIN KAO · 1985 to 2026
$122.1M
PRIMARY CANCER THERAPY GROUP--NSABP (HEADQUARTERS)U10CA012027 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI WOLMARK, NORMAN · 1985 to 2012
$117.2M
PRIMARY BREAST CANCER THERAPY--BIOSTATISTICS CENTERU10CA069651 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI COSTANTINO, JOSEPH P. · 1995 to 2012
$52.1M
Obesity and Outcomes After Early Stage Breast CancerR03CA099508 · NCI · UNIVERSITY OF CHICAGO · PI DIGNAM, JAMES J. · 2002 to 2003
$153k
NCI NIH HHS P30 CA014599NCI NIH HHS P30-CA-14599NCI NIH HHS R03 CA099508NCI NIH HHS R03-CA-99508NCI NIH HHS U10 CA012027NCI NIH HHS U10 CA069651NCI NIH HHS U10-CA-12027NCI NIH HHS U10-CA-69651
6 · The paper itself

Abstract

backgroundObesity is associated with both increased breast cancer risk and poorer prognosis after disease onset. However, little is known about the effect of obesity on treatment efficacy. We evaluated the association of obesity with outcomes and with tamoxifen efficacy in women with early-stage, hormone-responsive breast cancer participating in a multicenter cancer cooperative group clinical trial.

methodsThe cohort consisted of 3385 women enrolled in National Surgical Adjuvant Breast and Bowel Project (NSABP) protocol B-14, a randomized, placebo-controlled trial evaluating tamoxifen for lymph node-negative, estrogen receptor (ER)-positive breast cancer. Hazards of breast cancer recurrence, contralateral breast tumors, other new primary cancers, and several mortality endpoints were evaluated in relation to body mass index (BMI), using statistical modeling to adjust for other prognostic factors. Median follow-up time was 166 months. All statistical tests were two-sided.

resultsThe hazard of breast cancer recurrence was the same among obese (BMI > or =30.0 kg/m2) women as compared with underweight and normal-weight women (BMI <25.0; hazard ratio [HR] = 0.98, 95% confidence interval [CI] = 0.80 to 1.18). Contralateral breast cancer hazard was higher in obese women than in underweight/normal-weight women (HR = 1.58, 95% CI = 1.10 to 2.25), as was the risk of other primary cancers (HR = 1.62, 95% CI = 1.16 to 2.24). Compared with normal-weight women, obese women had greater all-cause mortality (HR = 1.31, 95% CI = 1.12 to 1.54) and greater risk of deaths due to causes unrelated to breast cancer (HR = 1.49, 95% CI = 1.15 to 1.92). Breast cancer mortality was not statistically significantly increased for obese women (HR = 1.20, 95% CI = 0.97 to 1.49). Tamoxifen reduced breast cancer recurrence and mortality, regardless of BMI.

conclusionsFor women with lymph node-negative, ER-positive breast cancer, obesity was not associated with a material increase in recurrence risk or a change in tamoxifen efficacy. However, because obesity was associated with increased risks of contralateral breast cancer, of other primary cancers, and of overall mortality, it may influence long-term outcomes for breast cancer survivors.

Indexed as

AdultAgedAntineoplastic Agents, HormonalBody CompositionBody Mass IndexBody WeightBreast NeoplasmsEstrogen Receptor ModulatorsFemaleHumansIncidenceMiddle AgedNeoplasms, Second PrimaryNeoplasm StagingObesityOdds RatioAntineoplastic Agents, HormonalEstrogen Receptor ModulatorsReceptors, EstrogenTamoxifen

Identifiers

PMID14519753
PMCPMC4676737
OpenAlexW2126589441

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.