Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2023

Open Access 01-12-2023 | Dyslipidemia | Research

Dyslipidemia is associated with a poor prognosis of breast cancer in patients receiving neoadjuvant chemotherapy

Authors: Youzhao Ma, Minhao Lv, Peng Yuan, Xiuchun Chen, Zhenzhen Liu

Published in: BMC Cancer | Issue 1/2023

Login to get access

Abstract

Background

Lipid metabolism disorders may be involved in the occurrence and development of breast cancer. This study aimed to investigate the serum lipid changes during neoadjuvant chemotherapy for breast cancer and the effect of dyslipidemia on the prognosis of breast cancer patients.

Methods

We collected the data from 312 breast cancer patients who underwent surgery after receiving standard neoadjuvant therapy. χ2 test and T-test were employed to analyze the effect of chemotherapy on the serum lipid metabolism of patients. The effects of dyslipidemia on the disease-free survival (DFS) of patients with breast cancer were analyzed by χ2 test and COX regression analysis.

Results

A total of 56 out of 312 patients (17.9%) suffered from relapse. The baseline serum lipid level of the patients was significantly correlated with their age and body mass index (BMI) (p < 0.05). Chemotherapy increased the levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol, but decreased the level of high-density lipoprotein cholesterol (p < 0.001). Preoperative dyslipidemia was significantly associated with the axillary pCR rate (p < 0.05). COX regression analysis revealed that the full-course serum lipid level (HR = 1.896 [95%CI 1.069–3.360]; p = 0.029), N stage (HR = 4.416 [95%CI 2.348–8.308]; p < 0.001) and the total pCR rate (HR = 4.319 [95%CI 1.029–18.135]; p = 0.046) acted as prognostic factors affecting DFS in breast cancer. The relapse rate in patients with a high level of total cholesterol was higher than that in patients with a high level of triglycerides (61.9% vs 30.0%; p < 0.05).

