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Published in: Breast Cancer Research and Treatment 1/2014

01-07-2014 | Epidemiology

Body mass index, diabetes, and triple-negative breast cancer prognosis

Authors: Sarah Tait, Jose M. Pacheco, Feng Gao, Caroline Bumb, Matthew James Ellis, Cynthia X. Ma

Published in: Breast Cancer Research and Treatment | Issue 1/2014

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Abstract

Higher body mass index (BMI) and diabetes are associated with worse breast cancer prognosis. However, few studies have focused on triple-negative breast cancer (TNBC). The goal of this study is to examine this association in a cohort of patients with TNBC. We retrospectively reviewed 501 consecutive patients with TNBC seen at the Washington University Breast Oncology Clinic. Cox proportional hazard models were used to determine the relationship between BMI and diabetes at diagnosis with overall survival (OS) and disease free survival (DFS). Four hundred and forty-eight patients had BMI recorded and 71 patients had diabetes. The median age at diagnosis was 53 (23–98) years and follow-up was 40.1 months (IQR 25.2–62.9). Baseline BMI and diabetes were not associated with OS or DFS. OS hazard ratios (HRs) for patients who were overweight (BMI 25.0–29.99), with class I obesity (BMI 30–34.99), or BMI ≥35 were 1.22 (CI 0.78–1.91), 0.92 (CI 0.59–1.43), and 1.16 (CI 0.70–1.90), respectively. The HRs for DFS in patients who were overweight, with class I obesity, or BMI ≥35 were 1.01 (CI 0.65–1.56), 0.94 (CI 0.60–1.47), and 0.99 (CI 0.63–1.57), respectively. Similarly, the HRs for diabetics were 1.27 (CI 0.82–1.96) for OS and 0.98 (CI 0.64–1.51) for DFS. Obesity and diabetes did not significantly affect survival for patients with TNBC in this study.
Literature
1.
go back to reference Ogden CL, Carroll MD, Kit BK, Flegal KM (2014) Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA 311(8):806–814PubMedCrossRef Ogden CL, Carroll MD, Kit BK, Flegal KM (2014) Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA 311(8):806–814PubMedCrossRef
2.
go back to reference Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH (2009) The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC public health 9:88PubMedCentralPubMedCrossRef Guh DP, Zhang W, Bansback N, Amarsi Z, Birmingham CL, Anis AH (2009) The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC public health 9:88PubMedCentralPubMedCrossRef
3.
go back to reference Eliassen AH, Colditz GA, Rosner B, Willett WC, Hankinson SE (2006) Adult weight change and risk of postmenopausal breast cancer. JAMA 296(2):193–201PubMedCrossRef Eliassen AH, Colditz GA, Rosner B, Willett WC, Hankinson SE (2006) Adult weight change and risk of postmenopausal breast cancer. JAMA 296(2):193–201PubMedCrossRef
4.
go back to reference Suzuki R, Orsini N, Saji S, Key TJ, Wolk A (2009) Body weight and incidence of breast cancer defined by estrogen and progesterone receptor status–a meta-analysis. Int J Cancer 124(3):698–712PubMedCrossRef Suzuki R, Orsini N, Saji S, Key TJ, Wolk A (2009) Body weight and incidence of breast cancer defined by estrogen and progesterone receptor status–a meta-analysis. Int J Cancer 124(3):698–712PubMedCrossRef
5.
go back to reference van den Brandt PA, Spiegelman D, Yaun SS, Adami HO, Beeson L, Folsom AR, Fraser G, Goldbohm RA, Graham S, Kushi L et al (2000) Pooled analysis of prospective cohort studies on height, weight, and breast cancer risk. Am J Epidemiol 152(6):514–527PubMedCrossRef van den Brandt PA, Spiegelman D, Yaun SS, Adami HO, Beeson L, Folsom AR, Fraser G, Goldbohm RA, Graham S, Kushi L et al (2000) Pooled analysis of prospective cohort studies on height, weight, and breast cancer risk. Am J Epidemiol 152(6):514–527PubMedCrossRef
6.
go back to reference Pierobon M, Frankenfeld CL (2013) Obesity as a risk factor for triple-negative breast cancers: a systematic review and meta-analysis. Breast Cancer Res Treat 137(1):307–314PubMedCrossRef Pierobon M, Frankenfeld CL (2013) Obesity as a risk factor for triple-negative breast cancers: a systematic review and meta-analysis. Breast Cancer Res Treat 137(1):307–314PubMedCrossRef
7.
