Petekkaya Ibrahim, Sahin Ugur, Gezgen Gamze, Solak Mustafa, Yuce Deniz, Dizdar Omer, Arslan Cagatay, Ayyildiz Veysel, Altundag Kadri
Department of Medical Oncology, Hacettepe University Institute of Oncology, Ankara, Turkey.
Tumori. 2013 Mar-Apr;99(2):129-33. doi: 10.1177/030089161309900201.
Breast cancer is a heterogeneous disease with various pathological and molecular subtypes. This study aims to determine the association between BMI and the distribution of breast cancer subtypes defined by estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER2/neu) expression in pre- and postmenopausal breast cancers.
A total of 1847 female breast cancer patients were involved. After the exclusion of 457 patients due to missing subtype information (n = 400) or benign histology (n = 57), 1390 were included in the analyses. The histological type of the tumor, ER and PR expression, HER2/neu with immunohistochemistry and HER2/neu gene evaluation with interphase fluorescence in situ hybridization (if necessary), age, body weight, height and menopausal status at diagnosis were investigated retrospectively. The patients were stratified as having a normal body weight if BMI was ≤24.9 kg/m², as being overweight if BMI was between 25.0 and 29.9 kg/m², and as being obese if BMI was ≥30.0 kg/m².
Median BMI was 28.7 kg/m² (17.6-55.6) in the postmenopausal and 25.6 kg/m² (16.4-51.1) in the premenopausal group (P <0.001). BMI at diagnosis did not differ significantly between the molecular subtypes (P = 0.12). Distribution of BMI strata was similar between the molecular subtypes both in pre- and postmenopausal breast cancer (P = 0.24 and P = 0.99, respectively). Premenopausal women with a BMI of ≥25.0 kg/m² showed a tendency towards ER- tumors when compared to premenopausal women with a BMI of <25.0 kg/m² (P = 0.009).
The risk of specific breast cancer subtypes may not be associated with BMI in pre- and postmenopausal breast cancer. However, obesity might be related to an increased risk of premenopausal hormone receptor-negative breast cancer. Further studies are needed for clarification of the probable mechanisms in the pathogenesis of premenopausal hormone receptor-negative breast cancer.
乳腺癌是一种具有多种病理和分子亚型的异质性疾病。本研究旨在确定体重指数（BMI）与绝经前和绝经后乳腺癌中由雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体（HER2/neu）表达所定义的乳腺癌亚型分布之间的关联。
共纳入1847例女性乳腺癌患者。在排除457例因亚型信息缺失（n = 400）或组织学为良性（n = 57）的患者后，1390例患者纳入分析。回顾性调查肿瘤的组织学类型、ER和PR表达、免疫组化检测HER2/neu以及必要时采用间期荧光原位杂交进行HER2/neu基因评估、诊断时的年龄、体重、身高和绝经状态。若BMI≤24.9 kg/m²，患者分层为体重正常；若BMI在25.0至29.9 kg/m²之间，为超重；若BMI≥30.0 kg/m²，为肥胖。
绝经后组BMI中位数为28.7 kg/m²（17.6 - 55.6），绝经前组为25.6 kg/m²（16.4 - 51.1）（P <0.001）。诊断时的BMI在分子亚型之间无显著差异（P = 0.12）。绝经前和绝经后乳腺癌中，分子亚型之间BMI分层分布相似（分别为P = 0.24和P = 0.99）。与BMI<25.0 kg/m²的绝经前女性相比，BMI≥25.0 kg/m²的绝经前女性显示出ER阴性肿瘤的倾向（P = 0.009）。
绝经前和绝经后乳腺癌中，特定乳腺癌亚型的风险可能与BMI无关。然而，肥胖可能与绝经前激素受体阴性乳腺癌风险增加有关。需要进一步研究以阐明绝经前激素受体阴性乳腺癌发病机制中的可能机制。
