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Gohar L, Riaz B, Nadeem MS, Abbas S, Afsar T, Razak S, Muccee F, Husain FM, Shafique H. Body mass index and altered lipid profile as major risk markers for breast cancer progression: a cross-sectional study of postmenopausal women in Pakistan. BMC Womens Health 2024; 24:90. [PMID: 38311739 PMCID: PMC10840221 DOI: 10.1186/s12905-024-02929-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 01/25/2024] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND In Pakistan, the death rate for post-menopausal women with breast cancer is significant due to late detection and delayed referral to proper facilities. There are a few reports on Pakistan's epidemiology and breast cancer risk factors. There are modifiable and non-modifiable risk factors associated with the development of breast carcinoma; of which body mass index (BMI), central obesity, and lipid profile are considered as major risk markers. METHODS This was a cross-sectional analytical study. A total of 384 women constituted the present study sample. Purposive sampling was used to collect 192 confirmed new breast cancer cases throughout the study. By using basic random sampling, an equal number of controls were chosen. Studied parameters included age, fasting blood sugar, cholesterol, triglyceride, serum high-density lipoprotein, cholesterol, serum low-density lipoprotein cholesterol, weight, height, BMI, waist circumference, and waist-to-hip ratio. The inclusion criteria of this study were post-menopausal women (45-65 years) in Pakistan. The confirmation of breast carcinoma was done through histopathology. Breast cancer occurrence was taken as a dependent variable, whereas BMI, central obesity, and lipid profile were taken as independent variables. RESULTS Studied risk factors (cholesterol, BMI, and central obesity) significantly correlated with breast cancer. Cholesterol has a significantly high positive correlation (0.646) with breast cancer. BMI has a positive significant correlation (0.491) with breast cancer, and central obesity has a low but positive significant correlation (0.266) with breast cancer. Moreover, the binary logistic regression model also showed a significant association between biochemical factors and breast cancer occurrence. Regression analysis depicted a linear relationship between a dependent variable (breast cancer occurrence) and independent variables (central obesity, cholesterol, BMI). CONCLUSION Postmenopausal overweight (central obesity), increased BMI and high cholesterol levels are major risk factors for breast cancer. Moreover, high total cholesterol proved to be the most significant risk marker for the occurrence of breast cancer in post-menopausal women of Pakistan.
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Affiliation(s)
- Lubna Gohar
- Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Bushra Riaz
- Department of Physiology, Pakistan International Medical College, Peshawar, Pakistan
| | - Muhammad Sohaib Nadeem
- Department of Clinical and Radiation Oncology, Combined Military Hospital, Rawalpindi, Pakistan
| | - Seyyedha Abbas
- Department of Biochemistry, National University of Science and Technology, Islamabad, Pakistan
| | - Tayyaba Afsar
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Suhail Razak
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Fatima Muccee
- School of biochemistry and Biotechnology (SBB), University of Punjab, Lahore, Pakistan
| | - Fohad Mabood Husain
- Department of Food Science and Nutrition, College of Food and Agriculture Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Huma Shafique
- Institute of Cellular Medicine, Newcastle University Medical School, Newcastle University, Upon Tyne, UK
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Chan DS, Vieira R, Abar L, Aune D, Balducci K, Cariolou M, Greenwood DC, Markozannes G, Nanu N, Becerra‐Tomás N, Giovannucci EL, Gunter MJ, Jackson AA, Kampman E, Lund V, Allen K, Brockton NT, Croker H, Katsikioti D, McGinley‐Gieser D, Mitrou P, Wiseman M, Cross AJ, Riboli E, Clinton SK, McTiernan A, Norat T, Tsilidis KK. Postdiagnosis body fatness, weight change and breast cancer prognosis: Global Cancer Update Program (CUP global) systematic literature review and meta-analysis. Int J Cancer 2023; 152:572-599. [PMID: 36279884 PMCID: PMC10092239 DOI: 10.1002/ijc.34322] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 07/29/2022] [Accepted: 09/05/2022] [Indexed: 02/01/2023]
Abstract
Previous evidence on postdiagnosis body fatness and mortality after breast cancer was graded as limited-suggestive. To evaluate the evidence on body mass index (BMI), waist circumference, waist-hip-ratio and weight change in relation to breast cancer prognosis, an updated systematic review was conducted. PubMed and Embase were searched for relevant studies published up to 31 October, 2021. Random-effects meta-analyses were conducted to estimate summary relative risks (RRs). The evidence was judged by an independent Expert Panel using pre-defined grading criteria. One randomized controlled trial and 225 observational studies were reviewed (220 publications). There was strong evidence (likelihood of causality: probable) that higher postdiagnosis BMI was associated with increased all-cause mortality (64 studies, 32 507 deaths), breast cancer-specific mortality (39 studies, 14 106 deaths) and second primary breast cancer (11 studies, 5248 events). The respective summary RRs and 95% confidence intervals per 5 kg/m2 BMI were 1.07 (1.05-1.10), 1.10 (1.06-1.14) and 1.14 (1.04-1.26), with high between-study heterogeneity (I2 = 56%, 60%, 66%), but generally consistent positive associations. Positive associations were also observed for waist circumference, waist-hip-ratio and all-cause and breast cancer-specific mortality. There was limited-suggestive evidence that postdiagnosis BMI was associated with higher risk of recurrence, nonbreast cancer deaths and cardiovascular deaths. The evidence for postdiagnosis (unexplained) weight or BMI change and all outcomes was graded as limited-no conclusion. The RCT showed potential beneficial effect of intentional weight loss on disease-free-survival, but more intervention trials and well-designed observational studies in diverse populations are needed to elucidate the impact of body composition and their changes on breast cancer outcomes.
