Survival of breast‐cancer patients and body size indicators

Abstract

The association of breast-cancer survival with various risk factors was investigated using data of 213 breast-cancer patients who underwent surgical operation between 1975 and 1978. They were followed-up until 1987, and a total of 64 deaths including 47 breast-cancer deaths were certified. The 5-year and 10-year relative survival rates were 78.5% and 75.3% respectively. Of the various factors investigated, some anthropometric indicators revealed interesting results; i.e., body weight, Quetelet index, and body surface area at the time of operation turned out to be strong predictors of survival with a statistically significant trend towards lower survival with larger body structure even after adjustment for confounding factors (e.g., clinical stage) using a proportional-hazard model. The estimated survival probability for women with Quetelet index of 20 was about 12% higher than that with Quetelet index of 24 over a 10-year or more follow-up period. Other variables exhibiting prognostic importance were clinical stage, TNM classification, and some histological findings, while height and reproductive life indicators were, as a rule, not significantly related to survival.

Enhanced Expression of Leptin and Leptin Receptor (OB-R) in Human Breast Cancer

“…Others have also reported that leptin can augment matrix metalloproteinase production in trophoblasts and endothelial cells (50 -52), although this has not been reported in cancer cells. In addition, an epidemiological study has also indicated that breast cancer in obese women is more aggressive, with a poor prognosis (53). These facts, together with our results, support the possibility that the leptin-OB-R signal can play positive roles in breast cancer metastasis.…”

Overweight, obesity and breast cancer prognosis: optimal body size indicator cut-points

“…As the BMI selected threshold values were 24 and 25 kg/m 2 , the role of excess weight in breast cancer prognosis starts to become significant at the WHO-defined threshold (cutpoint) for overweight. The W, IWR and BSA cut-offs are [18] found that there was a 12% difference in survival likelihood between patients with a BMI of 20 kg/m 2 and those with a BMI of 24 kg/m 2 , after a 10-year of follow-up. Kimura et al [1] defined stout patients as those with a BMI of at least 23 kg/m 2 , and revealed a significantly lower survival probability for stout post-menopausal women after a 10-year follow-up, when compared to leaner patients with a BMI lower than 21 kg/m 2 .…”

“…The Disease Free Interval (DFI), including the absence of metastases, nodal or local recurrences, was also explored. We thus computed several BSI from the patients' weight and height: BMI expressed in kg/m 2 , W in kg, IWR [18,25]. The search for optimal binary BSI cut-offs was supported by an observed continuous monotonous relationship between BSI and prognosis events in the studied population (data not shown).…”

“…Other Body Size Indicators (BSI), obtained from weight (W) and height (H), have also been considered in breast cancer prognosis, including weight itself [12][13][14][15][16][17][18][19], Ideal Weight Ratio (IWR) [18,[20][21][22] and Body Surface Area (BSA) [12,18]. Kyogoku et al [18] showed that there are strong quantitative correlations between BSI themselves, whilst significant multivariate breast cancer prognosis effects were observed when BSI were coded as categorical variables.…”

“…Kyogoku et al [18] showed that there are strong quantitative correlations between BSI themselves, whilst significant multivariate breast cancer prognosis effects were observed when BSI were coded as categorical variables. However, Himes et al [23] observed a lack of correspondence between some measures, commonly used to identify obesity, when the BSI cut-points were defined using the distributions' fifth quintile.…”