Overweight: Is It a Prognostic Factor in Women with Triple-Negative Breast Cancer?

Abstract

<br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Obesity is associated with poor outcomes in patients with breast cancer expressing hormone </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">receptors, but this association is not well established for triple-negative breast cancer. In this study, we investigated </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">the influence of body mass index (BMI) in triple-negative breast cancer outcomes. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">This is a descriptive </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">and analytical retrospective cohort study at the Regional Oncology Center Hassan II-Oujda. We identified 115 patients with triple-negative breast cancer, met the criteria for inclusion, treated between January 2009 and December 2011. </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The clinicopathological characteristics were collected to assess the association between BMI and overall survival and </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">disease-free survival at 5 years, using the Kaplan-Meier and Cox model. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Data analysis focused on 115 patients, 34 patients (28.7%) were normal weight (BMI < 25) and 82 patients (71.3%) were overweight (BMI ≥ 25). The rates of overall mortality and progression at 5 years were 37.4% and 69.6% respectively. After adjusting for clinicopathological variables and menopausal status, overweight was associated with OS (HR: 2.903, 95% CI: 1.551- 5.432, p = 0.001) and DFS (HR:1.899, 95% IC: 1.05 – 3.433, p=0.034) in all patients with triple-negative breast cancer. When stratified by menopausal status, overweight was associated with DFS and OS (HR : 3.242, 95% CI: 1.249 to 8.412, p = 0.016) and (HR : 2.752, 95% CI: 1.267 to 5.978, p = 0.011) respectively in pre-menopausal women. By cons, BMI was not associated with DFS or OS in postmenopausal women. </span></span><strong><span style="font-size: small;">Conclusions: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Overweight is an independent prognostic factor </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">for OS and DFS at 5 years in all patients with triple-negative breast cancer, and menopausal status may be a mitigating factor. Premenopausal women with overweight are at greater risk of death and progression than women with normal </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">weight. Once validated, these results should be considered in the development of prevention programs. </span></span>