Effect of Obesity on Prognosis After Early-Stage Breast Cancer

Ewertz, Marianne; Jensen, Maj‐Britt; Gunnarsdóttir, K.; Højris, Inger; Jakobsen, Erik; Nielsen, Dorte; Stenbygaard, Lars; Tange, Ulla Brix; Cold, Søren

doi:10.1200/jco.2010.29.7614

Cited by 521 publications

(420 citation statements)

References 15 publications

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“…Our results revealed that obesity is associated with larger tumor size and higher tumor grade in both premenopausal and postmenopausal women. These findings are consistent with studies conducted on African American (Zhu et al, 2005), Danish (Ewertz et al, 2011), Iranian (Kaviani et al, 2013) and Asian women (Amadou et al, 2013). However, an inverse association between BMI and BC risk, with a 7% reduction in risk per 5 kg m -2 increase in BMI was documented in premenopausal Caucasians womens (Renehan et al, 2008;Amadou et al, 2013).…”

Section: Discussionsupporting

confidence: 90%

Breast Cancer in Tunisia: Association of Body Mass Index with Histopathological Aspects of Tumors

Bouguerra

Guissouma²,

Labidi³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Previous studies have suggested a link between obesity and breast cancer (BC). However, there is no universal consensus, especially in population based studies. Because only few studies have been conducted on African women, we aimed here to assess the relationship between BMI at time of diagnosis and the BC histopathological features among Tunisian patients according to menopausal status using a hospital-based prospective cohort study. Materials and Methods: Clinical and pathological data were collected from 262 patients stratified on four groups according to their BMI. The relationship between BMI and histopathological features at diagnosis was analysed using univariate and multivariate analysis. Receiver-operating characteristic (ROC) curves were used to evaluate the performance of BMI in predicting of high tumor grade, in comparison to ki-67 index of proliferation. Results: Obesity was correlated with larger tumors, advanced grade and with ER-PRHer2+ BC subtype. An association of BMI with tumor size and tumor grade was observed in both premenopausal and postmenopausal women. Additionally, a significant association between BMI and ER+, ER+PR+Her2+ and ER-PR-Her2+ status was revealed for premenopausal patients, while only ER+PR+Her2+ was associated with BMI for postmenopausal women. Finally, our results showed that compared to Ki67 proliferation index, BMI is a useful prognostic marker of high grade BC tumors. Conclusions: These data are the first to show that in Tunisia obese women suffering from BC have significantly larger tumors and advanced tumor grade and that higher BMI might influence tumor characteristics and behavior.

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Section: Discussionsupporting

confidence: 90%

Breast Cancer in Tunisia: Association of Body Mass Index with Histopathological Aspects of Tumors

Bouguerra

Guissouma²,

Labidi³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…The relationship between nutritional status and quality of life in patients with cancer has been indicated (Nourissat et al, 2008). The contribution of obesity to risk of breast cancer recurrence has been revealed in several studies (McTiernan, 2005;Toles et al, 2008;Ewertz et al, 2011). It was also related to poor physical performance and quality of life in breast cancer survivors (Elme et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Association of Nutritional Status with Quality of Life in Breast Cancer Survivors

Mohammadi¹,

Sulaiman²,

Koon³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Nutritional status and dietary intake play a significant role in the prognosis of breast cancer and may modify the progression of disease. The aim of this study was to determine the influence of nutritional status on the quality of life of Iranian breast cancer survivors. Cross-sectional data were collected for 100 Iranian breast cancer survivors, aged 32 to 61 years, attending the oncology outpatient clinic at Golestan Hospital, Ahvaz, Iran. Nutritional status of subjects was assessed by anthropometric measurements, Patient-Generated Subjective Global Assessment (PG-SGA) and three non-consecutive 24-hour diet recalls. The European Organization of Research and Treatment of Cancer Quality of Life form (EORTC QLQ-C30) was used to assess quality of life. Ninety-four percent of the survivors were well-nourished, 6% were moderately malnourished or suspected of being malnourished while none were severely malnourished. Prevalence of overweight and obesity was 86%. Overall, participants had an inadequate intake of vitamin D, E, iron and magnesium according to dietary reference intake (DRI) recommendations. Survivors with better nutritional status had better functioning scales and experienced fewer clinical symptoms. It appears important to provide educational and nutritional screening programs to improve cancer survivor quality of life.

