Department of Oncology, Clinical Sciences, Lund University, Barngatan 2B, Lund, Sweden.
Cancer Causes Control. 2012 Aug;23(8):1307-16. doi: 10.1007/s10552-012-0008-9. Epub 2012 Jun 14.
Body mass index (BMI), waist-to-hip ratio (WHR), and tumor characteristics affect disease-free survival. Larger breast size may increase breast cancer risk, but its influence on disease-free survival is unclear. The purpose of this study was to elucidate whether breast size independently influenced disease-free survival in breast cancer patients.
Body measurements were obtained preoperatively from 772 breast cancer patients in a population-based ongoing cohort from southern Sweden. The research nurse measured breast volumes with plastic cups used by plastic surgeons doing breast reductions. Clinical data were obtained from patient charts and pathology reports.
Patients with a BMI ≥ 25 kg/m(2) had larger tumors (p < 0.001) and more axillary nodal involvement (p = 0.030). Patients with a WHR > 0.85 had larger tumors (p = 0.013), more advanced histological grade (p = 0.0016), and more axillary nodal involvement (p = 0.012). Patients with right + left breast volume ≥ 850 mL were more likely to have larger tumor sizes (p = 0.018), more advanced histological grade (p = 0.031), and more axillary nodal involvement (p = 0.025). There were 62 breast cancer events during the 7-year follow-up. Breast volume ≥ 850 mL was associated with shorter disease-free survival (p = 0.004) and distant metastasis-free survival (p = 0.001) in patients with estrogen receptor (ER)-positive tumors independent of other anthropometric measurements and age. In patients with ER-positive tumors, breast size was an independent predictor of shorter disease-free (HR 3.64; 95 % CI 1.42-9.35) and distant metastasis-free survival (HR 6.33; 95 %CI 1.36-29.43), adjusted for tumor characteristics, BMI, age, and treatment.
A simple and cheap anthropometric measurement with standardized tools may help identify a subgroup of patients in need of tailored breast cancer therapy.
体重指数（BMI）、腰臀比（WHR）和肿瘤特征会影响无病生存率。乳房较大可能会增加乳腺癌风险，但它对无病生存率的影响尚不清楚。本研究旨在阐明乳房大小是否会独立影响乳腺癌患者的无病生存率。
从瑞典南部一个基于人群的正在进行的队列中的 772 名乳腺癌患者术前获得身体测量值。研究护士使用整形外科医生进行乳房缩小手术时使用的塑料杯测量乳房体积。临床数据来自患者病历和病理报告。
BMI≥25kg/m²的患者肿瘤更大（p<0.001），腋窝淋巴结受累更多（p=0.030）。WHR>0.85 的患者肿瘤更大（p=0.013），组织学分级更高级（p=0.0016），腋窝淋巴结受累更多（p=0.012）。右侧+左侧乳房体积≥850ml 的患者更有可能肿瘤更大（p=0.018），组织学分级更高级（p=0.031），腋窝淋巴结受累更多（p=0.025）。在 7 年的随访中，有 62 例乳腺癌事件。在雌激素受体（ER）阳性肿瘤患者中，乳房体积≥850ml 与无病生存率（p=0.004）和无远处转移生存率（p=0.001）较短相关，独立于其他人体测量测量值和年龄。在 ER 阳性肿瘤患者中，乳房大小是无病生存（HR 3.64；95%CI 1.42-9.35）和无远处转移生存（HR 6.33；95%CI 1.36-29.43）较短的独立预测因子，调整了肿瘤特征、BMI、年龄和治疗。
使用标准化工具的简单廉价的人体测量学测量方法可以帮助识别需要个体化乳腺癌治疗的患者亚组。
