Pre-morbid anthropometric measurement and its impact on outcome in early-stage breast cancer in midwestern Ireland.

Abstract

45 Background: Obesity has become a grave public health concern of global proportions, especially in many developed counties. Clinical obesity may be defined as a body mass indeed (BMI) of greater than or equal to 30kg/m2. Within recent times, growing interest has been seen for the relationship between obesity and cancer; with it being identified as a significant risk factor. It has also been appreciated that it is one of the greatest modifiable risk factors for malignancy. Obesity at the time of diagnosis of early-stage breast cancer (EBC) has been associated with poor outcome, especially breast-cancer specific survival. The potential mechanism for this has been linked to several factors including: associated adverse disease features; hormonal influences; co-morbidities that can interfere with therapy; and other yet unknown pathways. We herein report our experience on patients with newly diagnosed EBC and related pre-morbid anthropometric data and its impact on their outcome in an ambulatory Medical Oncology practice in Mid-Western Ireland. Methods: Study period: 01/01/2001 – 31/12/2010. Retrospective data was derived from (1) MWCC Oncology database, (2) pathology reports, and (3) patient files. Data was collated and entered into an Access database and exported into IBM SPSS Statistics 20 version for statistical analysis. Results: One thousand and forty-one (1,041) patients with EBC were identified and analysed. Median age: 55 years (23 – 87 years). Median follow-up: 5.04 years. BMI distribution revealed: Underweight (<18.5kg/m2): 1%; Normal (18.5 – 25kg/m2): 33%; Overweight (25.1 – 30kg/m2): 39%; and Obese (>30kg/m2): 27%. It was noted that obese patients had disproportionately later age of presentation, larger tumours, ductal carcinoma on histology and a smoking history (including current and former smokers). Obese patients accounted for 50% of the non-cancer related deaths observed. Obese patients showed poorer survival in all categories, but it was only statistically significant for non-cancer related deaths. Conclusions: Pre-morbid anthropometric data has shown that obese patients had poorer outcome, and highlights that potential intervention can have impact on improving outcome in EBC.