The effect of body mass index on breast cancer stage and breast cancer specific survival.

IF 3 3区医学 Q2 ONCOLOGY

Breast Cancer Research and Treatment Pub Date : 2025-03-10 DOI:10.1007/s10549-025-07678-7

A Bellini, T H M Keegan, Q Li, A Jacinto, F B Maguire, V Lyo, C A M Sauder

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引用次数: 0

Abstract

Purpose: Underweight women and those with obesity, defined as having a body mass index (BMI) ≥ 30 kg/m², diagnosed with breast cancer (BC) are known to have worse prognosis. Whether BMI impacts BC stage at diagnosis and BC specific survival (BCSS) is not understood. We aim to better understand the relationship between BMI with stage at BC diagnosis and BCSS.

Methods: Women age ≥ 15 years old diagnosed with BC between 2014 and 2019 were identified from the California Cancer Registry. BMI at diagnosis was classified as underweight (< 18.5 kg/m²), normal weight (18.5-24.9 kg/m²), overweight (25-29.9 kg/m²), obesity class 1-2 (30-39.9 kg/m²), and obesity class 3 (≥ 40 kg/m²). BC late stage of diagnosis was defined as American Joint Committee on Cancer stage 3 and 4. Multivariate logistic regression was performed to compare sociodemographic and clinical factors associated with late stage. Multivariable cox proportional hazards regression models assessed association of BMI and BCSS.

Results: Of 159,248 patients: 2.2% were underweight, 34.6% normal weight, 30.5% overweight, 26.7% obesity class 1-2, and 6.0% obesity class 3. Compared to normal weight, patients who were underweight [Hazard Ratio (HR) 1.54, 95% Confidence Interval (CI) 1.51-1.57], obesity class 1-2 [HR 1.06, 1.05-1.07], and obesity class 3 [HR 1.14, 1.12-1.16] were more likely to be diagnosed with late-stage BC. In models stratified by age, patients ≥ 40 years who were underweight had worse BCSS, while patients ≥ 51 years with obesity class 1-2 had better BCSS.

Conclusion: Patients with obesity class 1-2 were more likely to be diagnosed with a later stage, but had improved BCSS, supporting an "obesity paradox" in BC and suggesting that other measures are needed to better assess body composition, adipose distribution, and metabolic health of patients. Patients who were underweight had worse survival, suggesting this high-risk group may benefit from being assessed and treated for possible sarcopenia and malnourishment.

查看原文本刊更多论文

体重指数对乳腺癌分期及乳腺癌特异性生存率的影响。

目的：体重不足和肥胖的女性，定义为身体质量指数(BMI)≥30 kg/m2，诊断为乳腺癌（BC），已知预后较差。BMI是否影响诊断时的BC分期和BC特异性生存（BCSS）尚不清楚。我们的目的是更好地了解BMI与BC诊断阶段和BCSS之间的关系。方法：从加州癌症登记处确定2014年至2019年期间诊断为BC的年龄≥15岁的女性。诊断时BMI分为体重过轻（2级）、正常（18.5 ~ 24.9 kg/m2）、超重（25 ~ 29.9 kg/m2）、肥胖1 ~ 2级（30 ~ 39.9 kg/m2）、肥胖3级（≥40 kg/m2）。BC晚期诊断定义为美国癌症联合委员会3期和4期。采用多因素logistic回归比较与晚期相关的社会人口学和临床因素。多变量cox比例风险回归模型评估BMI和BCSS的相关性。结果：159248例患者中，体重过轻占2.2%，正常体重占34.6%，超重占30.5%，1-2级肥胖占26.7%，3级肥胖占6.0%。与体重正常的患者相比，体重过轻[危险比（HR） 1.54, 95%可信区间（CI） 1.51-1.57]、肥胖1-2级[HR 1.06, 1.05-1.07]和肥胖3级[HR 1.14, 1.12-1.16]的患者更容易被诊断为晚期BC。在按年龄分层的模型中，≥40岁体重过轻的患者BCSS较差，而≥51岁肥胖1-2级的患者BCSS较好。结论：1-2级肥胖患者更有可能被诊断为晚期，但BCSS有所改善，这支持了BC中的“肥胖悖论”，并提示需要其他措施来更好地评估患者的身体组成、脂肪分布和代谢健康。体重过轻的患者生存率较差，这表明对这一高危人群进行肌肉减少症和营养不良的评估和治疗可能有益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Cancer Research and Treatment 医学-肿瘤学

CiteScore

6.80

自引率

2.60%

发文量

342

审稿时长

1 months

期刊介绍： Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.