Body mass index, tumor characteristics, and prognosis following diagnosis of early-stage breast cancer in a mammographically screened population
Body mass index, tumor characteristics, and prognosis following diagnosis of early-stage breast cancer in a mammographically screened population
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DOI：
10.1007/s10552-012-0115-7
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发表时间：
2013-02-01
影响因子：
2.3
通讯作者：
Buist，Diana S. M.
中科院分区：
文献类型：
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作者：
Kamineni，Aruna;Anderson，Melissa L.;Buist，Diana S. M.
许多研究表明，体重指数（BMI）增加与乳腺癌预后不良有关，但很少考虑筛查、治疗和肿瘤差异的差异性。我们研究了BMI与乳腺癌复发风险、乳腺癌特异性死亡率和全因死亡率之间的关系，并评估了在接受乳腺X线筛查并接受治疗的人群中，BMI是否会导致肿瘤特征的不同。我们对485名年龄≥40岁、在1988年至1993年间接受筛查性乳房X线检查的24个月内诊断为I/II期乳腺癌的女性进行了随访，年成果。诊断前BMI分为正常（<25 kg/m2）、超重（25-29.9 kg/m2）和肥胖（≥30 kg/m2）。使用辅助治疗前收集的组织通过免疫组织化学评估肿瘤标志物表达。提取医疗记录以确定治疗、复发和死亡率。我们使用考克斯比例风险分别对我们的三个结果的风险比（HR）进行建模，同时调整年龄、分期和他莫昔芬的使用。（HR 2.43; 95% CI 1.34-4.41）和乳腺癌死亡（HR 2.41; 95% CI 1.00-5.81）。BMI和全因死亡率之间没有关联。肥胖女性肿瘤生长速度明显加快，Ki-67检测结果显示。结论我们的研究结果增加了肥胖可能导致乳腺癌预后不良的证据，同时也表明肥胖女性肿瘤增殖增加是导致其不良预后过度风险的一个途径。
PurposeMany studies suggest increased body mass index (BMI) is associated with worse breast cancer outcomes, but few account for variability in screening, access to treatment, and tumor differences. We examined the association between BMI and risk of breast cancer recurrence, breast cancer-specific mortality, and all-cause mortality, and evaluated whether tumor characteristics differ by BMI among a mammographically screened population with access to treatment.MethodsUsing a retrospective cohort study design, we followed 485 women aged ≥40 years diagnosed with stage I/II breast cancer within 24 months of a screening mammogram occurring between 1988 and 1993 for 10-year outcomes. BMI before diagnosis was categorized as normal (<25 kg/m2), overweight (25–29.9 kg/m2), and obese (≥30 kg/m2). Tumor marker expression was assessed via immunohistochemistry using tissue collected before adjuvant treatment. Medical records were abstracted to identify treatment, recurrence, and mortality. We used Cox proportional hazards to separately model the hazard ratios (HR) of our three outcomes by BMI while adjusting for age, stage, and tamoxifen use.ResultsRelative to normal-weight women, obese women experienced increased risk of recurrence (HR 2.43; 95 % CI 1.34–4.41) and breast cancer death (HR 2.41; 95 % CI 1.00–5.81) within 10 years of diagnosis. There was no association between BMI and all-cause mortality. Obese women had significantly faster growing tumors, as measured by Ki-67.ConclusionsOur findings add to the growing evidence that obesity may contribute to poorer breast cancer outcomes, and also suggest that increased tumor proliferation among obese women is a pathway that explains part of their excess risk of adverse outcomes.