Obesity and breast cancer prognosis: pre-diagnostic anthropometric measures in relation to patient, tumor, and treatment characteristics.

IF 6 3区医学 Q1 CELL BIOLOGY

Cancer & Metabolism Pub Date : 2023-06-27 DOI:10.1186/s40170-023-00308-0

Sixten Harborg, Maria Feldt, Deirdre Cronin-Fenton, Marie Klintman, Susanne O Dalton, Ann H Rosendahl, Signe Borgquist

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引用次数: 4

Abstract

Purpose: Examine the association between obesity and clinical outcomes in early breast cancer and assess if patient, tumor, and treatment characteristics modify such associations in Malmö Diet and Cancer Study patients (MDCS).

Methods: The MDCS enrolled 17,035 Swedish women from 1991 to 1996. At enrollment, participants' body mass index (BMI), waist circumference and body fat percentage measures were collected. We identified all female MDCS participants with invasive breast cancer from 1991 to 2014. Follow-up began at breast cancer diagnosis and ended at breast cancer recurrence (BCR), death, emigration, or June 8, 2020. The World Health Organization guidelines were used to classify BMI, waist circumference, and body fat percentage into three categories of healthy weight, overweight, and obesity. We fit Cox regression models to compute adjusted hazard ratios (HRs) with 95% confidence intervals (CI) of BCR according to body composition. To evaluate effect measure modification, we stratified Cox models by patient, tumor, and treatment characteristics.

Results: In total, 263 BCRs were diagnosed over 12,816 person-years among 1099 breast cancer patients with a median follow-up of 11.1 years. Obesity according to BMI (HR = 1.44 [95%CI 1.00-2.07]), waist circumference (HR = 1.31 [95%CI 0.98-1.77]), and body fat percentage (HR = 1.41 [95%CI 1.02-1.98]) was associated with increased risk of BCR compared with healthy weight. Obesity was stronger associated with BCR in patients with low socioeconomic position (HR = 2.55 [95%CI 1.08-6.02]), larger tumors > 20 mm (HR = 2.68 [95%CI 1.42-5.06]), estrogen-receptor-negative breast cancer (HR = 3.13 [95%CI 1.09-8.97]), and with adjuvant chemotherapy treatment (HR = 2.06 [95%CI 1.08-4.31]).

Conclusion: Higher pre-diagnostic BMI, waist circumference, and body fat percentage was associated with increased risk of BCR. The association between obesity and BCR appears dependent on patient, tumor, and treatment characteristics.

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肥胖与乳腺癌预后:与患者、肿瘤和治疗特征相关的诊断前人体测量测量

目的:在Malmö饮食和癌症研究患者(MDCS)中，研究肥胖与早期乳腺癌临床结局之间的关系，并评估患者、肿瘤和治疗特征是否改变了这种关系。方法:MDCS从1991年到1996年纳入了17035名瑞典女性。在入组时，收集了参与者的身体质量指数(BMI)、腰围和体脂百分比测量。我们确定了1991年至2014年间所有患有浸润性乳腺癌的女性MDCS参与者。随访开始于乳腺癌诊断，结束于乳腺癌复发(BCR)、死亡、移民或2020年6月8日。根据世界卫生组织的指导方针，BMI、腰围和体脂率被分为健康体重、超重和肥胖三类。我们拟合Cox回归模型，计算调整后的风险比(HRs)， BCR根据身体组成的95%置信区间(CI)。为了评估效果测量修改，我们根据患者、肿瘤和治疗特征对Cox模型进行分层。结果:在1099例乳腺癌患者中，共诊断出263例bcr，超过12816人年，中位随访时间为11.1年。与健康体重相比，BMI (HR = 1.44 [95%CI 1.00-2.07])、腰围(HR = 1.31 [95%CI 0.98-1.77])和体脂率(HR = 1.41 [95%CI 1.02-1.98])的肥胖与BCR风险增加相关。在社会经济地位低(HR = 2.55 [95%CI 1.08-6.02])、肿瘤较大> 20 mm (HR = 2.68 [95%CI 1.42-5.06])、雌激素受体阴性乳腺癌(HR = 3.13 [95%CI 1.09-8.97])和辅助化疗(HR = 2.06 [95%CI 1.08-4.31])的患者中，肥胖与BCR的相关性更强。结论:较高的诊断前BMI、腰围和体脂率与BCR的风险增加有关。肥胖和BCR之间的关系取决于患者、肿瘤和治疗特点。

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来源期刊

Cancer & Metabolism Multiple-

自引率

1.70%

发文量

审稿时长

14 weeks

期刊介绍： Cancer & Metabolism welcomes studies on all aspects of the relationship between cancer and metabolism, including: -Molecular biology and genetics of cancer metabolism -Whole-body metabolism, including diabetes and obesity, in relation to cancer -Metabolomics in relation to cancer; -Metabolism-based imaging -Preclinical and clinical studies of metabolism-related cancer therapies.