Body mass index increases the lymph node metastasis risk of breast cancer: a dose-response meta-analysis with 52904 subjects from 20 cohort studies

Wang, Junyi; Cai, Yanli; Yu, Fangfang; Ping, Zhiguang; Liu, Li

doi:10.1186/s12885-020-07064-0

Cited by 17 publications

(17 citation statements)

References 71 publications

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“…The American Cancer Society’s Cancer Prevention Study II, which followed 495 477 women from 1982 to 1998, reported a positive association between BMI and BC mortality: women with a BMI of 40 kg/m 2 had more than a two-fold increased risk of death compared with those with a BMI of 18 to 24.9 kg/m 2 ( 57 ). Moreover, a meta-analysis of 52 904 subjects showed that BMI increased the LN metastasis risk of BC, and for every 1 kg/m 2 increment in BMI, the risk of LN metastasis increased by 0.89 ( 58 ). This may be attributed to the increase in pro-inflammatory cytokines in the local and circulation caused by the high BMI, which promotes tumor growth, angiogenesis, invasion, and metastasis ( 59 ).…”

Section: Discussionmentioning

confidence: 99%

Preoperative Nomogram for Predicting Sentinel Lymph Node Metastasis Risk in Breast Cancer: A Potential Application on Omitting Sentinel Lymph Node Biopsy

Hu¹,

Xue²,

Peng³

et al. 2021

Front. Oncol.

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BackgroundSentinel lymph node (SLN) biopsy is feasible for breast cancer (BC) patients with clinically negative axillary lymph nodes; however, complications develop in some patients after surgery, although SLN metastasis is rarely found. Previous predictive models contained parameters that relied on postoperative data, thus limiting their application in the preoperative setting. Therefore, it is necessary to find a new model for preoperative risk prediction for SLN metastasis to help clinicians facilitate individualized clinical decisions.Materials and MethodsBC patients who underwent SLN biopsy in two different institutions were included in the training and validation cohorts. Demographic characteristics, preoperative tumor pathological features, and ultrasound findings were evaluated. Multivariate logistic regression was used to develop the nomogram. The discrimination, accuracy, and clinical usefulness of the nomogram were assessed using Harrell’s C-statistic and ROC analysis, the calibration curve, and the decision curve analysis, respectively.ResultsA total of 624 patients who met the inclusion criteria were enrolled, including 444 in the training cohort and 180 in the validation cohort. Young age, high BMI, high Ki67, large tumor size, indistinct tumor margins, calcifications, and an aspect ratio ≥1 were independent predictive factors for SLN metastasis of BC. Incorporating these parameters, the nomogram achieved a robust predictive performance with a C-index and accuracy of 0.92 and 0.85, and 0.82 and 0.80 in the training and validation cohorts, respectively. The calibration curves also fit well, and the decision curve analysis revealed that the nomogram was clinically useful.ConclusionsWe established a nomogram to preoperatively predict the risk of SLN metastasis in BC patients, providing a non-invasive approach in clinical practice and serving as a potential tool to identify BC patients who may omit unnecessary SLN biopsy.

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Section: Discussionmentioning

confidence: 99%

Preoperative Nomogram for Predicting Sentinel Lymph Node Metastasis Risk in Breast Cancer: A Potential Application on Omitting Sentinel Lymph Node Biopsy

Hu¹,

Xue²,

Peng³

et al. 2021

Front. Oncol.

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“…[13][14][15][16][17][18][19][20]. Previous studies have shown that clinico-pathological features such as size, age at diagnosis, palpable mass or not, body mass index (BMI) and hormone receptors are related to ALNM [21][22]. However, in our study, we aimed to compare the incidence of SLNM and ALNM based on the quadrant of breast and size of tumor in breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Clinical Value of Size, quadrant, and Hormonal Status in Predicting Axillary Node Metastasis in Early Clinico-Radiologically Negative Indian Breast Cancer- A Hospital Based Prospective Observational Study

