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Breast Cancer Research
Published in: Breast Cancer Research 6/2013

Open Access 01-12-2013 | Research article

Obesity and survival in operable breast cancer patients treated with adjuvant anthracyclines and taxanes according to pathological subtypes: a pooled analysis

Authors: Bella Pajares, Marina Pollán, Miguel Martín, John R Mackey, Ana Lluch, Joaquín Gavila, Charles Vogel, Manuel Ruiz-Borrego, Lourdes Calvo, Tadeusz Pienkowski, Álvaro Rodríguez-Lescure, Miguel Angel Seguí, Olivier Tredan, Antonio Antón, Manuel Ramos, María del Carmen Cámara, César Rodríguez-Martín, Eva Carrasco, Emilio Alba

Published in: Breast Cancer Research | Issue 6/2013

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Abstract

Introduction

Obesity is an unfavorable prognostic factor in breast cancer (BC) patients regardless of menopausal status and treatment received. However, the association between obesity and survival outcome by pathological subtype requires further clarification.

Methods

We performed a retrospective analysis including 5,683 operable BC patients enrolled in four randomized clinical trials (GEICAM/9906, GEICAM/9805, GEICAM/2003–02, and BCIRG 001) evaluating anthracyclines and taxanes as adjuvant treatments. Our primary aim was to assess the prognostic effect of body mass index (BMI) on disease recurrence, breast cancer mortality (BCM), and overall mortality (OM). A secondary aim was to detect differences of such prognostic effects by subtype.

Results

Multivariate survival analyses adjusting for age, tumor size, nodal status, menopausal status, surgery type, histological grade, hormone receptor status, human epidermal growth factor receptor 2 (HER2) status, chemotherapy regimen, and under-treatment showed that obese patients (BMI 30.0 to 34.9) had similar prognoses to that of patients with a BMI < 25 (reference group) in terms of recurrence (Hazard Ratio [HR] = 1.08, 95% Confidence Interval [CI] = 0.90 to 1.30), BCM (HR = 1.02, 0.81 to 1.29), and OM (HR = 0.97, 0.78 to 1.19). Patients with severe obesity (BMI ≥ 35) had a significantly increased risk of recurrence (HR = 1.26, 1.00 to 1.59, P = 0.048), BCM (HR = 1.32, 1.00 to 1.74, P = 0.050), and OM (HR = 1.35, 1.06 to 1.71, P = 0.016) compared to our reference group. The prognostic effect of severe obesity did not vary by subtype.

Conclusions

Severely obese patients treated with anthracyclines and taxanes present a worse prognosis regarding recurrence, BCM, and OM than patients with BMI < 25. The magnitude of the harmful effect of BMI on survival-related outcomes was similar across subtypes.
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Metadata
Title
Obesity and survival in operable breast cancer patients treated with adjuvant anthracyclines and taxanes according to pathological subtypes: a pooled analysis
Authors
Bella Pajares
Marina Pollán
Miguel Martín
John R Mackey
Ana Lluch
Joaquín Gavila
Charles Vogel
Manuel Ruiz-Borrego
Lourdes Calvo
Tadeusz Pienkowski
Álvaro Rodríguez-Lescure
Miguel Angel Seguí
Olivier Tredan
Antonio Antón
Manuel Ramos
María del Carmen Cámara
César Rodríguez-Martín
Eva Carrasco
Emilio Alba
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Breast Cancer Research / Issue 6/2013
Electronic ISSN: 1465-542X
DOI
https://doi.org/10.1186/bcr3572

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