Conclusions

Dyslipidemia deteriorated after chemotherapy. The full-course serum lipid level may thus serve as a blood marker for predicting breast cancer prognosis. Serum lipids should therefore be closely monitored in breast cancer patients throughout the treatment course, and patients with dyslipidemia should be treated in a timely manner.
Literature
1.
Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66(2):115–32.CrossRefPubMed
2.
Abdel-Qadir H, Austin PC, Lee DS, Amir E, Tu JV, Thavendiranathan P, Fung K, Anderson GM. A Population-Based Study of Cardiovascular Mortality Following Early-Stage Breast Cancer. JAMA Cardiol. 2017;2(1):88–93.CrossRefPubMed
3.
Xu J, Qiu X, Li Y, Sun N, Zhang Y, Shu J. Hyperlipoproteinemia (a) is associated with breast cancer in a Han Chinese population. Medicine (Baltimore). 2020;99(38):e22037.CrossRefPubMed
4.
Chowdhury FA, Islam MF, Prova MT, Khatun M, Sharmin I, Islam KM, Hassan MK, Khan MAS, Rahman MM. Association of hyperlipidemia with breast cancer in Bangladeshi women. Lipids Health Dis. 2021;20(1):52.CrossRefPubMedPubMedCentral
5.
6.
Nelson ER, Wardell SE, Jasper JS, Park S, Suchindran S, Howe MK, Carver NJ, Pillai RV, Sullivan PM, Sondhi V, et al. 27-Hydroxycholesterol links hypercholesterolemia and breast cancer pathophysiology. Science. 2013;342(6162):1094–8.CrossRefPubMedPubMedCentral
7.
Rodrigues Dos Santos C, Fonseca I, Dias S, Mendes de Almeida JC. Plasma level of LDL-cholesterol at diagnosis is a predictor factor of breast tumor progression. BMC Cancer. 2014;14:132.CrossRefPubMedPubMedCentral
8.
Lu Y, Wang P, Lan N, Kong F, Abdumijit A, Tu S, Li Y, Yuan W. Metabolic Syndrome Predicts Response to Neoadjuvant Chemotherapy in Breast Cancer. Front Oncol. 2022;12:899335.CrossRefPubMedPubMedCentral
9.
Jung SM, Kang D, Guallar E, Yu J, Lee JE, Kim SW, Nam SJ, Cho J, Lee SK. Impact of Serum Lipid on Breast Cancer Recurrence. J Clin Med. 2020;9(9):2846.CrossRefPubMedPubMedCentral
10.
Goto W, Kashiwagi S, Takada K, Asano Y, Ogisawa K, Morisaki T, Shibutani M, Tanaka H, Maeda K. Clinical verification of the relationship between serum lipid metabolism and immune activity in breast cancer patients treated with neoadjuvant chemotherapy. Eur J Med Res. 2023;28(1):2.CrossRefPubMedPubMedCentral
11.
He T, Wang C, Tan Q, Wang Z, Li J, Chen T, Cui K, Wu Y, Sun J, Zheng D, et al. Adjuvant chemotherapy-associated lipid changes in breast cancer patients: A real-word retrospective analysis. Medicine (Baltimore). 2020;99(33):e21498.CrossRefPubMed
12.
Li X, Liu ZL, Wu YT, Wu H, Dai W, Arshad B, Xu Z, Li H, Wu KN, Kong LQ. Status of lipid and lipoprotein in female breast cancer patients at initial diagnosis and during chemotherapy. Lipids Health Dis. 2018;17(1):91.CrossRefPubMedPubMedCentral
13.
Dieli-Conwright CM, Wong L, Waliany S, Mortimer JE. Metabolic syndrome and breast cancer survivors: a follow-up analysis after completion of chemotherapy. Diabetol Metab Syndr. 2022;14(1):36.CrossRefPubMedPubMedCentral
14.
Zhou Z, Zhang Y, Li Y, Jiang C, Wu Y, Shang L, Huang Y, Cheng S. Metabolic syndrome is a risk factor for breast cancer patients receiving neoadjuvant chemotherapy: A case-control study. Front Oncol. 2022;12:1080054.CrossRefPubMed
15.
Lu Q, Wu X, Zhu Y, Yang J, Wang X, Ye C, Cai R, Zhang K, Xu T, Wang B, et al. Effects of Chemotherapy on Serum Lipids in Chinese Postoperative Breast Cancer Patients. Cancer Manag Res. 2020;12:8397–408.CrossRefPubMedPubMedCentral
16.
Joint committee issued Chinese guideline for the management of dyslipidemia in adults: [2016 Chinese guideline for the management of dyslipidemia in adults]. Zhonghua Xin Xue Guan Bing Za Zhi. 2016;44(10):833–53.
17.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.CrossRefPubMed
18.
Kalabova H, Melichar B, Ungermann L, Dolezal J, Krcmova L, Kasparova M, Plisek J, Hyspler R, Pecka M, Solichova D. Intima-media thickness, myocardial perfusion and laboratory risk factors of atherosclerosis in patients with breast cancer treated with anthracycline-based chemotherapy. Med Oncol. 2011;28(4):1281–7.CrossRefPubMed
