Yazici Ozan, Aksoy Sercan, Sendur Mehmet An, Babacan Taner, Ozdemir Nuriye, Ozisik Yavuz, Zengin Nurullah, Altundag Kadri
Ankara Numune Education and Research Hospital, Department of Medical Oncology, Ankara, Turkey.
J BUON. 2015 Jul-Aug;20(4):954-62.
Obesity is a well known risk factor for breast cancer recurrence and poor prognosis. We studied the effect of body mass index (BMI) on recurrence pattern in early breast cancer patients.
This retrospective cross-sectional study analyzed the data of 2731 early stage breast cancer patients. Patients who had metastatic disease at the time of diagnosis and with unknown BMI values were excluded from study (N=276). Patients were classified into three BMI categories: normal body weight, overweight, and obese. The recurrent/metastatic sites of patients were grouped in 8 categories: local, contralateral, lymph node, bone, lung, liver, brain and others. The association between first relapse site of early breast cancer patients and BMI categories were evaluated.
The median patient age was 48 years (range 18-92). The median follow up time was 40 months (range 1-284). During follow-up, 469 (17.1%) patients developed recurrence and/or metastasis. Of 2455 total patients, 853 (34.6%) were classified as having normal weight, 898 (36.2%) were overweighted and 704 (29.2%) were obese. In the whole patient group no relation between metastatic sites and BMI groups was noticed. The first primary metastatic sites were also not associated with BMI groups in pre and postmenopausal subpopulations. In obese patients, disease free survival (DFS) was shorter compared to normal weighted patients, but the difference was not significant. There was no significant difference between site-specific DFS in relation to BMI categorization. Obese and overweighted patients had significantly shorter overall survival (OS) compared to the normal-weight group (p=0.003).
Although obesity had no effect on recurrence pattern of early breast cancer patients, obese early breast cancer patients had shorter OS compared to their normal-weight counterparts.
肥胖是乳腺癌复发和预后不良的一个众所周知的危险因素。我们研究了体重指数（BMI）对早期乳腺癌患者复发模式的影响。
这项回顾性横断面研究分析了2731例早期乳腺癌患者的数据。诊断时患有转移性疾病且BMI值未知的患者被排除在研究之外（N = 276）。患者被分为三个BMI类别：正常体重、超重和肥胖。患者的复发/转移部位分为8类：局部、对侧、淋巴结、骨、肺、肝、脑和其他。评估早期乳腺癌患者的首次复发部位与BMI类别之间的关联。
患者的中位年龄为48岁（范围18 - 92岁）。中位随访时间为40个月（范围1 - 284个月）。在随访期间，469例（17.1%）患者出现复发和/或转移。在2455例患者中，853例（34.6%）被归类为体重正常，898例（36.2%）超重，704例（29.2%）肥胖。在整个患者组中，未发现转移部位与BMI组之间存在关联。在绝经前和绝经后亚组中，首次原发转移部位也与BMI组无关。与体重正常的患者相比，肥胖患者的无病生存期（DFS）较短，但差异不显著。与BMI分类相关的部位特异性DFS之间无显著差异。与正常体重组相比，肥胖和超重患者的总生存期（OS）显著缩短（p = 0.003）。
尽管肥胖对早期乳腺癌患者的复发模式没有影响，但与体重正常的早期乳腺癌患者相比，肥胖患者的总生存期较短。
