Abstract
PurposeObesity is associated with poorer outcomes in patients with hormone receptor-positive breast cancers, but this association is not well established for women with triple-negative breast cancers (TNBC). Here, we investigated the prognostic effects of body mass index (BMI) on clinical outcomes in patients with TNBC.MethodsWe identified 1106 patients with TNBC who met the inclusion criteria and were treated between January 2002 and June 2012. Clinical and biological features were collected to evaluate the relation between BMI and breast cancer-specific survival (BCSS) and overall survival (OS) after controlling for other clinically significant variables.ResultsOf 1106 patients, 656 (59.3%) were normal weight (BMI ≤24) and 450 patients (40.7%) were overweight(BMI>24). Median follow-up time was 44.8 months. Breast cancer specific death was observed in 140 patients. After adjusting for clinicopathologic risk factors, overweight was associated with OS (hazard ratio [HR]: 1.46, 95% confidence interval [CI]: 1.04-2.06, P =0.028) but not BCSS (HR: 1.34, 95% CI: 0.90–2.01, P =0.15)in all the patients with TNBC. When stratified with menopausal status, overweight was associated with BCSS and OS (HR: 2.27, 95% CI: 1.11-4.63, P = 0.024 and HR: 2.16, 95% CI: 1.21-3.87, P = 0.010, respectively) in premenopausal women. BMI was not associated with BCSS or OS in postmenopausal women.ConclusionsOverweight is an independent prognostic factor of OS in all women with TNBC, and menopause status may be a mitigating factor. Among premenopausal women, overweight women are at a greater risk of poor prognosis than normal weight women. If validated, these findings should be considered in developing preventive programs.
Highlights
Gene expression profiles have reshaped our understanding of breast cancer by defining and characterizing four main subtypes: human epidermal growth factor receptor-2 (HER2)enriched, basal-like, luminal A, and luminal B[1]
Breast cancer specific death was observed in 140 patients
After adjusting for clinicopathologic risk factors, overweight was associated with overall survival (OS) but not breast cancer-specific survival (BCSS) (HR: 1.34, 95% CI: 0.90–2.01, P =0.15)in all the patients with triple-negative breast cancers (TNBC)
Summary
Gene expression profiles have reshaped our understanding of breast cancer by defining and characterizing four main subtypes: human epidermal growth factor receptor-2 (HER2)enriched, basal-like, luminal A, and luminal B[1]. Basal-like breast cancer has a unique clinical-pathological presentation, prognosis, and response to therapy, with poorer prognosis than luminal tumors, but can be difficult to identify in clinic. For 30 years, accumulating evidence suggests that obese women have poorer prognoses than lean ones after breast cancer treatment[3,4,5]. In an observational prospective study of about 350,000 US women, higher BMI was very significantly associated with increasing risk of dying from breast cancer[6]. We examined the impact of overweight on breast cancer-specific survival (BCSS) and overall survival (OS)in Chinese patients treated for TNBC between January 2002 and June 2012
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