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Relationships Between Weight Change and Physical and Psychological Distress in Early-Stage Breast Cancer Survivors

Vance, Vivienne, PhD, RN; Mourtzakis, Marina, PhD; Hanning, Rhona, PhD, RD

doi: 10.1097/NCC.0000000000000612

Background Weight gain and unfavorable changes in body composition are common in a growing population of breast cancer survivors, but the etiology of these changes is poorly understood.

Objective The aim of this study was to investigate relationships between weight change and symptoms of physical and psychological distress in the first 12 months of completing treatment in women who had completed treatment for breast cancer.

Methods Physical distress and psychological distress were assessed using the Rotterdam Symptom Checklist, the Distress Thermometer, and the Fatigue Symptom Inventory.

Results Weight change in 28 women since the completion of treatment (mean, 6.4 ± 4.4 months) ranged from −6.0 kg to +5.2 kg (mean, −0.4 ± 3.2), with 6 women gaining and 7 women losing an average of 3.5 ± 1.0 and 5.1 ± 0.8 kg, respectively. Rotterdam mean scores for physical (17.5 ± 9.0) and psychological distress (27.1 ± 16.9) were similar to previous findings for patients with early-stage breast cancer in active treatment and appear to be markedly higher than distress levels previously reported in cancer-free adults. Distress levels, based on the Distress Thermometer, were moderate to severe in 35% of women. Fatigue was common and associated with interference in daily living for some women. Fatigue duration was negatively correlated with weight change (P = −0.46, P < .05).

Conclusions Symptoms of physical and psychological distress persist for some women in the first year after completing treatment and may associate with weight change.

Implications These findings underscore a need for ongoing assessment and supportive care across the breast cancer trajectory and may guide dietary counseling aimed at promoting healthy body weight and overall health in early survivorship.

Author Affiliations: Department of Health Sciences, Wilfrid Laurier University, Waterloo (Dr Vance); and Department of Kinesiology (Dr Mourtzakis) and School of Public Health and Health Systems (Dr Hanning), University of Waterloo, Ontario, Canada.

This research was supported by a grant from the Canadian Foundation for Dietetic Research.

The authors have no conflicts of interest to disclose.

Correspondence: Vivienne Vance, PhD, RN, Department of Health Sciences, Wilfrid Laurier University, 75 University Ave, Waterloo, Ontario, Canada N2L 3C5 (

Accepted for publication February 13, 2018.

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