Effects of obesity and race on prognosis in lymph node-negative, estrogen receptor-negative breast cancer

Dignam, James J.; Wieand, Kelly; Johnson, Karen A.; Raich, Peter C.; Anderson, Stewart J.; Somkin, Carol P.; Wickerham, D. Lawrence

doi:10.1007/s10549-005-9118-3

Cited by 97 publications

(100 citation statements)

References 48 publications

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“…Estudos têm demonstrado a existência de associação entre fatores étnicos/raciais e a sobrevida pela doença, sendo a raça negra, em geral, considerada como fator de pior prognóstico 14,15,16 , o que pode, em parte, estar relacionado ao nível sócio-econômico. Nesta pesquisa, embora tenha sido observada sobrevida inferior nas pacientes não brancas na análise não ajustada, a cor da pele não se mostrou, no modelo multivariado, estatisticamente associada ao risco de óbito.…”

Section: Discussionunclassified

“…Nos Estados Unidos, tem sido evidenciada pior sobrevida nas mulheres negras e de outros grupos étnicos em comparação com as mulheres brancas caucasianas 14,15,16 , o que pode resultar de desigualdades no acesso e na qualidade de cuidados à saúde e/ou de diferenças nas características tumorais dentro de cada estádio. Inegavelmente, está-dios mais precoces se associam à sobrevida e ao tempo livre de doença mais elevados 4,16,17,18 .…”

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Sobrevida de cinco anos e fatores prognósticos em coorte de pacientes com câncer de mama assistidas em Juiz de Fora, Minas Gerais, Brasil

et al. 2009

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O objetivo deste estudo foi analisar a sobrevida de cinco anos e os fatores prognósticos em mulheres com câncer invasivo da mama, submetidas à cirurgia e assistidas em Juiz de Fora, Minas Gerais, Brasil, com diagnóstico da doença entre 1998 e 2000. As variáveis analisadas foram: idade, cor, local de residência, variáveis relacionadas ao tumor e ao tratamento. Foram estimadas as funções de sobrevida pelo método de Kaplan-Meier, e o modelo de riscos proporcionais de Cox foi utilizado para avaliação prognóstica. A sobrevida estimada foi de 81,8%. Tamanho tumoral e comprometimento de linfonodos axilares foram os fatores prognósticos independentes mais importantes, com risco de óbito aumentado para mulheres com tamanho do tumor maior que 2,0cm (HR = 1,97; IC95%: 1,26-3,07) e com metástase para gânglios axilares (HR = 4,04; IC95%: 2,55-6,39). Tais achados enfatizam a importância do diagnóstico e tratamento precoces. O acesso às ações de rastreamento nos diversos níveis de assistência, especialmente para o grupo considerado como de maior risco, deve ser uma prioridade para os gestores de saúde no país.

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Sobrevida de cinco anos e fatores prognósticos em coorte de pacientes com câncer de mama assistidas em Juiz de Fora, Minas Gerais, Brasil

et al. 2009

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“…One of the largest study with ER-and lymph node-negative breast cancer patients was the NSABP-14 trial [9], and confirmed that the risk of contralateral breast cancer and overall mortality (although not necessarily breast cancer-related mortality) were increased in the obese patients. In addition, the subgroup analysis of the BIG 02-98 trial also showed that obese patients appeared to have worse outcomes if they had at least 1 hormone receptor negativity [5].…”

Section: Discussionmentioning

confidence: 78%

“…Although obesity and lack of hormone receptors are known as distinctive unfavorable prognostic factors in breast cancer, there are only limited data on how obesity interacts with prognosis of non-luminal tumors [8,9]. TNBC is an aggressive subtype of breast cancer with higher local and distant recurrence rates and shorter survival, and, in this study, we evaluated the impact of obesity on clinical outcomes of patients with this form of cancer.…”