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Affiliation(s)
- Doris S.M. Chan
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Rita Vieira
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Leila Abar
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Dagfinn Aune
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- Department of NutritionBjørknes University CollegeOsloNorway
- Department of Endocrinology, Morbid Obesity and Preventive MedicineOslo University HospitalOsloNorway
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska InstitutetStockholmSweden
| | - Katia Balducci
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Margarita Cariolou
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Darren C. Greenwood
- Leeds Institute for Data Analytics, Faculty of Medicine and HealthUniversity of LeedsLeedsUK
| | - Georgios Markozannes
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- Department of Hygiene and EpidemiologyUniversity of Ioannina Medical SchoolIoanninaGreece
| | - Neesha Nanu
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Nerea Becerra‐Tomás
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Edward L. Giovannucci
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
- Department of Nutrition, Harvard T. H. Chan School of Public HealthBostonMassachusettsUSA
| | - Marc J. Gunter
- Nutrition and Metabolism Section, International Agency for Research on CancerLyonFrance
| | - Alan A. Jackson
- Faculty of Medicine, School of Human Development and HealthUniversity of SouthamptonSouthamptonUK
- National Institute of Health Research Cancer and Nutrition CollaborationSouthamptonUK
| | - Ellen Kampman
- Division of Human Nutrition and HealthWageningen University & ResearchWageningenThe Netherlands
| | - Vivien Lund
- World Cancer Research Fund InternationalLondonUK
| | - Kate Allen
- World Cancer Research Fund InternationalLondonUK
| | | | - Helen Croker
- World Cancer Research Fund InternationalLondonUK
| | | | | | | | | | - Amanda J. Cross
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Elio Riboli
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Steven K. Clinton
- Division of Medical Oncology, The Department of Internal MedicineCollege of Medicine and Ohio State University Comprehensive Cancer Center, Ohio State UniversityColumbusOhioUSA
| | - Anne McTiernan
- Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleWashingtonUSA
| | - Teresa Norat
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- World Cancer Research Fund InternationalLondonUK
| | - Konstantinos K. Tsilidis
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- Department of Hygiene and EpidemiologyUniversity of Ioannina Medical SchoolIoanninaGreece
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Pang Y, Wei Y, Kartsonaki C. Associations of adiposity and weight change with recurrence and survival in breast cancer patients: a systematic review and meta-analysis. Breast Cancer 2022; 29:575-588. [PMID: 35579841 PMCID: PMC9226105 DOI: 10.1007/s12282-022-01355-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/23/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Adiposity and weight change among patients with breast cancer are associated with mortality, but there is limited evidence on the associations with distant recurrence or other causes of death or on central adiposity. Moreover, the relationship with breast cancer subtypes and by menopause status is unclear. METHODS We conducted a systematic review and meta-analysis of prospective studies of breast cancer patients investigating the associations of general and central adiposity (body mass index [BMI] and waist circumference [WC], respectively), before and after diagnosis, and weight change, with all-cause mortality, breast cancer-specific mortality (BCSM), and recurrence. RESULTS 173 studies (519,544 patients, 60,249 deaths overall, and 25,751 breast cancer deaths) were included. For BMI < 1 year post diagnosis, compared with normal weight women, the summary relative risk (RR) for obese women was 1.21 (1.15-1.27) for all-cause mortality, 1.22 (1.13-1.32) for BCSM, 1.12 (1.06-1.18) for recurrence, and 1.19 (1.11-1.28) for distant recurrence. Obesity was associated with all-cause mortality and BCSM in patients with ER+ or HER2+ tumors, whereas no clear association was observed in patients with triple-negative tumors. Similar associations were observed by menopausal status. Stronger associations were observed in East Asians than Europeans. Central adiposity was associated with all-cause mortality, while large weight gain was associated with all-cause mortality, BCSM, and recurrence. CONCLUSION Higher adiposity is associated with all-cause mortality, BCSM, recurrence, and distant recurrence in breast cancer patients, with similar associations by menopausal status and some evidence of heterogeneity by subtypes. Weight gain is also associated with recurrence and survival among breast cancer patients.
