Increasing preoperative body size in breast cancer patients between 2002 and 2016: implications for prognosis

Wisse, Agatha; Tryggvadottir, Helga; Simonsson, Maria; Isaksson, Karolin; Rose, Carsten; Ingvar, Christian; Jernström, Helena

doi:10.1007/s10552-018-1042-z

Cited by 17 publications

(22 citation statements)

References 43 publications

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“…A recent study based on the BCBlood cohort showed that a breast volume ≥850 ml was the strongest prognostic anthropometric factor in terms of breast cancer-free interval, both in all patients and in various treatment groups. Meanwhile, BMI and waist circumference were the strongest prognostic anthropometric factors for overall survival ( 38 ). Given the inverse association between the body size and the IGF-I/IGFBP3 molar ratio, it is unlikely that the association between breast volume and recurrence-risk is mediated via increases in IGF-I or IGFBP-3.…”

Section: Discussionmentioning

confidence: 99%

Pre- and Postoperative Circulating IGF-I, IGFBP-3, and IGFBP-7 Levels in Relation to Endocrine Treatment and Breast Cancer Recurrence: A Nested Case-Control Study

et al. 2021

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Insulin-like growth factor-I (IGF-I) and its binding proteins (BPs) have been associated with breast cancer risk, especially high IGF-I concentrations and the biologically active fraction estimated as the IGF-I/IGFBP-3 molar ratio. The relation of circulating IGF-I and IGFBP-3 concentrations with risk of breast cancer recurrence has been less documented. In addition a new member to a sub-group of the IGFBP-superfamily was recently identified, the low affinity IGFBP-7. To date, the role of systemic IGFBP-7 in breast cancer progression has not been investigated. Our purpose was to establish whether circulating IGF-I, IGFBP-3, and IGFBP-7 levels are related to recurrence-risk in breast cancer. A case-control study was nested within the population-based BCBlood cohort of 853 breast cancer patients diagnosed 2002–2010 in Sweden and followed through 2012. In total, 95 patients with recurrence and 170 controls were matched on age and tumor characteristics. Plasma IGF analytes and tumor membrane IGF-I receptor (IGF-IRm) positivity were analyzed and recurrence-risk was evaluated with conditional logistic regression. Preoperative tertiles of IGF-I and IGFBP-3 were both positively associated with recurrence-risk, but not IGFBP-7. The trend was of borderline significance for IGF-I, T1:REF, T2 OR:1.6, T3 OR: 2.2 adjusted Ptrend=0.057 and significant for IGFBP-3 T1:REF, T2 OR:1.2, T3 OR: 2.1 adjusted Ptrend=0.042. The models were adjusted for age, anthropometric factors, smoking, and treatments. There was a significant interaction between IGFBP-7 and IGF-IRm positivity on recurrence, where the highest IGFBP-7 highest IGFBP-7 tertile conferred increased recurrence-risk in patients with IGF-IRm positive tumors but not in those with IGF-IRm negative tumors (Pinteraction=0.024). By the 1-year visit, age-adjusted IGF-I levels were reduced by 17% while IGFBP-3 and IGFBP-7 were stable. IGF-I levels were significantly reduced by radiotherapy in all patients and by tamoxifen in patients with ER+ tumors. Postoperative changes >10% (n=208) in IGF-I, IGFBP-3, IGFBP-7, or the IGF-I/IGFBP-3 ratio did not predict recurrence after adjustment for preoperative levels, age, anthropometric factors, smoking, and treatments. In conclusion, this study suggests that preoperative IGF-I and IGFBP-3 levels, but not postoperative changes, might provide independent prognostic information and influence breast cancer recurrence. The role of IGFBP-7 in breast cancer merits further study.

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Section: Discussionmentioning

confidence: 99%

Pre- and Postoperative Circulating IGF-I, IGFBP-3, and IGFBP-7 Levels in Relation to Endocrine Treatment and Breast Cancer Recurrence: A Nested Case-Control Study

et al. 2021

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“…Primary breast cancer patients assessed preoperatively since October 2002 at the Skåne University Hospital in Lund were asked to join a prospective cohort study regarding lifestyle factors, as previously described [5]. The preoperative visit typically took place a few weeks after diagnosis.…”

Section: Methodsmentioning

confidence: 99%

“…Concurrently, an obesity epidemic has emerged worldwide, which negatively impacts both breast cancer risk and recurrence [3,4]. Preoperative body sizes increased significantly 2002-2016 with a negative prognostic impact [5]. Weight change has been investigated in multiple studies, but the impact on breast cancer prognosis remains unclear [6][7][8][9][10][11][12][13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

