Many women struggle to maintain a healthy weight, trying diet after diet or various exercise machines at the gym.
That's because a high body mass index - which indicates a person's body fat - serves as a risk factor for multiple health problems, and studies show breast cancer is one such disease. And being overweight or obese, several local health officials said, is a problem in Carroll County.
"The important thing here is that we have known for years that one of the best measures to prevent breast cancer is exercise and weight loss," said Dr. Flavio Kruter, Carroll Regional Cancer Center director.
A recent study in the American Cancer Society's peer-reviewed journal Cancer found that despite chemotherapy and hormonal therapy, extra pounds increase the possibility of death and of the recurrence of the most common type of breast cancer.
This extra weight at the time of diagnosis is associated with a 50 percent higher risk of death and 30 percent higher risk of recurrence, Dr. Joseph Sparano, of Albert Einstein College of Medicine, stated in a press release. He worked on the study and is also the associate chairman of the Montefiore Medical Center's Department of Oncology.
This prospect is widely known throughout the medical field, as various study results - such as those from the National Cancer Institute - have popped up throughout the years, said Kruter, who is also the program director of Carroll Hospital Center's hematology and oncology division.
Yet, nobody knows exactly why, he said.
The study published in Cancer suggests that extra body fat can result in hormonal changes and inflammation, which could cause some cases of breast cancer to spread and recur. This finding is for the most common type of breast cancer, which accounts for two-thirds of the cases worldwide, according to the study.
On average, about 127 women in Carroll County are diagnosed with breast cancer annually, according to the National Cancer Institute's data compiled from 2005 to 2009. That is the seventh-highest incidence rate amongst counties in Maryland, the data shows.
About 55.2 percent of women in the county are overweight or obese, according to the 2010 Maryland Behavioral Risk Factor Surveillance System.
That's concerning, said Carroll County Health Department public health nutritionist Darlene Flaherty, because this excess fat can contribute to a slew of health problems.
Being obese or overweight doesn't necessarily cause breast cancer, it just increases the risk. But it's one that differs from genetic predispositions, Flaherty said.
"The thing about it is it's one risk factor that is under our control," Flaherty said. "There's a lot of other things we can't control. It is difficult, and it's a lifestyle control, but it is something that we think if you can get it under control it's easier to maintain good health."
At Carroll Regional Cancer Center, Kruter refers patients with nutritional questions to the hospital's dietary department. Some might see Jean Daniello, a Carroll Hospital Center outpatient clinical dietician.
During chemotherapy, it's best to focus on finding foods the woman can tolerate rather than worrying about weight loss, Daniello said.
"I don't want them losing large quantities of weight [during chemotherapy]," Daniello said. "The main goal is to help them get through the process and then talk about healthier eating once they recover."
Sometimes, a patient will come back to see Daniello once she's in remission. Then, it's time to focus on exercising and decreasing a woman's total fat intake if they have a high body mass index.
"There are a lot of similarities to a diet that I would give to somebody that's trying to improve their heart health," she said. "It's low in saturated fat, low in cholesterol, and ideally it should be a little bit reduced in calories if they're trying to lose weight."
And if they lose weight, Flaherty said, they'll be in better nutritional standing overall.
