Association of dyslipidemia with the aggressive molecular subtypes and pathologic profile of newly diagnosed nonmetastatic breast cancer patients.

Abstract

19 Background: To investigate the association of dyslipidemia with the aggressive pathologic profile and molecular subtypes among the premenopausal and postmenopausal breast cancer patients. Methods: A retrospective review of Filipino breast cancer patients from 1990 to 2010 from an oncology clinic was done. Patients were grouped to pre- and post-menopausal and each group were divided to those with and without dyslipidemia. Association of dyslipidemia with breast cancer aggressiveness, (1) by pathology (histopathologic diagnosis, grade, invasion, TNM stage) and (2) by molecular phenotype (using the hormone status: estrogen and progesterone receptor positivity) and HER-2 neu status (overexpression by immunohistochemical stain / gene amplification by fluorescent in situ hybridization), was assessed using Fisher exact test. Results: Among 728 breast cancer patients, 201 met the inclusion criteria with 103 premenopausal (36 with dyslipidemia, 67 without dyslipidemia) and 98 were postmenopausal (42 with dyslipidemia, 56 without dyslipidemia). Significant association was noted only among pre-menopausal in terms of the molecular phenotypes (p value 0.002) when compared to individual parameters: total cholesterol (p value <0.001), LDL (p value <0.001), HDL (p value 0.006), and triglyceride (p value <0.001). Conclusions: Dyslipidemia was not found to be a factor associated with aggressiveness of breast cancer in terms of the pathology for both pre-menopausal and post-menopausal groups. Only among premenopausal patients was dyslipidemia shown to be a significant marker of aggressiveness in terms of poorer molecular subset (luminal B, HER-2, basal like). This finding was not observed among post-menopausal group.