Heroor¹,

T.P²,

Rahman³

et al. 2021

JSCRI

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Background: Sentinel lymph node biopsy (SLNB) is standard of care in clinico- radiologically negative axilla in early breast cancer case. It’s an oncologically safe alternative to Axillary lymph node dissection (ALND), however factors predicting sentinel node metastasis in Indian population is lacking. Methods: A prospective observational study which recruited 80 patients with breast cancer who underwent SLNB with or without ALND, with evaluation of predictive factors including size, type and quadrant , hormonal status of breast this characteristics were prospectively analyzed to predict the axillary metastasis and need of SLNB . Result: Mean age of the patients included in our study was 52.4 years. On univariate analysis, size (p<0.013), upper outer quadrant (UOQ) (p<0.038), central quadrant (CQ) (0.07) were significantly associated with axillary node metastasis in T2 tumors. While on multivariate analysis, UOQ (P<0.009), CQ (p<0.02) metastasis were associated with axillary node metastasis in T2 tumors. Overall sensitivity, specificity, positive predictive valve (PPV) and negative predictive valve (NPV) of SLNB in predicting axillary node status was 77.59%, 100%, 100% and 62.86% respectively. The overall accuracy was 83.7%. Conclusion: Upper outer quadrant, central quadrant and size of the tumors are important prognostic factors to predict axillary node metastasis without the need of sentinel node biopsy in early breast cancers.

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“…[9] Chlebowski determined that there was a lower risk of breast cancer in post-menopausal women who lose weight. [10] Blackburn determined in the Women's Intervention Nutrition Study that risk of breast cancer recurrence was reduced 24% in women who lost an average of 6 lbs. with a low fat diet intervention over those who had regular care.…”

Section: Discussionmentioning

confidence: 99%

Are craniofacial skeletal indices an independent risk factor for temporomandibular joint disorders?

Sertel¹,

Goller²

2020

Int J Radiol Radiat Oncol

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Objective: The purpose of this paper is to discuss how autologous fl ap reconstruction following mastectomy can serve as a unique opportunity for patients with breast cancer to reduce their risk of recurrence through weight reduction in the pre-operative, intraoperative and postoperative phases of healing. Background: Autologous mastectomy reconstruction with tissue from the lower abdomen is common. Patients, with breast cancer, who test positive for the BRCA gene are known to have a survival benefi t from prophylactic mastectomy. It is also known that satisfaction for autologous breast reconstruction is high in the patient population with a high body mass index (BMI). This population has the unique opportunity to further reduce their risk of breast cancer through weight loss. Methods: Prior to surgery, our patients are instructed to consume a high protein diet intake on the magnitude of 1-2 grams per/kg of body weight which was on average 80-100 grams of protein per day. A case report chart review was conducted on a breast cancer patient who underwent autologous breast reconstruction with deep inferior epigastric artery perforator (DIEP) fl aps. The patient had a high body mass index on the initial presentation of their breast cancer diagnosis. After the bilateral mastectomies, the patient lost additional weight after the completion of autologous fl ap reconstruction. Results: Our patient with a high body mass index, who underwent bilateral mastectomy with autologous fl ap reconstruction, was followed between 2018 and 2020. Aesthetic outcome and weight loss following reconstruction was evaluated at various time points. Weight loss, as documented in chart review and patient report, was examined as well as before and after photographs post autologous fl ap reconstruction. Conclusions: Bilateral mastectomy is a common procedure and typical among patients with BRCA positivity or other strong family history of breast cancer. Although mastectomy reduces the risk of recurrence, the risk reduction is not zero. Breast cancer patients often wish to complete all possible modalities to reduce their risk of recurrence. We have found that weight loss is often a controllable risk factor that patients often choose to pursue.

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Body mass index increases the lymph node metastasis risk of breast cancer: a dose-response meta-analysis with 52904 subjects from 20 cohort studies

Cited by 17 publications

References 71 publications

Preoperative Nomogram for Predicting Sentinel Lymph Node Metastasis Risk in Breast Cancer: A Potential Application on Omitting Sentinel Lymph Node Biopsy

Preoperative Nomogram for Predicting Sentinel Lymph Node Metastasis Risk in Breast Cancer: A Potential Application on Omitting Sentinel Lymph Node Biopsy

Clinical Value of Size, quadrant, and Hormonal Status in Predicting Axillary Node Metastasis in Early Clinico-Radiologically Negative Indian Breast Cancer- A Hospital Based Prospective Observational Study

Are craniofacial skeletal indices an independent risk factor for temporomandibular joint disorders?

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