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“…62 (64%), suffered from a neoplasm belonging to the group of cancers related to obesity, such as colorectal, breast, uterine, ovarian, and kidney cancer. Obesity is a factor associated with the risk of occurrence of multiple malignancies (1, 2, 13-15) and the risk of developing metastases in the course of some malignancies (3,16). However, a favorable influence of overweight and obesity on the course of some neoplastic diseases have been also observed (17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%

Influence of Obesity on the Course of Malignant Neoplastic Disease in Patients After Pulmonary Metastasectomy

Rzechonek

Błasiak

Pniewski³

et al. 2018

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Abstract. Background (82.1±83.5 months vs. 43.0±44.4, p<0.01 and 110.7±81.3 months vs. 69.9±52.9 p<0.005, respectively). Survival after pulmonary metastasectomy was 27.2±25.6 months and was longer in obese and overweight patients than in normal weight patients (20.2±18.4 months vs. 29.4±26.5, p<0.05). Conclusion: Being obese or overweight is a favorable prognostic factor in patients after surgical resection of lung metastases of different malignancies.With the increasing epidemic of obesity in the world, the incidence of malignancies related to obesity also increases (1). Obesity-related cancers include breast cancer in postmenopausal women, colon cancer, cancer of the lower esophagus, gastric cancer, liver cancer, gall bladder cancer, pancreatic cancer, uterine cancer, ovarian cancer and renal cancer (2). Obesity is also associated with increased risk of metastases, including lung metastases, in some cancers (3).In the course of some malignancies a paradoxical phenomenon has been observed, indicating that obesity may be an oncogenic factor and -at the same time -may constitute a favorable prognostic factor (4, 5). The dual and opposite influence of obesity on the course of the same disease has been called the obesity paradox and has been described in some chronic diseases, including cardiovascular (6) and cerebrovascular diseases (7). These paradoxical effects of obesity may occur also in patients with metastases, including patients with malignancies not related to obesity. In a recent large-scale study of 4,010 cancer patients in good general condition, with distant metastases, median OS was twice as high in obese patients as in normal weight patients (8). However, there are also reports stating that there is no beneficial effect of obesity on metastatic neoplastic disease (9-11).The problem of the influence of obesity on the course of metastatic malignancies has not yet been unequivocally explained. Especially, there are no studies on the influence of obesity on survival of patients with operable lung metastases. Therefore, this study was undertaken to evaluate the long-term outcome of surgical treatment of obese and non-obese patients who after resection of primary neoplasm had lung metastases removed. Materials and MethodsData from 99 patients who had a resection of lung metastasis from different primary malignancies between 2001 and 2016 were analyzed. The study was retrospective, and the condition for including patients in the study was access to anesthesia documentation containing body weight and height prior to performing pulmonary metastasectomy. Analysis was performed in the groups depending on body mass index (BMI). Underweight was diagnosed when the BMI 197

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Effect of Obesity on Prognosis After Early-Stage Breast Cancer

Abstract: Obesity is an independent prognostic factor for developing distant metastases and for death as a result of breast cancer; the effects of adjuvant therapy seem to be lost more rapidly in patients with breast cancer and obesity.

Cited by 521 publications

References 15 publications

Breast Cancer in Tunisia: Association of Body Mass Index with Histopathological Aspects of Tumors

Breast Cancer in Tunisia: Association of Body Mass Index with Histopathological Aspects of Tumors

Association of Nutritional Status with Quality of Life in Breast Cancer Survivors

Influence of Obesity on the Course of Malignant Neoplastic Disease in Patients After Pulmonary Metastasectomy

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