go back to reference Key TJ, Appleby PN, Reeves GK, Roddam A, Dorgan JF, Longcope C, Stanczyk FZ, Stephenson HE Jr, Falk RT, Miller R et al (2003) Body mass index, serum sex hormones, and breast cancer risk in postmenopausal women. J Natl Cancer Inst 95(16):1218–1226PubMedCrossRef Key TJ, Appleby PN, Reeves GK, Roddam A, Dorgan JF, Longcope C, Stanczyk FZ, Stephenson HE Jr, Falk RT, Miller R et al (2003) Body mass index, serum sex hormones, and breast cancer risk in postmenopausal women. J Natl Cancer Inst 95(16):1218–1226PubMedCrossRef
8.
go back to reference Li CI, Malone KE, Daling JR (2006) Interactions between body mass index and hormone therapy and postmenopausal breast cancer risk (United States). Cancer Causes Control 17(5):695–703PubMedCrossRef Li CI, Malone KE, Daling JR (2006) Interactions between body mass index and hormone therapy and postmenopausal breast cancer risk (United States). Cancer Causes Control 17(5):695–703PubMedCrossRef
9.
go back to reference Endogenous Hormones and Breast Cancer Collaborative Group, Key TJ, Appleby PN, Reeves GK, Roddam AW (2010) Insulin-like growth factor 1 (IGF1), IGF binding protein 3 (IGFBP3), and breast cancer risk: pooled individual data analysis of 17 prospective studies. Lancet Oncol 11(6):530–542PubMedCrossRef Endogenous Hormones and Breast Cancer Collaborative Group, Key TJ, Appleby PN, Reeves GK, Roddam AW (2010) Insulin-like growth factor 1 (IGF1), IGF binding protein 3 (IGFBP3), and breast cancer risk: pooled individual data analysis of 17 prospective studies. Lancet Oncol 11(6):530–542PubMedCrossRef
10.
go back to reference Gunter MJ, Hoover DR, Yu H, Wassertheil-Smoller S, Rohan TE, Manson JE, Li J, Ho GY, Xue X, Anderson GL et al (2009) Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women. J Natl Cancer Inst 101(1):48–60PubMedCentralPubMedCrossRef Gunter MJ, Hoover DR, Yu H, Wassertheil-Smoller S, Rohan TE, Manson JE, Li J, Ho GY, Xue X, Anderson GL et al (2009) Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women. J Natl Cancer Inst 101(1):48–60PubMedCentralPubMedCrossRef
11.
go back to reference Tworoger SS, Eliassen AH, Kelesidis T, Colditz GA, Willett WC, Mantzoros CS, Hankinson SE (2007) Plasma adiponectin concentrations and risk of incident breast cancer. J Clin Endocrinol Metab 92(4):1510–1516PubMedCrossRef Tworoger SS, Eliassen AH, Kelesidis T, Colditz GA, Willett WC, Mantzoros CS, Hankinson SE (2007) Plasma adiponectin concentrations and risk of incident breast cancer. J Clin Endocrinol Metab 92(4):1510–1516PubMedCrossRef
12.
go back to reference Lorincz AM, Sukumar S (2006) Molecular links between obesity and breast cancer. Endocr Relat Cancer 13(2):279–292PubMedCrossRef Lorincz AM, Sukumar S (2006) Molecular links between obesity and breast cancer. Endocr Relat Cancer 13(2):279–292PubMedCrossRef
13.
go back to reference Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 348(17):1625–1638PubMedCrossRef Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 348(17):1625–1638PubMedCrossRef
14.
go back to reference Conroy SM, Maskarinec G, Wilkens LR, White KK, Henderson BE, Kolonel LN (2011) Obesity and breast cancer survival in ethnically diverse postmenopausal women: the Multiethnic Cohort Study. Breast Cancer Res Treat 129(2):565–574PubMedCentralPubMedCrossRef Conroy SM, Maskarinec G, Wilkens LR, White KK, Henderson BE, Kolonel LN (2011) Obesity and breast cancer survival in ethnically diverse postmenopausal women: the Multiethnic Cohort Study. Breast Cancer Res Treat 129(2):565–574PubMedCentralPubMedCrossRef
15.
