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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 1/2018

01-01-2018 | Epidemiology

Obesity and survival in the neoadjuvant breast cancer setting: role of tumor subtype in an ethnically diverse population

Authors: Ying L. Liu, Anurag Saraf, Benjamin Catanese, Shing M. Lee, Yuan Zhang, Eileen P. Connolly, Kevin Kalinsky

Published in: Breast Cancer Research and Treatment | Issue 1/2018

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Abstract

Background

Obesity may negatively affect survival in breast cancer (BC), but studies are conflicting, and associations may vary by tumor subtypes and race/ethnicity groups.

Methods

In a retrospective review, we identified 273 women with invasive BC administered Adriamycin/Taxane-based neoadjuvant chemotherapy from 2004 to 2016 with body mass index (BMI) data at diagnosis. Obesity was defined as BMI ≥30. Associations between obesity and event-free survival (EFS), using STEEP events, and overall survival (OS), using all-cause mortality, were assessed overall and stratified by tumor subtype [[Hormone Receptor Positive (HR+)/HER2−, HER2+, and Triple-Negative Breast Cancer (TNBC])] in our diverse population.

Results

Median follow-up was 32.6 months (range 5.7–137.8 months). Overall, obesity was associated with worse EFS (HR 1.71, 95% CI 1.03–2.84, p = 0.04) and a trend towards worse OS (p = 0.13). In HR+/HER2− disease (n = 135), there was an interaction between obesity and hormonal therapy with respect to OS but not EFS. In those receiving tamoxifen (n = 33), obesity was associated with worse OS (HR 9.27, 95% CI 0.96–89.3, p = 0.05). In those receiving an aromatase inhibitor (n = 89), there was no association between obesity and OS. In TNBC (n = 44), obesity was associated with worse EFS (HR 2.62, 95% CI 1.03–6.66, p = 0.04) and a trend towards worse OS (p = 0.06). In HER2+ disease (n = 94), obesity was associated with a trend towards worse EFS (HR 3.37, 95% CI 0.97–11.72, p = 0.06) but not OS. Race/ethnicity was not associated with survival in any subtype, and there were no interactions with obesity on survival.

Conclusions

Obesity may negatively impact survival, with differences among tumor subtypes.
Appendix
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Liu YL, Saraf A, Catanese B et al (2017) Obesity and survival in the neoadjuvant breast cancer setting: role of tumor subtype in an ethnically diverse population. Breast Cancer Res Treat. doi:10.​1007/​s10549-017-4507-y
Metadata
Title
Obesity and survival in the neoadjuvant breast cancer setting: role of tumor subtype in an ethnically diverse population
Authors
Ying L. Liu
Anurag Saraf
Benjamin Catanese
Shing M. Lee
Yuan Zhang
Eileen P. Connolly
Kevin Kalinsky
Publication date
01-01-2018
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2018
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-017-4507-y

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