Metabolic syndrome and risk of breast cancer mortality by menopause, obesity, and subtype

Abstract

Purpose: To investigate the association between metabolic syndrome (MetS) and risk of breast cancer mortality by menopausal status, obesity, and subtype.Methods: Data from 94,555 women free of cancer at baseline in the National Institute of Health-American Association of Retired Persons Diet and Health Study cohort (NIH-AARP) was used to investigate the prospective associations of baseline MetS and components with risk of breast cancer mortality using Cox proportional hazard regression models adjusted for baseline behavioral and demographic covariates.Results: During a mean follow-up duration of 14 years, 607 women in the cohort died of breast cancer. Overall, MetS was associated with a 73% increased risk of breast cancer mortality (HR: 1.73; 95% CI: 1.09-2.75), but the association was significant among post-menopausal women overall (HR: 2.07, 95% CI: 1.32, 3.25), and those with overweight/obesity (HR: 1.15, 95% CI: 0.81, 1.64). MetS was associated with increased risk of breast cancer mortality for ER+/PR+ (HR: 1.28, 95% CI: 0.52, 3.16) and lower risk for ER-/PR-(HR: 0.44, 95% CI: 0.11, 1.75) subtypes; however, the associations were not statistically significant. Of the individual MetS components, high waist circumference (HR: 1.32, 95% CI: 1.03, 1.70), high cholesterol (HR: 1.24, 95% CI: 1.05, 1.46), and hypertension (HR: 1.24, 95% CI: 1.05, 1.46) were independently associated with increased risk of breast cancer mortality.

The prognostic link between metabolic syndrome and the different breast cancer molecular subtypes: a case control study.

“…Epidemiological studies have indicated the close association between MetS and increased risk of recurrence and overall mortality due to BC (7,9,10). Based on the intrinsic molecular subtypes, some researchers reported that a non-significant trend for increased risk of mortality was observed among the hormone-receptor (HR)positive patients with BC and MetS (11,12). Moreover, the lack of data on Her-2 status may affect the conclusion of the impression of Mets on the prognosis of early BC, which is based on the molecular profiles.…”

“…Moreover, the lack of data on Her-2 status may affect the conclusion of the impression of Mets on the prognosis of early BC, which is based on the molecular profiles. Accordingly, several related studies have shown conflicting results because of the hypothesis that the different components of MetS may be involved in the development and prognosis of the molecular subtypes of BC (11)(12)(13)(14).…”

Obesity-Altered Adipose Stem Cells Promote Radiation Resistance of Estrogen Receptor Positive Breast Cancer through Paracrine Signaling

“…Further, RT reduces the long-term risk for local recurrence [5].Beyond RT, systemic treatments such as endocrine therapy are also a mainstay in BC treatment; however, flexible guidelines and patient preferences often leave therapy choice to physicians' discretion although endocrine therapy is recommended for patients whose cancer display any level of estrogen expression [6,7]. Notably, it has been found that endocrine therapy and RT can be safely concurrently administered without danger of weakening disease control [6].Obesity has been implicated as a risk factor in RT resistance, metastasis, and overall poor prognosis in breast cancer [8][9][10]. Furthermore, moderate to severe obesity increases the likelihood of BC recurrence and BC-specific mortality [10,11].…”

“…Notably, it has been found that endocrine therapy and RT can be safely concurrently administered without danger of weakening disease control [6].Obesity has been implicated as a risk factor in RT resistance, metastasis, and overall poor prognosis in breast cancer [8][9][10]. Furthermore, moderate to severe obesity increases the likelihood of BC recurrence and BC-specific mortality [10,11]. Obesity may promote resistance to RT through metabolic dysregulation and altered signaling axis [8].…”

“…Obesity has been implicated as a risk factor in RT resistance, metastasis, and overall poor prognosis in breast cancer [8][9][10]. Furthermore, moderate to severe obesity increases the likelihood of BC recurrence and BC-specific mortality [10,11].…”