Impact of Body Mass Index on Prognostically Relevant Breast Cancer Tumor Characteristics

Eichholzer, Monika; Huang, Dorothy Jane; Modlasiak, Alexandra; Schmid, Seraina; Schötzau, Andreas; Rohrmann, Sabine; Güth, Uwe

doi:10.1159/000350002

Cited by 26 publications

(21 citation statements)

References 59 publications

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“…The prevalence of obesity in our study population was 28.15%. While this prevalence is comparable to that reported for breast cancer patients in the United States [22], it is greater than the obesity prevalence described in European studies (13% to 20%) [16, 23, 24]. Collectively, these data suggest that there is a demographic factor in the prevalence of obesity in breast cancer patients [25].…”

Section: Discussionsupporting

confidence: 69%

Obesity and Prognostic Variables in Colombian Breast Cancer Patients: A Cross-Sectional Study

Cuello-López

Fidalgo-Zapata

Vásquez-Trespalacios

2017

International Journal of Breast Cancer

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Introduction Obesity is an established risk factor for cancer and cancer-related deaths, including that of the breast. While the prevalence of female obesity has accelerated over the past decade in many developing countries, such as Colombia, the prevalence of overweight and obesity specifically in breast cancer populations has not been fully described. Methods A cross-sectional study including 849 women diagnosed with breast cancer between 2009 and 2014. Based on body mass index, prevalence of overweight (BMI ≥ 25 < 30) and obesity (BMI ≥ 30) and associations of BMI with clinical and tumor histopathological features were analyzed. Results Colombian breast cancer patients had a prevalence of overweight of 34.28% and obesity of 28.15%. Mean BMI was comparable between premenopausal and postmenopausal women (27.2 versus 27.7, resp.). Among premenopausal women, higher BMI was significantly positively associated with hormone receptor negative tumors, as well as with greater lymphovascular invasion. Conclusions Colombian breast cancer patients exhibit a significant prevalence of overweight and obesity. Associations of high BMI and poor prognosis variables in the premenopausal population suggest risk of aggressive disease in this population. Future studies to further validate our observations are warranted in order to implement multidisciplinary clinical guidelines.

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Section: Discussionsupporting

confidence: 69%

Obesity and Prognostic Variables in Colombian Breast Cancer Patients: A Cross-Sectional Study

Cuello-López

Fidalgo-Zapata

Vásquez-Trespalacios

2017

International Journal of Breast Cancer

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“…While several studies indicate that OB and OW patients more likely have a TN breast cancer [33,34], others reveal a significant relationship with ER-positive breast cancer [35]. In our series, OW was strongly associated with Luminal A molecular type (p = 0.012), which is known to have a better prognosis.…”

Section: Discussioncontrasting

confidence: 53%

Correlation between obesity and prognostic/predictive parameters with emphasis on the importance of lymph node metastases in patients with invasive breast carcinoma

Hankó-Bauer¹,

Georgescu²,

Coroș³

et al. 2017

pjp

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We aimed to evaluate whether obese women experience more advanced invasive breast carcinoma (IBC) with a higher number of involved lymph nodes, higher range of axillary lymph node ratio (LNR) and presence and size of extracapsular extension as it may have an impact on prognosis and management. 245 patients diagnosed with IBC were divided into normal weight (NW), overweight (OW) and obese (OB) groups. Patients were divided into high range of LNR (LNR over or equal to 0.2) and low LNR (LNR less than 0.2). The extracapsular extension dimensions were measured on the original slides of each case and grouped into ≤ 1 mm and > 1 mm. 84 patients (33.07%) were OW, 72 (29.38%) OB and 91 (37.14%) NW. 45.7% of cases had macrometastasis in the axillary lymph nodes. NW patients had significantly fewer metastatic lymph nodes (p = 0.05) than in the OW/OB groups. There was no statistically significant difference between BMI groups according to the LNR (p = 0.66). Out of 111 cases with macrometastasis, 58 cases (52.25%) had extracapsular extension (ECE) (11.7% NW, 24.32% OW and 16.22% OB). Significantly more OW patients presented extranodal invasion (p = 0.04). We found no statistically significant relationship between the extracapsular extension diameter and BMI groups (p = 0.1).