go back to reference Imkampe AK, Bates T (2010) Impact of a raised body mass index on breast cancer survival in relation to age and disease extent at diagnosis. Breast J 16(2):156–161PubMedCrossRef Imkampe AK, Bates T (2010) Impact of a raised body mass index on breast cancer survival in relation to age and disease extent at diagnosis. Breast J 16(2):156–161PubMedCrossRef
16.
go back to reference Jiralerspong S, Kim ES, Dong W, Feng L, Hortobagyi GN, Giordano SH (2013) Obesity, diabetes, and survival outcomes in a large cohort of early-stage breast cancer patients. Ann Oncol 24(10):2506–2514PubMedCrossRef Jiralerspong S, Kim ES, Dong W, Feng L, Hortobagyi GN, Giordano SH (2013) Obesity, diabetes, and survival outcomes in a large cohort of early-stage breast cancer patients. Ann Oncol 24(10):2506–2514PubMedCrossRef
17.
go back to reference Kamineni A, Anderson ML, White E, Taplin SH, Porter P, Ballard-Barbash R, Malone K, Buist DS (2013) Body mass index, tumor characteristics, and prognosis following diagnosis of early-stage breast cancer in a mammographically screened population. Cancer Causes Control 24(2):305–312PubMedCentralPubMedCrossRef Kamineni A, Anderson ML, White E, Taplin SH, Porter P, Ballard-Barbash R, Malone K, Buist DS (2013) Body mass index, tumor characteristics, and prognosis following diagnosis of early-stage breast cancer in a mammographically screened population. Cancer Causes Control 24(2):305–312PubMedCentralPubMedCrossRef
18.
go back to reference Protani M, Coory M, Martin JH (2010) Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat 123(3):627–635PubMedCrossRef Protani M, Coory M, Martin JH (2010) Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat 123(3):627–635PubMedCrossRef
19.
go back to reference Sestak I, Distler W, Forbes JF, Dowsett M, Howell A, Cuzick J (2010) Effect of body mass index on recurrences in tamoxifen and anastrozole treated women: an exploratory analysis from the ATAC trial. J Clin Oncol 28(21):3411–3415PubMedCrossRef Sestak I, Distler W, Forbes JF, Dowsett M, Howell A, Cuzick J (2010) Effect of body mass index on recurrences in tamoxifen and anastrozole treated women: an exploratory analysis from the ATAC trial. J Clin Oncol 28(21):3411–3415PubMedCrossRef
20.
go back to reference Xing P, Li JG, Jin F, Zhao TT, Liu Q, Dong HT, Wei XL (2013) Prognostic significance of body mass index in breast cancer patients with hormone receptor-positive tumours after curative surgery. Clini Invest Med 36(6):E297–E305 Xing P, Li JG, Jin F, Zhao TT, Liu Q, Dong HT, Wei XL (2013) Prognostic significance of body mass index in breast cancer patients with hormone receptor-positive tumours after curative surgery. Clini Invest Med 36(6):E297–E305
21.
go back to reference Ademuyiwa FO, Groman A, O’Connor T, Ambrosone C, Watroba N, Edge SB (2011) Impact of body mass index on clinical outcomes in triple-negative breast cancer. Cancer 117(18):4132–4140PubMedCrossRef Ademuyiwa FO, Groman A, O’Connor T, Ambrosone C, Watroba N, Edge SB (2011) Impact of body mass index on clinical outcomes in triple-negative breast cancer. Cancer 117(18):4132–4140PubMedCrossRef
22.
go back to reference Dawood S, Lei X, Litton JK, Buchholz TA, Hortobagyi GN, Gonzalez-Angulo AM (2012) Impact of body mass index on survival outcome among women with early stage triple-negative breast cancer. Clin Breast Cancer 12(5):364–372PubMedCrossRef Dawood S, Lei X, Litton JK, Buchholz TA, Hortobagyi GN, Gonzalez-Angulo AM (2012) Impact of body mass index on survival outcome among women with early stage triple-negative breast cancer. Clin Breast Cancer 12(5):364–372PubMedCrossRef
23.
go back to reference Mowad R, Chu QD, Li BD, Burton GV, Ampil FL, Kim RH (2013) Does obesity have an effect on outcomes in triple-negative breast cancer? J Surg Res 184(1):253–259PubMedCrossRef Mowad R, Chu QD, Li BD, Burton GV, Ampil FL, Kim RH (2013) Does obesity have an effect on outcomes in triple-negative breast cancer? J Surg Res 184(1):253–259PubMedCrossRef
24.
