Breast Cancer: Why things can get complicated for overweight women

Being obese or overweight can not only increase your chances of getting breast cancer, but also create complications in its diagnosis and treatment.

October is breast cancer awareness month and its motive is to spread awareness about the most common cancer in women. Around 14% of cancer in women is due to breast cancer and the percentage is higher in urban cities than in rural India.

The best way to nip the breast cancer in bud is treating it at an early stage, but excess weight can interfere with the self-examination too, says an expert. Also, obese patients have a higher risk of developing complications during chemotherapy or after reconstructive surgery.

“Obesity has emerged as an important risk factor for developing breast cancer in women after menopause. Obesity is also said to be associated with worse disease outcomes for women in all ages, hence it is important to understand the impact of obesity on breast cancer,” says Dr. Aparna Govil Bhasker, Bariatric and Laparoscopic Surgeon, Saifee, Apollo Spectra, Namaha and Currae Hospitals, Mumbai.

Dr Bhasker explains how obesity could have a negative impact on the diagnosis and treatment of breast cancer:

High fat levels could increase your estrogen levels

Fat is a metabolically active tissue. Women with obesity have higher fat levels which can lead to excess estrogen production which has been implicated as a possible mechanism for poorer outcomes in breast cancer.

Trouble with self-examination

Women with heavy breasts are less likely to feel smaller lumps in the breast during self-examination.

Delay in diagnosis

There is a higher level of fear of death, low self-esteem and embarrassment in women with obesity and many times this can prevent them from seeking care from the healthcare system and lead to a delay in diagnosis, says Dr Bhasker.

Negative perception of healthcare providers

Healthcare providers may sometimes reflect negative perceptions and preconceived biases against women with obesity and this may have an adverse effect on decision making.

Higher risk of complication after surgery

Patients with obesity have a higher risk of complications after anesthesia and surgery for cancer. Many a times they also have other co-morbidities like diabetes, high blood pressure, breathing issues, heart disease etc, thus putting them in the high-risk category. The operative times are also longer.

Complications in reconstructive surgery

Women with obesity are poorer candidates for reconstructive surgery after removal of breast cancer. They are two times more prone to develop complications after reconstructive surgery.

Could impact heart and lungs

Patients with large breasts may need higher dose of radiotherapy which may have an adverse impact on the heart and lungs.

Lymphoedema

Lymphoedema is a dreaded complication after breast cancer surgery and is seen to be more common in women with obesity as compared to normal women.

Problems with chemotherapy

Appropriate dosing of chemotherapy is challenging in patients with obesity. Underdosing may have an impact on the overall disease outcome and lead to poorer disease-free survival in these patients.

Lose weight to prevent breast cancer

Losing weight reduces your chances of getting breast cancer significantly.

“In a recent study that looked at 180,885 women over a period of ten years, it was observed that losing even a small amount of weight was associated with a significantly decreased risk of developing breast cancer. Women who lost 2 to 4.5 kg had a 13% lower risk than women with stable weight. Women who lost 9 kg or more had a 26% lower risk of developing breast cancer,” says Dr Bhasker.