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“…In addition to being a risk factor, obesity is related to poorer global survival and specific survival for breast cancer patients [16][17][18] . Obesity is associated with locally advanced disease at diagnosis and, consequently, a poorer prognosis 11,16,19 .…”

Section: Introductionmentioning

confidence: 99%

“…Obesity is associated with locally advanced disease at diagnosis and, consequently, a poorer prognosis 11,16,19 . The mechanism has not been well-established, but high BMI values have been usually associated with greater concentrations of circulating sex hormones, insulin, and insulin growth factor, leading to a disequilibrium in the relationship between cell differentiation and apoptosis with a consequent progression and proliferation of tumor cells [16][17][18]20 .…”

Section: Introductionmentioning

confidence: 99%

Variations in the body mass index in Brazilian women undergoing adjuvant chemotherapy for breast cancer

Ricci

Formigoni

Zuliani

et al. 2014

Rev. Bras. Ginecol. Obstet.

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PURPOSE: To evaluate variations in the body mass index in patients undergoing adjuvant chemotherapy for breast cancer, and to associate these changes with patient's age and adjuvant chemotherapy regimen. METHODS: We performed a retrospective cohort study in order to correlate any variation in the body mass index before and after adjuvant chemotherapy with patient's age and adjuvant chemotherapy regimen. Patients who received any form of prior hormone therapy, such as tamoxifen or aromatase inhibitors, were excluded. We selected data for 196 patients with stage I to III breast cancer who were treated by radical or conservative surgery and received adjuvant chemotherapy at the Cancer Institute of the State of São Paulo, Brazil. RESULTS: Before adjuvant chemotherapy, 67.8% of patients were classified as overweight or obese according to their body mass indices. Around 66.3% (95% CI 59.7-73.0) of the patients exhibited an increase in the body mass index after adjuvant chemotherapy. The average age of all patients was 56.3±11.3 years. Participants whose body mass index increased were younger than those with no increase (54.7±11.1 versus 59.3±11.2 years; p=0.007). Patients were treated with the following adjuvant chemotherapy regimens: doxorubicin, cyclophosphamide, and paclitaxel (AC-T, 129 patients, 65.8%); 5-fluoracil, doxorubicin, and cyclophosphamide (36 patients, 18.4%); cyclophosphamide, methotrexate, and 5-fluoracil (16 patients, 8.2%); docetaxel and cyclophosphamide (7 patients, 3.6%); and other regimen (8 patients, 4.1%). The AC-T regimen showed a statistically significant association with increase in the body mass index (p<0.001 by ANOVA). CONCLUSIONS: Most patients with breast cancer showed an increase in the body mass index after adjuvant chemotherapy, especially after the AC-T chemotherapy regimen. ResumoOBJETIVO: Avaliar variações no índice de massa corpórea em pacientes que estão passando por quimioterapia devido ao câncer de mama, e relacionar tais alterações com a idade da paciente e o regime de quimioterapia. MÉTODOS: Estudo de coorte retrospectivo que correlacionou variações no índice de massa corpórea pré-e pós-quimioterapia com a idade da paciente e o regime de quimioterapia. Foram excluídas as pacientes que receberam terapia hormonal prévia, seja como tamoxifeno ou inibidores da aromatase. Os dados de 196 pacientes com estágio I a III de câncer de mama foram selecionados, e elas foram tratadas por cirurgia radical ou conservadora que receberam quimioterapia adjuvante no Instituto do Câncer do Estado de São Paulo, Brasil. RESULTADOS: Antes da quimioterapia adjuvante, 67,8% das pacientes foram classificadas com sobrepeso ou obesas de acordo com seus índices de massa corpórea. Aproximadamente 66,3% (IC95% 59,7-73,0) das pacientes exibiram aumento no índice de massa corpórea após a quimioterapia adjuvante. A média de idade das pacientes foi de 56,3±11,3 anos. Pacientes que apresentaram aumento no índice de massa corpórea eram mais jovens do que aquelas que não apresentaram aumento algum (54,7...

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Impact of Body Mass Index on Prognostically Relevant Breast Cancer Tumor Characteristics

Cited by 26 publications

References 59 publications

Obesity and Prognostic Variables in Colombian Breast Cancer Patients: A Cross-Sectional Study

Obesity and Prognostic Variables in Colombian Breast Cancer Patients: A Cross-Sectional Study

Correlation between obesity and prognostic/predictive parameters with emphasis on the importance of lymph node metastases in patients with invasive breast carcinoma

Variations in the body mass index in Brazilian women undergoing adjuvant chemotherapy for breast cancer

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