Fig. 4

Relationship between changing slope of BMI over time (kg/m²/year) and three clinical outcomes: overall survival (a), breast cancer-specific survival (b), and disease-free survival (c). The curves were estimated from delayed entry Cox models of continuous BMI slopes fitted using restricted cubic spline, while the hazard ratios and 95% confidence intervals (CI) were estimated from Cox models that fit categorical BMI changing slopes with stable category as the reference category (BMI change less than 0.5 kg/m²/year)