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肥胖对服务欠缺的美国社区医疗保障医院乳腺癌临床病理特征的影响:一项回顾性单中心研究。

Impact of Obesity on Breast Cancer Clinicopathological Characteristics in Underserved US Community Safety-Net Hospital: A Retrospective Single-Center Study.

机构信息

Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL.

Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL.

出版信息

Clin Breast Cancer. 2024 Dec;24(8):e714-e722. doi: 10.1016/j.clbc.2024.08.008. Epub 2024 Aug 13.

Abstract

BACKGROUND

Breast cancer continues to pose a significant public health challenge, with its incidence and disproportionate impact on underserved populations in the United States. The relationship between obesity and clinicopathological characteristics at presentation remains a critical area of investigation. Safety-net hospitals caring for underserved communities provide a unique setting to explore these associations. This study seeks to explore a critical gap in knowledge on obesity and breast cancer characteristics in underserved populations in the United States.

MATERIALS AND METHODS

In this retrospective study, 927 breast cancer patients were included. Analysis was conducted to assess the association between body mass index (BMI), age of diagnosis, tumor clinicopathologic characteristics, and molecular types stratified by menopausal status at diagnosis. Analysis was performed using the Statistical Package for Social Sciences version 29.

RESULTS

A significant association was found between BMI and menopausal status (P < .05). Disease stage at presentation was significantly associated with BMI (P < .05). Further investigation into BMI categories and tumor characteristics revealed a significant correlation in postmenopausal women, with obesity linked to tumor size and lymph node status (P < .05). No significant associations were observed between HER-2 status, ER/PR status, and obesity in either premenopausal or postmenopausal groups.

CONCLUSION

This observational retrospective hypothesis-generating study revealed the association between obesity and disease stage and menopause status at diagnosis. In postmenopausal patients, obesity correlated with larger tumor size and advanced lymph node disease involvement. Additionally, ethnic variations were observed, with a higher prevalence of obesity among African American patients.

摘要

背景

乳腺癌在美国仍然是一个重大的公共卫生挑战,其发病率及其对服务不足人群的不成比例影响仍然是一个关键领域。肥胖与就诊时的临床病理特征之间的关系仍然是一个关键的研究领域。为服务不足的社区提供服务的安全网医院为探索这些关联提供了一个独特的环境。本研究旨在探讨美国服务不足人群中肥胖与乳腺癌特征之间的一个重要知识空白。

材料和方法

在这项回顾性研究中,纳入了 927 名乳腺癌患者。分析旨在评估体重指数(BMI)、诊断时的年龄、肿瘤临床病理特征以及根据诊断时的绝经状态分层的分子类型之间的关联。使用社会科学统计软件包 29 版进行分析。

结果

BMI 与绝经状态之间存在显著关联(P <.05)。就诊时的疾病分期与 BMI 显著相关(P <.05)。进一步研究 BMI 类别和肿瘤特征发现,在绝经后妇女中存在显著相关性,肥胖与肿瘤大小和淋巴结状态相关(P <.05)。在绝经前或绝经后妇女中,HER-2 状态、ER/PR 状态与肥胖之间均无显著关联。

结论

这项观察性回顾性假设生成研究揭示了肥胖与疾病分期和诊断时的绝经状态之间的关联。在绝经后患者中,肥胖与更大的肿瘤大小和更晚期的淋巴结疾病有关。此外,还观察到了种族差异,非裔美国患者中肥胖的患病率更高。

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