go back to reference Pajares B, Pollán M, Martín M, Mackey JR, Lluch A, Gavila J, Vogel C, Ruiz-Borrego M, Calvo L, Pienkowski T et al (2013) Obesity and survival in operable breast cancer patients treated with adjuvant anthracyclines and taxanes according to pathological subtypes: a pooled analysis. Breast Cancer Res 15(6):R105PubMedCentralPubMedCrossRef Pajares B, Pollán M, Martín M, Mackey JR, Lluch A, Gavila J, Vogel C, Ruiz-Borrego M, Calvo L, Pienkowski T et al (2013) Obesity and survival in operable breast cancer patients treated with adjuvant anthracyclines and taxanes according to pathological subtypes: a pooled analysis. Breast Cancer Res 15(6):R105PubMedCentralPubMedCrossRef
25.
go back to reference Sparano JA, Wang M, Zhao F, Stearns V, Martino S, Ligibel JA, Perez EA, Saphner T, Wolff AC, Sledge GW Jr et al (2012) Obesity at diagnosis is associated with inferior outcomes in hormone receptor-positive operable breast cancer. Cancer 118(23):5937–5946PubMedCentralPubMedCrossRef Sparano JA, Wang M, Zhao F, Stearns V, Martino S, Ligibel JA, Perez EA, Saphner T, Wolff AC, Sledge GW Jr et al (2012) Obesity at diagnosis is associated with inferior outcomes in hormone receptor-positive operable breast cancer. Cancer 118(23):5937–5946PubMedCentralPubMedCrossRef
26.
go back to reference Turkoz FP, Solak M, Petekkaya I, Keskin O, Kertmen N, Sarici F, Arik Z, Babacan T, Ozisik Y, Altundag K (2013) The prognostic impact of obesity on molecular subtypes of breast cancer in premenopausal women. J BUON 18(2):335–341PubMed Turkoz FP, Solak M, Petekkaya I, Keskin O, Kertmen N, Sarici F, Arik Z, Babacan T, Ozisik Y, Altundag K (2013) The prognostic impact of obesity on molecular subtypes of breast cancer in premenopausal women. J BUON 18(2):335–341PubMed
27.
go back to reference De Bruijn KM, Arends LR, Hansen BE, Leeflang S, Ruiter R, van Eijck CH (2013) Systematic review and meta-analysis of the association between diabetes mellitus and incidence and mortality in breast and colorectal cancer. Br J Surg 100(11):1421–1429PubMedCrossRef De Bruijn KM, Arends LR, Hansen BE, Leeflang S, Ruiter R, van Eijck CH (2013) Systematic review and meta-analysis of the association between diabetes mellitus and incidence and mortality in breast and colorectal cancer. Br J Surg 100(11):1421–1429PubMedCrossRef
28.
go back to reference Gold HT, Makarem N, Nicholson JM, Parekh N (2014) Treatment and outcomes in diabetic breast cancer patients. Breast Cancer Res Treat 143(3):551–570PubMedCrossRef Gold HT, Makarem N, Nicholson JM, Parekh N (2014) Treatment and outcomes in diabetic breast cancer patients. Breast Cancer Res Treat 143(3):551–570PubMedCrossRef
29.
go back to reference Peairs KS, Barone BB, Snyder CF, Yeh HC, Stein KB, Derr RL, Brancati FL, Wolff AC (2011) Diabetes mellitus and breast cancer outcomes: a systematic review and meta-analysis. J Clin Oncol 29(1):40–46PubMedCentralPubMed Peairs KS, Barone BB, Snyder CF, Yeh HC, Stein KB, Derr RL, Brancati FL, Wolff AC (2011) Diabetes mellitus and breast cancer outcomes: a systematic review and meta-analysis. J Clin Oncol 29(1):40–46PubMedCentralPubMed
30.
go back to reference Bayraktar S, Hernadez-Aya LF, Lei X, Meric-Bernstam F, Litton JK, Hsu L, Hortobagyi GN, Gonzalez-Angulo AM (2012) Effect of metformin on survival outcomes in diabetic patients with triple receptor-negative breast cancer. Cancer 118(5):1202–1211PubMedCentralPubMedCrossRef Bayraktar S, Hernadez-Aya LF, Lei X, Meric-Bernstam F, Litton JK, Hsu L, Hortobagyi GN, Gonzalez-Angulo AM (2012) Effect of metformin on survival outcomes in diabetic patients with triple receptor-negative breast cancer. Cancer 118(5):1202–1211PubMedCentralPubMedCrossRef
31.
