Biochemistry Unit, Department of Biomedicine, Faculty of Medicine, University of Porto (FMUP), Al Prof Hernâni Monteiro, 4200-319, Porto, Portugal.
i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.
Clin Transl Oncol. 2023 Oct;25(10):2922-2930. doi: 10.1007/s12094-023-03154-0. Epub 2023 Apr 4.
Obesity is a relevant risk factor in breast cancer (BC), but little is known about the effects of overweight and obesity in surgical outcomes of BC patients. The aim of this study is to analyse surgical options and associated overall survival (OS) in overweight and obese women with BC. In this study, 2143 women diagnosed between 2012 and 2016 at the Portuguese Oncology Institute of Porto (IPO-Porto) were included, and the clinicopathological information was retrieved from the institutional database. Patients were stratified by body mass index (BMI). Statistical analysis included Pearson's chi-squared test with statistical significance set at p < 0.05. Multinomial, binary logistic regression and cox proportional-hazards model were also performed to calculate odd ratios and hazard ratios with 95% confidence intervals for adjusted and non-adjusted models. The results revealed no statistical difference in histological type, topographic localization, tumour stage and receptor status and in the number of surgical interventions. Overweight women have increased probability to be subjected to sentinel node biopsy. Obese and overweight women are more likely to be submitted to conservative surgery and contrariwise, less likely to undergo total mastectomy. Patients submitted to conservative surgery and not submitted to total mastectomy had a favourable OS although without statistical significance. No significant differences were observed in OS when stratified by BMI. Our results revealed significant variations regarding the surgical options in overweight and obese patients, but these were not translated in OS difference. More research is recommended to better address treatment options in overweight and obese BC patients.
肥胖是乳腺癌（BC）的一个相关危险因素，但人们对超重和肥胖对 BC 患者手术结果的影响知之甚少。本研究旨在分析超重和肥胖 BC 女性的手术选择和相关总生存（OS）。本研究纳入了 2012 年至 2016 年期间在葡萄牙波尔图肿瘤研究所（IPO-Porto）诊断的 2143 名女性患者，并从机构数据库中检索了临床病理信息。患者按体重指数（BMI）分层。统计分析包括 Pearson 卡方检验，以 p<0.05 为统计学意义。还进行了多项、二项逻辑回归和 Cox 比例风险模型，以计算调整和未调整模型的优势比和风险比及其 95%置信区间。结果显示，组织学类型、拓扑定位、肿瘤分期和受体状态以及手术干预次数无统计学差异。超重女性接受前哨淋巴结活检的可能性增加。肥胖和超重女性更有可能接受保乳手术，相反，不太可能接受全乳切除术。接受保乳手术而未接受全乳切除术的患者 OS 较好，尽管无统计学意义。按 BMI 分层时，OS 无显著差异。我们的结果显示，超重和肥胖患者的手术选择存在显著差异，但这并没有转化为 OS 差异。建议进行更多研究，以更好地解决超重和肥胖 BC 患者的治疗选择问题。
