Tong Yiwei, Zhu Siyi, Chen Weiguo, Chen Xiaosong, Shen Kunwei
Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Oncol. 2022 May 5;12:862224. doi: 10.3389/fonc.2022.862224. eCollection 2022.
To evaluate the influence of obesity on clinicopathological characteristics of breast cancer; to explore the effect of obesity on the prognosis and performance of endocrine therapy in breast cancer patients.
Patients with luminal/HER2-negative early breast cancer were included and categorized into the non-obese (BMI<28kg/m) and obese (BMI≥28kg/m) groups according to body mass index (BMI). Clinicopathological characteristics and treatment modalities were compared between groups. Interaction of adjuvant endocrine therapy with obesity was analyzed.
A total of 2,875 patients were included: 2,598 non-obese and 277 obese. A higher rate of patients with comorbidities (OR: 2.83, 95%CI 2.13-3.74, <0.001) or PR-positive tumor (OR: 1.63, 95%CI 1.03-2.58, =0.037) were identified in the obese group. Obesity was not associated with disease recurrence (=0.839) or overall survival (=0.140) in the whole population. Subgroup analysis did show an association with worse relapse-free survival (RFS, HR 3.48, 95%CI 1.31-9.22, =0.012) and overall survival (OS, HR 4.67, 95%CI 1.28-16.95, =0.019) in luminal A breast cancer. These results could not be reproduced in the luminal B subtype with a RFS (HR 0.78, 95%CI 0.41-1.49, =0.454) or OS (HR 1.17, 95%CI 0.50-2.74, =0.727). Furthermore, obesity did not impact endocrine therapy effectiveness in Tamoxifen or the aromatase inhibitor group (RFS: interact =0.381; OS: interact =0.888).
The impact of obesity on prognosis interacted with luminal subtype status in Chinese breast cancer patients which was not related with endocrine treatment modality.
评估肥胖对乳腺癌临床病理特征的影响；探讨肥胖对乳腺癌患者预后及内分泌治疗效果的作用。
纳入腔面型/HER2阴性早期乳腺癌患者，并根据体重指数（BMI）分为非肥胖组（BMI<28kg/m）和肥胖组（BMI≥28kg/m）。比较两组的临床病理特征和治疗方式。分析辅助内分泌治疗与肥胖的相互作用。
共纳入2875例患者：2598例非肥胖患者和277例肥胖患者。肥胖组中合并症患者比例较高（OR：2.83，95%CI 2.13 - 3.74，<0.001）或PR阳性肿瘤患者比例较高（OR：1.63，95%CI 1.03 - 2.58，=0.037）。在总体人群中，肥胖与疾病复发（=0.839）或总生存期（=0.140）无关。亚组分析显示，在腔面A型乳腺癌中，肥胖与无复发生存期（RFS，HR 3.48，95%CI 1.31 - 9.22，=0.012）和总生存期（OS，HR 4.67，95%CI 1.28 - 16.95，=0.019）较差相关。在腔面B型亚型中，这些结果未得到重现，RFS（HR 0.78，95%CI 0.41 - 1.49，=0.454）或OS（HR 1.17，95%CI 0.50 - 2.74，=0.727）。此外，肥胖对他莫昔芬或芳香化酶抑制剂组的内分泌治疗效果无影响（RFS：相互作用=0.381；OS：相互作用=0.888）。
在中国乳腺癌患者中，肥胖对预后的影响与腔面亚型状态相互作用，与内分泌治疗方式无关。