go back to reference Bartucci M, Morelli C, Mauro L, Andò S, Surmacz E (2001) Differential insulin-like growth factor I receptor signaling and function in estrogen receptor (ER)-positive MCF-7 and ER-negative MDA-MB-231 breast cancer cells. Cancer Res 61(18):6747–6754PubMed Bartucci M, Morelli C, Mauro L, Andò S, Surmacz E (2001) Differential insulin-like growth factor I receptor signaling and function in estrogen receptor (ER)-positive MCF-7 and ER-negative MDA-MB-231 breast cancer cells. Cancer Res 61(18):6747–6754PubMed
32.
go back to reference Hartog H, Horlings HM, van der Vegt B, Kreike B, Ajouaou A, van de Vijver MJ, Marike Boezen H, de Bock GH, van der Graaf WT, Wesseling J (2011) Divergent effects of insulin-like growth factor-1 receptor expression on prognosis of estrogen receptor positive versus triple negative invasive ductal breast carcinoma. Breast Cancer Res Treat 129(3):725–736PubMedCrossRef Hartog H, Horlings HM, van der Vegt B, Kreike B, Ajouaou A, van de Vijver MJ, Marike Boezen H, de Bock GH, van der Graaf WT, Wesseling J (2011) Divergent effects of insulin-like growth factor-1 receptor expression on prognosis of estrogen receptor positive versus triple negative invasive ductal breast carcinoma. Breast Cancer Res Treat 129(3):725–736PubMedCrossRef
33.
go back to reference Law JH, Habibi G, Hu K, Masoudi H, Wang MY, Stratford AL, Park E, Gee JM, Finlay P, Jones HE et al (2008) Phosphorylated insulin-like growth factor-i/insulin receptor is present in all breast cancer subtypes and is related to poor survival. Cancer Res 68(24):10238–10246PubMedCrossRef Law JH, Habibi G, Hu K, Masoudi H, Wang MY, Stratford AL, Park E, Gee JM, Finlay P, Jones HE et al (2008) Phosphorylated insulin-like growth factor-i/insulin receptor is present in all breast cancer subtypes and is related to poor survival. Cancer Res 68(24):10238–10246PubMedCrossRef
34.
go back to reference Litzenburger BC, Creighton CJ, Tsimelzon A, Chan BT, Hilsenbeck SG, Wang T, Carboni JM, Gottardis MM, Huang F, Chang JC et al (2011) High IGF-IR activity in triple-negative breast cancer cell lines and tumorgrafts correlates with sensitivity to anti-IGF-IR therapy. Clin Cancer Res 17(8):2314–2327PubMedCentralPubMedCrossRef Litzenburger BC, Creighton CJ, Tsimelzon A, Chan BT, Hilsenbeck SG, Wang T, Carboni JM, Gottardis MM, Huang F, Chang JC et al (2011) High IGF-IR activity in triple-negative breast cancer cell lines and tumorgrafts correlates with sensitivity to anti-IGF-IR therapy. Clin Cancer Res 17(8):2314–2327PubMedCentralPubMedCrossRef
35.
go back to reference Peiró G, Adrover E, Sánchez-Tejada L, Lerma E, Planelles M, Sánchez-Payá J, Aranda FI, Giner D, Gutiérrez-Aviñó FJ (2011) Increased insulin-like growth factor-1 receptor mRNA expression predicts poor survival in immunophenotypes of early breast carcinoma. Mod Pathol 24(2):201–208PubMedCrossRef Peiró G, Adrover E, Sánchez-Tejada L, Lerma E, Planelles M, Sánchez-Payá J, Aranda FI, Giner D, Gutiérrez-Aviñó FJ (2011) Increased insulin-like growth factor-1 receptor mRNA expression predicts poor survival in immunophenotypes of early breast carcinoma. Mod Pathol 24(2):201–208PubMedCrossRef
Metadata
Title
Body mass index, diabetes, and triple-negative breast cancer prognosis
Authors
Sarah Tait
Jose M. Pacheco
Feng Gao
Caroline Bumb
Matthew James Ellis
Cynthia X. Ma
Publication date
01-07-2014
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2014
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-014-3002-y

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