Evaluation of the impact of serum lipid levels in breast cancer patients in a Moroccan cardio-oncology unit

Abstract

Breast cancer (BC) is the most frequent cancer in women with a high morbidity and mortality. The identification of risk factors can improve BC prevention of cancer, especially modifiable ones such as obesity and hypercholesterolemia. The association between serum lipid level and BC prognosis is controversial. The purpose of this study was to evaluate the impact of serum lipid level in breast cancer prognosis. We conducted a prospective observational study from June 2018 to March 2021 in the cardio-oncology unit of Casablanca, Morocco. We analyzed a total of 684 patients with BC who had baseline serum lipid profiles; total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C) and high density lipoprotein-cholesterol (HDL-C), and divided them into 2 groups: group 1 ( n = 178) defined by lipid abnormalities at admission (CT > 2 g/L, HDL > 0.65, LDL > 1.8 or TG > 2) and group 2 ( n = 506) defined by normal values of lipid parameters. Patients were grouped on the basis of tumor grade, tumor size, lymph node metastasis and disease free survival. In comparison with the second group, group 1 patients had worse prognosis factors related to their BC such as higher nuclear grade ( P = 0.041), negative hormone receptor status ( P = 0.036), positive HER2 expression ( P = 0.024), and higher BC recurrence ( P = 0.047). Our study also showed that low levels of HDL cholesterol (≤ 0.65 g/L) were mainly present in BC patients with lymph node metastasis ( P = 0.024) and negative progesterone receptor ( P = 0.041). However, this study revealed no association between hyperlipemia and patients overall survival. Our study showed that baseline hyperlipemia is associated with a worse prognosis in BC patients and that a low level of HDL cholesterol may impact clinical outcome but not overall survival.