Section: Introductionmentioning

confidence: 99%

The Role of Body Mass Index in Triple Negative Breast Cancer

et al. 2015

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Background: Triple-negative breast cancer (TNBC) has none of the targeted treatment choices due to its distinct biological property, making this subtype a unique disease. In this study, we evaluated the impact of obesity on clinical outcomes of TNBC. Methods: The data of breast cancer patients admitted to our department were collected. TNBC was defined as lack of estrogen receptor (ER), progesterone receptor (PR) and HER-2. The body mass index (BMI) of 112 TNBC patients was calculated with weight at the time of diagnosis and height. The patients were classified into groups with a BMI of < 25 (normal/underweight), 25-29.9 (overweight) or ≥ 30 (obese). After a mean follow-up of 23.2 ± 15.5 months, there were 12 recurrences (10.71%) and 6 deaths (5.35%). Disease-free survival (DFS) and overall survival (OS) were assessed. Results: The survival analyses of all the patients did not demonstrate any differences in OS or DFS in obese as compared to non-obese patients. However, we showed that obesity was associated with a poorer OS for postmenopausal TNBC patients (p < 0.05). Conclusion: Obesity is related to a poorer OS in postmenopausal TNBC patients. Due to the heterogeneous disease profile of TNBC, larger randomized studies will be needed to clarify the exact role of obesity in TNBC.

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“…Dignam et al (2006) demonstrated higher BMI to be associated with greater overall mortality within a hormone-insensitive, node-negative breast cancer patient population. This was most pronounced in patients with a BMI >35, who were noted to have a two-fold increased risk of non-cancer death, most commonly due to chronic disease.…”

Section: Discussionmentioning

confidence: 92%

The Impact of Weight Change During and After Post-Operative Chemotherapy on Breast Cancer Control in Node-Positive Patients Treated With Trimodality Therapy

Johnson¹,

Lamb²,

Mills³

et al. 2014

CCO

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Objective: The purpose of this investigation was to determine whether an association exists between post-operative chemotherapy weight change and breast cancer control and survival, specifically within a high-risk population of women with node-positive breast cancer diagnosed and treated in the contemporary setting. Methods:A retrospective investigation with the following eligibility criteria: women who underwent primary surgical therapy for invasive breast cancer, were found to have pathologic evidence of nodal involvement, and were treated with adjuvant chemotherapy and radiation therapy. Demographic, tumor-, and treatment-related data were recorded and analyzed for association with disease control and survival outcomes. The post-operative/pre-chemotherapy weight and BMI served as the baseline comparator for future weight/BMI changes. Results:From January 2004 through December 2008, 52 patients were identified for inclusion. At a median follow-up of 77.2 months (range 19.9-119.4, with 85% followed >5 years), 8 patients experienced disease recurrence and 7 patients had died (3 with recurrent disease). Analysis of factors associated with study endpoints identified absolute weight and BMI change at 1, 3, and 4 years post-chemotherapy completion as significantly inversely associated with overall survival, but not associated with freedom from failure. Additionally, a statistically significant association between number of lymph nodes involved and freedom from failure was identified. Conclusion:This investigation did not detect statistically significant associations between weight or BMI change during chemotherapy and disease control or survival within this high-risk population, while the number of lymph nodes involved was directly related to risk of disease failure. Weight change at intervals following chemotherapy completion demonstrated some association with overall survival.

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Effects of obesity and race on prognosis in lymph node-negative, estrogen receptor-negative breast cancer

Cited by 97 publications

References 48 publications

Sobrevida de cinco anos e fatores prognósticos em coorte de pacientes com câncer de mama assistidas em Juiz de Fora, Minas Gerais, Brasil

Sobrevida de cinco anos e fatores prognósticos em coorte de pacientes com câncer de mama assistidas em Juiz de Fora, Minas Gerais, Brasil

The Role of Body Mass Index in Triple Negative Breast Cancer

The Impact of Weight Change During and After Post-Operative Chemotherapy on Breast Cancer Control in Node-Positive Patients Treated With Trimodality Therapy

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