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Zhang M, Zhang X, Liu J, Su W, Li J, Zhang S, Zhang J. Body mass index and diabetes are important prognostic signatures for bilateral breast cancer prognosis. J Cell Biochem 2019; 120:7363-7374. [PMID: 30618092 DOI: 10.1002/jcb.28011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 10/10/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Several research have suggested that high body mass index (BMI) and diabetes were related to poor breast cancer prognosis. The purpose of this study was to investigate the relationships between BMI/diabetes and the prognosis of bilateral breast cancer (BBC). METHODS A total of 26 992 patients with primary breast cancer underwent operations at the Tianjin Medical University Cancer Institute and Hospital between January 1971 and November 2011. Among them, 512 consecutive patients with BBC and 1024 patients with unilateral breast cancer (UBC) were retrospectively reviewed. Overall survival (OS) and progression-free survival (PFS) rates after tumor removal were estimated with Kaplan-Meier method followed by log-rank test for evaluating their differences that stratified by BMI (<25, 25~30, ≥30) or diabetes (suffer/not suffer). Multivariate Cox proportional hazards regression model was used to uncover the relationship between common clinical pathological features and prognosis of breast cancers. RESULTS Compared with UBC, patients with BBC tended to be with higher BMI (P = 0.000) and larger percentage of diabetes ( P = 0.035). The Kaplan-Meier survival analysis indicated that higher BMI complicated by diabetes and negative estrogen receptor significantly decreased the survival rate of BBC patient ( P < 0.05). In addition, diabetes was closely associated with OS or PFS in metachronous BBC ( P = 0.006). The result of multivariate Cox proportional hazards regression model showed that BMI and diabetes were two independent prognostic factors for OS. CONCLUSION Obesity and diabetes have a significant impact on the survival of the patients with BBC.
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Affiliation(s)
- Min Zhang
- The 3rd Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, PR China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China.,Tianjin's Clinical Research Center for Cancer, Tianjin, PR China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, PR China
| | - Xiaobei Zhang
- The 3rd Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, PR China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China.,Tianjin's Clinical Research Center for Cancer, Tianjin, PR China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, PR China
| | - Jingjing Liu
- The 3rd Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, PR China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China.,Tianjin's Clinical Research Center for Cancer, Tianjin, PR China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, PR China
| | - Wei Su
- The 3rd Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, PR China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China.,Tianjin's Clinical Research Center for Cancer, Tianjin, PR China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, PR China
| | - Jiao Li
- The 3rd Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, PR China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China.,Tianjin's Clinical Research Center for Cancer, Tianjin, PR China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, PR China
| | - Sheng Zhang
- The 3rd Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, PR China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China.,Tianjin's Clinical Research Center for Cancer, Tianjin, PR China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, PR China
| | - Jin Zhang
- The 3rd Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, PR China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin, PR China.,Tianjin's Clinical Research Center for Cancer, Tianjin, PR China.,Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, PR China
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Ayoub NM, Yaghan RJ, Abdo NM, Matalka II, Akhu-Zaheya LM, Al-Mohtaseb AH. Impact of Obesity on Clinicopathologic Characteristics and Disease Prognosis in Pre- and Postmenopausal Breast Cancer Patients: A Retrospective Institutional Study. J Obes 2019; 2019:3820759. [PMID: 31019808 PMCID: PMC6452538 DOI: 10.1155/2019/3820759] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/15/2019] [Accepted: 03/03/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To investigate the association between obesity and breast cancer clinicopathologic characteristics at presentation along with prognostic impact among Jordanian breast cancer patients. Such data are lacking in Arabian countries. METHODS In this retrospective study, 348 breast cancer patients were included. Analyses were conducted for associations between body mass index (BMI) and age at diagnosis, tumor clinicopathologic characteristics, and molecular subtypes. Eight prognostic factors were considered, and total prognostic scores were calculated. The analysis was stratified by menopausal status. Multivariate logistic stepwise regression analysis was conducted to identify predictors for breast cancer recurrence and death. RESULTS Mean age at diagnosis was 50.98 ± 10.96 years. Mean BMI at diagnosis was 29.52 ± 5.32 kg/m2. Mean age at diagnosis was significantly higher for overweight and obese patients compared to underweight/normal patients (P < 0.001). A significant positive correlation was observed between patient age and BMI at diagnosis (r = 0.251, P < 0.001). Grade of carcinoma was significantly correlated with BMI in the whole population examined (P=0.003). Obese breast cancer patients had significantly higher prognostic scores compared to nonobese cases, indicating worse prognostic features at presentation (P=0.034). Stratification of data analysis based on menopausal status revealed significant associations between obesity and each of tumor stage and grade among postmenopausal but not premenopausal patients (P=0.019 and P=0.031, respectively). Similarly, postmenopausal obese patients had significantly higher prognostic scores compared to nonobese counterparts (P=0.007), indicating worse prognosis, a finding which was also absent among premenopausal breast cancer patients. No significant association between BMI with expression status of hormone receptors, HER2, lymphovascular invasion, and molecular subtypes was found among patients. BMI was a significant predictor for disease recurrence in which obese breast cancer patients had greater odds (2-fold) to develop locoregional and distant recurrence compared to nonobese cases (P=0.011). CONCLUSIONS Obesity was associated with advanced stage and grade of breast carcinoma at diagnosis. The impact of BMI on clinicopathologic characteristics and prognosis was confined to postmenopausal cases. Jordanian obese breast cancer patients are at greater risk of breast cancer recurrence and reduced survival compared to their nonobese counterparts.
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Affiliation(s)
- Nehad M. Ayoub
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Rami J. Yaghan
- Department of Surgery, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Nour M. Abdo
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Ismail I. Matalka
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Laila M. Akhu-Zaheya
- Department of Adults Health Nursing, Faculty of Nursing, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Alia H. Al-Mohtaseb
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan
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