19.
Panis C, Binato R, Correa S, Victorino VJ, Dias-Alves V, Herrera A, Cecchini R, Simao ANC, Barbosa DS, Pizzatti L, et al. Short infusion of paclitaxel imbalances plasmatic lipid metabolism and correlates with cardiac markers of acute damage in patients with breast cancer. Cancer Chemother Pharmacol. 2017;80(3):469–78.CrossRefPubMed
20.
Yeo W, Mo FKF, Pang E, Suen JJS, Koh J, Loong HHF, Yip CCH, Ng RYW, Yip CHW, Tang NLS, et al. Profiles of lipids, blood pressure and weight changes among premenopausal Chinese breast cancer patients after adjuvant chemotherapy. BMC Womens Health. 2017;17(1):55.CrossRefPubMedPubMedCentral
21.
22.
dos Santos CR, Domingues G, Matias I, Matos J, Fonseca I, de Almeida JM, Dias S. LDL-cholesterol signaling induces breast cancer proliferation and invasion. Lipids Health Dis. 2014;13:16.CrossRefPubMed
23.
Llaverias G, Danilo C, Mercier I, Daumer K, Capozza F, Williams TM, Sotgia F, Lisanti MP, Frank PG. Role of cholesterol in the development and progression of breast cancer. Am J Pathol. 2011;178(1):402–12.CrossRefPubMedPubMedCentral
24.
Van Wyhe RD, Rahal OM, Woodward WA. Effect of statins on breast cancer recurrence and mortality: a review. Breast Cancer (Dove Med Press). 2017;9:559–65.PubMed
25.
Marti JLG, Beckwitt CH, Clark AM, Wells A. Atorvastatin facilitates chemotherapy effects in metastatic triple-negative breast cancer. Br J Cancer. 2021;125(9):1285–98.CrossRefPubMedPubMedCentral
26.
Kwan ML, Habel LA, Flick ED, Quesenberry CP, Caan B. Post-diagnosis statin use and breast cancer recurrence in a prospective cohort study of early stage breast cancer survivors. Breast Cancer Res Treat. 2008;109(3):573–9.CrossRefPubMed
27.
Lim YP, Lin CL, Lin YN, Ma WC, Hung DZ, Kao CH. Tamoxifen Treatment and the Reduced Risk of Hyperlipidemia in Asian Patients With Breast Cancer: A Population-Based Cohort Study. Clin Breast Cancer. 2015;15(4):294–300.CrossRefPubMed
28.
Gaibar M, Fernandez G, Romero-Lorca A, Novillo A, Tejerina A, Bandres F, Fernandez-Santander A. Tamoxifen therapy in breast cancer: do apolipoprotein E genotype and menopausal state affect plasma lipid changes induced by the drug? Int J Biol Markers. 2013;28(4):e371-376.CrossRefPubMed
29.
Aristarco V, Serrano D, Gandini S, Johansson H, Macis D, Guerrieri-Gonzaga A, Lazzeroni M, Feroce I, Pruneri G, Pagani G, et al. A Randomized, Placebo-Controlled, Phase II, Presurgical Biomarker Trial of Celecoxib Versus Exemestane in Postmenopausal Breast Cancer Patients. Cancer Prev Res (Phila). 2016;9(5):349–56.CrossRefPubMed
30.
Bell LN, Nguyen AT, Li L, Desta Z, Henry NL, Hayes DF, Wolff AC, Stearns V, Storniolo AM, Flockhart DA, et al. Comparison of changes in the lipid profile of postmenopausal women with early stage breast cancer treated with exemestane or letrozole. J Clin Pharmacol. 2012;52(12):1852–60.CrossRefPubMed
Metadata
Title
Dyslipidemia is associated with a poor prognosis of breast cancer in patients receiving neoadjuvant chemotherapy
Authors
Youzhao Ma
Minhao Lv
Peng Yuan
Xiuchun Chen
Zhenzhen Liu
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-023-10683-y

Other articles of this Issue 1/2023

BMC Cancer 1/2023 Go to the issue

Research

Cost-effectiveness analysis of pembrolizumab in combination with chemotherapy compared with chemotherapy alone as first-line treatment for patients with advanced biliary tract cancer in China

Research

Risk of venous thromboembolism in patients undergoing gastric cancer surgery: a systematic review and meta-analysis

Research

Peripheral immune cell profiling of double-hit lymphoma by mass cytometry

Research

Application of the CDK9 inhibitor FIT-039 for the treatment of KSHV-associated malignancy

Research

Clinical perspectives and outcomes of the giant breast phyllodes tumor and sarcoma: a real-world retrospective study

Research

PSMD1 as a prognostic marker and potential target in oropharyngeal cancer
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits