How Obesity Can Affect Your Breast Cancer Diagnosis and Treatment

If you are struggling with weight management and are concerned about your risk or diagnosis of breast cancer, and whether it might impact treatment, knowing how obesity can affect your diagnosis and treatment journey can help to manage your expectations and raise awareness about the challenges you may face. Being aware can arm you with the knowledge to ask deeper questions about your situation, treatment options and when to get a second opinion. However, do be assured that healthcare professionals will be there to assist and help you overcome these challenges along the way.

There are certain obesity-related factors that may potentially lead to delayed breast cancer diagnosis.

• Psychological barriers to breast cancer screening

Due to psychological reasons such as poor self-esteem, body image, embarrassment, a perceived lack of respect from healthcare providers, and wanting to avoid unwanted weight loss advice, overweight or obese individuals may avoid breast cancer screening and preventive medical care.

• Socioeconomic barriers

Generally, individuals of a lower socioeconomic status (SES) are more likely to be obese than those of a higher socioeconomic status. This could be due to less access to healthy food choices and the lack of time or resources to partake in physical activities. People of a lower SES may also have less access to medical care, which may lead to a delay in diagnosis.

• Presence of obesity-related comorbid conditions

Unfortunately, it is common for obese individuals to have multiple health conditions that are present at the same time—these are known as comorbidities. Obesity-related comorbidities can include conditions such as diabetes, cardiovascular disease, and others. The presence of such comorbidities may prevent healthcare providers from focusing on preventive services such as breast cancer screening.

• Inadequate resources and education in examining obese individuals

It has been reported by physicians in some studies that there are inadequate resources on how to examine and provide care for larger-sized individuals. This often leads to negative experiences for both the patients and healthcare providers, exacerbating already existing stigmas and obesity-related biasedness.

• Physical limitations of medical equipment

Some obese individuals face challenges due to the inadequate size of medical equipment. For example, some people who are obese may not be able to physically fit into an MRI machine, preventing them from getting an MRI scan.

Obese individuals diagnosed with breast cancer may face treatment challenges due to difficulties in surgery, radiation therapy, and medication dosing.

Obesity can pose several challenges during the treatment of breast cancer, affecting various aspects of care:

• Surgical complications

Some studies report obese individuals have a higher risk of wound complications and infections after surgery.

• Anesthesia risks

Obese individuals undergoing surgery may have a higher risk of anesthesia-related complications due to altered drug metabolism, respiratory issues, and other obesity-related comorbidities. These complications include difficulties in intubation and maintaining ventilatory support as compared to normal-weight individuals. An increase in obesity-related comorbid conditions also increases the risk of general anesthesia.

• Radiation therapy

Radiation therapy is a common treatment for breast cancer. However, obese individuals may inadvertently receive increased doses of radiation therapy to crucial organs such as the heart or lungs due to the positioning of the breasts when the patient lies on her back. Fortunately, minimizing the toxicities associated with radiation therapy is still possible using other methods, such as prone whole breast radiation. However, proper planning is needed to take such factors into consideration.

• Challenges in chemotherapy dosing

Chemotherapy drugs are sometimes administered according to the patient's weight. Determining the right dosage of cytotoxic agents for obese individuals presents difficulties, and inadequate dosing could affect the effectiveness of treatment for these individuals. To ensure both safety and effectiveness, adjustments in drug dosing may be necessary in obese patients, taking into account their higher body weight.

• Hormone therapy effectiveness

Hormone therapy is a standard treatment for hormone receptor-positive breast cancer. However, obesity can impact how the body processes hormones, potentially affecting the effectiveness of hormone therapy.

Despite these challenges, it is essential to emphasize that obese individuals with breast cancer can still achieve positive treatment outcomes. Oncologists and other healthcare providers are well aware of these considerations and will tailor treatment plans to address the specific needs and circumstances of each patient.

In the context of breast cancer treatment for obese individuals, a multidisciplinary approach is vital. Collaboration between surgeons, oncologists, radiation therapists, nurses, and other healthcare professionals can optimize treatment decisions and support patients throughout their cancer journey.

Moreover, ongoing research and advances in personalized medicine can help provide tailored treatment options that consider an individual's unique characteristics, including body weight and composition. This can lead to more effective and better-tolerated treatments for obese patients with breast cancer.

Ultimately, addressing obesity as a risk factor for breast cancer and promoting weight management can not only help reduce breast cancer risk but also improve treatment outcomes and overall health for individuals diagnosed with the disease. If you are obese and are concerned about your breast cancer risk, consider making changes in your eating habits and diet as a start to a healthier life. Eating less red or processed meat as well as less foods high in sugar or fat content is beneficial in moving away from obesity and it may reduce the risk of breast cancer. Instead, you may wish to add more fish, vegetables and fruit to your diet. Avoiding or lowering your alcohol consumption may also bring about health benefits and a lower breast cancer risk.

Additionally, individuals should undergo regular breast cancer screenings as recommended by their healthcare providers to detect any potential issues early on.