Body mass index as a prognostic feature in operable breast cancer: the International Breast Cancer Study Group experience

Berclaz, Gilles; Li, S.; Price, Karen N.; Coates, Alan S.; Castiglione‐Gertsch, Monica; Rudenstam, C. M.; Holmberg, Stig B.; Lindtner, J.; Erien, D.; Collins, John P.; Snyder, Ray; Thürlimann, Beat; Fey, Martin F.; Mendiola, C.; Werner, I. D.; Simoncini, Edda; Crivellari, Diana; Gelber, Richard D.; Goldhirsch, Aron

doi:10.1093/annonc/mdh222

Cited by 234 publications

(188 citation statements)

References 22 publications

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“…As indicated by our data, not taking HRT use into consideration could introduce spurious associations when analysing the influence of BMI on prognosis. However, two large and well-designed studies have found similar breast cancer survival regardless of BMI without taking HRT use into consideration (Dignam et al, 2003;Berclaz et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

“…Obesity has repeatedly been associated with breast tumours of larger size, lymph node positivity, and poor prognosis Dal Maso et al, 2008), although some studies have produced contrasting findings (Dignam et al, 2003;Berclaz et al, 2004). However, many studies lack information on the use of hormone replacement therapy (HRT) and mammography examinations before diagnosis.…”

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confidence: 99%

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Obesity and poor breast cancer prognosis: an illusion because of hormone replacement therapy?

2009

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High body mass index (BMI) and use of hormone replacement therapy (HRT) increase the risk of postmenopausal breast cancer. It has been shown that BMI modifies the effect of HRT, as its influence is most pronounced in lean women. We investigated the influence of BMI and HRT on prognosis in 2640 postmenopausal women diagnosed with breast cancer in Sweden in 1993 -1995, taking into account HRT and mammography before diagnosis. Logistic and Cox regression were used. In non-users of HRT, obese women (BMI 430) compared with normal weight women (BMI o25) had a similar prognosis (hazard ratio (HR) 1.1, 95% confidence interval (CI) 0.8 -1.6), despite larger tumours found in obese women. Obese HRT users had less favourable tumour characteristics and poorer prognosis compared with normal weight women (HR 3.7, 95% CI 1.9 -7.2). The influence of BMI on breast cancer prognosis was similar whether diagnosed by mammographic screening or not. We found a similar prognosis of postmenopausal breast cancer-specific death regardless of BMI in non-users of HRT, but among HRT users obesity was associated with a poorer breast cancer prognosis.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Obesity and poor breast cancer prognosis: an illusion because of hormone replacement therapy?

2009

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“…Apart from the general increased breast cancer risk in obese women, obese breast cancer patients appear to have a worse prognosis relating to lymph node metastasis, tumor size, and death when compared with non-obese breast cancer patients [3,48,49]. Concerning A-FABP and tumor characteristics of breast cancer, to date, no data are available.…”

Section: Adipocytokines and Tnmmentioning

confidence: 99%

Adipocyte fatty acid-binding protein as a novel prognostic factor in obese breast cancer patients

Hancke

Grubeck

Hauser

et al. 2009

Breast Cancer Res Treat

104

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Several adipocytokines, such as leptin or adiponectin, are associated with obesity and the risk for breast cancer. Adiopcyte fatty acid binding-protein (A-FABP) is another protein found in adipose tissue; therefore, we investigated the association of A-FABP with the occurrence and prognosis of breast cancer. In our study, 200 women attending the University of Ulm for breast surgery between the years 2005 and 2007 were included; 159 had histologically confirmed breast cancer; 41 had histologically confirmed benign lesions. Serum levels of A-FABP, leptin, and adiponectin were measured, and their relationship to body-mass-index (BMI), breast cancer, and tumor characteristics were analyzed; logistic regression model was adjusted to age, BMI, menopausal status, use of Hormone Replacement Therapy (HRT), and family history of breast cancer. Serum A-FABP levels were found to be significantly higher in obese (BMI C 25) than in non-obese women (BMI B 24.9), 41.16 ng/ml and 24.95 ng/ml, respectively (P \ 0.0001). Independent of obesity, the serum A-FABP levels were significantly higher in breast cancer patients (34.65 ng/ml) than in healthy controls (24.47 ng/ml), P \ 0.0001; the odds ratio (1.038, P \ 0.05, 95% confidence interval 1.001-1.72) showed a significant association of A-FABP with breast cancer risk. Serum leptin levels showed a strong correlation with BMI (r s = 0.78) and were significantly higher in breast cancer patients (20.87 ng/ml) than in controls (14.90 ng/ml), P \ 0.05. In contrast, adiponectin showed no significant association with breast cancer. Concerning tumor characteristics, A-FABP was positively connected with tumor size (T C 2 cm, P \ 0.05) and nodal-status (P \ 0.05). Our study reveals that high A-FABP serum levels are associated with obesity, breast cancer risk, and adverse tumor characteristics.

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“…Several studies (Dignam et al, 2003;Berclaz et al, 2004;Loi et al, 2005) reported a higher risk of death in patients with BMI above 30 compared to those with a BMI less than 25. Furthermore, results from the Nurses' Health Study (Kroenke et al, 2005) showed that the association of weight gain after breast cancer diagnosis and increased breast cancer mortality was limited among women who had normal weight (BMI<25) before diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Association of Nutritional Status with Quality of Life in Breast Cancer Survivors

Mohammadi¹,

Sulaiman²,

Koon³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Nutritional status and dietary intake play a significant role in the prognosis of breast cancer and may modify the progression of disease. The aim of this study was to determine the influence of nutritional status on the quality of life of Iranian breast cancer survivors. Cross-sectional data were collected for 100 Iranian breast cancer survivors, aged 32 to 61 years, attending the oncology outpatient clinic at Golestan Hospital, Ahvaz, Iran. Nutritional status of subjects was assessed by anthropometric measurements, Patient-Generated Subjective Global Assessment (PG-SGA) and three non-consecutive 24-hour diet recalls. The European Organization of Research and Treatment of Cancer Quality of Life form (EORTC QLQ-C30) was used to assess quality of life. Ninety-four percent of the survivors were well-nourished, 6% were moderately malnourished or suspected of being malnourished while none were severely malnourished. Prevalence of overweight and obesity was 86%. Overall, participants had an inadequate intake of vitamin D, E, iron and magnesium according to dietary reference intake (DRI) recommendations. Survivors with better nutritional status had better functioning scales and experienced fewer clinical symptoms. It appears important to provide educational and nutritional screening programs to improve cancer survivor quality of life.

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Body mass index as a prognostic feature in operable breast cancer: the International Breast Cancer Study Group experience

Abstract: BMI is an independent prognostic factor for OS in patients with breast cancer, especially among pre-/perimenopausal patients treated with chemotherapy without endocrine therapy.

Cited by 234 publications

References 22 publications

Obesity and poor breast cancer prognosis: an illusion because of hormone replacement therapy?

Obesity and poor breast cancer prognosis: an illusion because of hormone replacement therapy?

Adipocyte fatty acid-binding protein as a novel prognostic factor in obese breast cancer patients

Association of Nutritional Status with Quality of Life in Breast Cancer Survivors

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