The impact of body size changes on recurrence risk depends on age and estrogen receptor status in primary breast cancer

Tryggvadottir

Rödström

Markkula

et al. 2019

Cancer Causes Control

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Purpose To investigate the prognostic impact of body size changes during the first postoperative year in breast cancer. Methods A cohort of 1,317 primary breast cancer patients included in Sweden (2002-2014) underwent body size measurements at the preoperative and 1-year visits (n = 1,178). Landmark survival analyses were used to investigate how postoperative weight gain or loss (> 5%) or change in waist-hip ratio (WHR) categories (≤ 0.85 or > 0.85) impact prognosis. Results Median age at inclusion was 61 years and body mass index 25.1 kg/m 2. After a median follow-up of 5.0 years from inclusion, 165 recurrences and 77 deaths occurred. Weight gain (17.0%) conferred over twofold recurrence risk only in patients < 50 years (P interaction = 0.033). Weight loss (8.6%) was only associated with a poor prognosis in patients ≥ 70 years, but not after restriction analysis. Weight change did not impact prognosis in patients 50 to < 70 years. Changes between WHR categories were associated with differential recurrence risk depending on estrogen receptor (ER) status (P interaction = 0.007), with higher recurrence risk in patients with ER+ tumors and lower recurrence risk with ER− tumors. Conclusion Both changes in terms of weight and WHR category yielded independent prognostic information. Further research is imperative before recommending weight loss for all overweight breast cancer patients.

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“…First, current evidence shows that a larger body size, which is usually indicated by a higher BSA or BMI, may predispose to LNM and further require extensive lymph node dissection in a variety of oncological specialties, resulting in a poor prognosis. [33][34][35][36][37] In our cohort, both N1 and N2 stage LNM were more frequently observed in patients with BSA > 1.69 m 2 than in patients with BSA ≤ 1.69 m 2 , although LNM is not associated with a risk of chylothorax (Table 1). Mediastinal lymph nodes are generally located around important blood vessels and airways.…”

Section: Interpretationsmentioning

confidence: 97%

Body surface area as a novel risk factor for chylothorax complicating video‐assisted thoracoscopic surgery lobectomy for non‐small cell lung cancer

Wang

Zhou

et al. 2018

Thoracic Cancer

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BackgroundThe study was conducted to demonstrate the predictive value of body surface area (BSA) for chylothorax complicating video‐assisted thoracoscopic surgery (VATS) lobectomy for non‐small cell lung cancer (NSCLC).MethodsLarge‐scale retrospective analysis was conducted on the data of 1379 patients who underwent VATS lobectomy between January 2014 and October 2017 at our institution. Receiver operating characteristic analysis was conducted to determine a threshold BSA value for the prediction of chylothorax. This optimal BSA cutoff, other clinicopathological variables, and P < 0.15 were included into a multivariable logistic regression model to determine the risk factors for chylothorax.ResultsTwenty‐six patients (1.9%) developed postoperative chylothorax. The mean BSA in patients with chylothorax was significantly higher than in patients without (1.84 ± 0.14 vs. 1.73 ± 0.16 m2; P = 0.001). A BSA of 1.69 m2 was identified as the threshold value with maximum joint sensitivity (96.2%) and specificity (43.8%). Patients with BSA > 1.69 m2 had a significantly higher incidence of chylothorax (3.0% vs. 0.3%; P < 0.001) and a longer hospital stay (log rank P < 0.001) than patients with BSA ≤ 1.69 m2. Multivariable logistic regression analysis suggested that BSA > 1.69 m2 (odds ratio 7.35, 95% confidence interval 1.54–35.71; P = 0.013) was predictive of postoperative chylothorax.ConclusionsBSA can serve as a novel categorical predictor for chylothorax complicating VATS lobectomy for NSCLC. It may be more helpful to incorporate a BSA cutoff into routine risk stratification tools for lung cancer surgery.

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Increasing preoperative body size in breast cancer patients between 2002 and 2016: implications for prognosis

Cited by 17 publications

References 43 publications

Pre- and Postoperative Circulating IGF-I, IGFBP-3, and IGFBP-7 Levels in Relation to Endocrine Treatment and Breast Cancer Recurrence: A Nested Case-Control Study

Pre- and Postoperative Circulating IGF-I, IGFBP-3, and IGFBP-7 Levels in Relation to Endocrine Treatment and Breast Cancer Recurrence: A Nested Case-Control Study

The impact of body size changes on recurrence risk depends on age and estrogen receptor status in primary breast cancer

Body surface area as a novel risk factor for chylothorax complicating video‐assisted thoracoscopic surgery lobectomy for non‐small cell lung cancer

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