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Open Access 01-07-2020 | Breast Cancer | Clinical trial

Metabolic syndrome and early stage breast cancer outcome: results from a prospective observational study

Authors: Giuseppe Buono, Anna Crispo, Mario Giuliano, Carmine De Angelis, Francesco Schettini, Valeria Forestieri, Rossella Lauria, Michelino De Laurentiis, Pietro De Placido, Carmen Giusy Rea, Carmen Pacilio, Emanuela Esposito, Maria Grimaldi, Flavia Nocerino, Giuseppe Porciello, Aldo Giudice, Alfonso Amore, Anita Minopoli, Gerardo Botti, Sabino De Placido, Meghana V. Trivedi, Grazia Arpino

Published in: Breast Cancer Research and Treatment | Issue 2/2020

Abstract

Purpose

Obesity and insulin resistance have been associated with poor prognosis in breast cancer (BC). The present prospective study aimed to investigate the impact of metabolic syndrome (MetS) and its components on early BC (eBC) patients’ outcome.

Methods

MetS was defined by the presence of 3 to 5 of the following components: waist circumference > 88 cm, blood pressure ≥ 130/≥ 85 mmHg, serum levels of triglycerides ≥ 150 mg/dL, high density lipoprotein < 50 mg/dL and fasting glucose ≥ 110 mg/dL. Seven hundred and seventeen patients with data on ≥ 4 MetS components at BC diagnosis were enrolled. Study population was divided into two groups: patients with < 3 (non-MetS) vs. ≥ 3 components (MetS). Categorical variables were analyzed by Chi-square test and survival data by log-rank test and Cox proportional hazards regression model.

Results

Overall, 544 (75.9%) and 173 (24.1%) women were categorized as non-MetS and MetS, respectively. MetS patients were more likely to be older, postmenopausal, and insulin-resistant compared to non-MetS patients (p < 0.05). In multivariate analysis, MetS patients had a numerically higher risk of relapse [disease-free survival (DFS), hazard ratio (HR) 1.51, p = 0.07] and a significantly higher risk of death compared to non-MetS patients [overall survival (OS), HR 3.01, p < 0.0001; breast cancer-specific survival (BCSS), HR 3.16, p = 0.001]. Additionally, patients with 1 to 2 components of MetS had an increased risk of dying compared to patients with 0 components (OS, HR 4.90, p = 0.01; BCSS, HR 6.07, p = 0.02).

Conclusions

MetS correlated with poor outcome in eBC patients. Among patients without full criteria for MetS diagnosis, the presence of 1 or 2 components of the syndrome may predict for worse survival.

https://gco.iarc.fr/today/data/factsheets/cancers/20-Breast-fact-sheet.pdf

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Title: Metabolic syndrome and early stage breast cancer outcome: results from a prospective observational study
Authors: Giuseppe Buono
Anna Crispo
Mario Giuliano
Carmine De Angelis
Francesco Schettini
Valeria Forestieri
Rossella Lauria
Michelino De Laurentiis
Pietro De Placido
Carmen Giusy Rea
Carmen Pacilio
Emanuela Esposito
Maria Grimaldi
Flavia Nocerino
Giuseppe Porciello
Aldo Giudice
Alfonso Amore
Anita Minopoli
Gerardo Botti
Sabino De Placido
Meghana V. Trivedi
Grazia Arpino
Publication date: 01-07-2020
Publisher: Springer US
Keywords: Breast Cancer
Breast Cancer
Published in: Breast Cancer Research and Treatment / Issue 2/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-020-05701-7

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