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Affiliation(s)
- Yuanjie Pang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Beijing, 100191, China
| | - Yuxia Wei
- Institute of Environmental Medicine, Karolinska Institutet, C6 Institutet för miljömedicin, 17177, Stockholm, Sweden
| | - Christiana Kartsonaki
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Big Data Institute Building, Roosevelt Drive, Oxford, UK.
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Big Data Institute Building, Old Road Campus, Oxford, OX3 7LF, UK.
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The effect of bariatric surgery on breast cancer incidence and characteristics: A meta-analysis and systematic review. Am J Surg 2021; 222:715-722. [PMID: 33771341 DOI: 10.1016/j.amjsurg.2021.03.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/05/2021] [Accepted: 03/08/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Obesity is a major risk factor for breast cancer. This study examines whether bariatric surgery affects breast cancer incidence in women with obesity compared to BMI-matched controls. METHODS EMBASE, MEDLINE, Web of Science, and CINAHL were searched. Primary studies on female breast cancer incidence after bariatric surgery were eligible. RESULTS 11 studies were included (n = 1,106,939). The rate of cancer diagnosis was lower in the surgical group (0.54%) compared to control (0.84%; risk ratio (RR) 0.50, 95%CI 0.37-0.67, I2 = 88%). The results were robust to sensitivity analyses for patient age and study size. Bariatric surgery was associated with increased risk of stage I cancer (RR 1.23, 95%CI 1.06-1.44) and reduced risk of stage III or IV cancer (RR 0.50, 95%CI 0.28-0.88). Hormone receptor characteristics were not affected. CONCLUSIONS Bariatric surgery is associated with reduced incidence and earlier stage at diagnosis of breast cancer in women with obesity compared to BMI-matched controls.
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Wen H, Xu T, Huang Q, Zhang C, Zhang Q, Chen H. Nonpalpable breast masses: One-year ultrasound follow-up and morbidity outcomes in Shanghai. Medicine (Baltimore) 2020; 99:e23556. [PMID: 33327307 PMCID: PMC7738100 DOI: 10.1097/md.0000000000023556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Women with nonpalpable breast masses are at a high risk of developing breast cancer (BC) due to misdiagnosis during the follow-up period.A total of 40,334 women were divided into palpable and nonpalpable breast mass groups. We assessed the risk factors for cancer development in patients with nonpalpable breast masses during a 1-year follow-up period.Of the 1335 patients in the nonpalpable breast mass group, we found 50 patients of BC, of which 35 patients accepted surgery and were confirmed with biopsy at the beginning of the study. The remaining 15 (1.1%) were diagnosed with BC during follow-up, and included 10 in situ and 5 invasive carcinomas. Four of the 10 patients in the in situ subgroup, and 2 out of the 5 in the invasive subgroup were overweight (Body mass index > 24 kg/m). Nine in situ BC patients had breast-conserving surgery, 1 had a mastectomy. No patient in the in situ group received chemotherapy or radiotherapy. All 5 patients with invasive disease received 6 cycles of chemotherapy. Only 3 (20%) of the 15 patients with BC had a positive family history. We found 131 BC cases, including BC detected during screening (81) and follow-up (50). The incidence of BC was 240.2 per 100,000 inhabitants.Patients with nonpalpable breast masses require regular follow-up as they have a high risk of cancer occurrence. Regular follow-up can lead to early diagnosis and effective treatment of these early-stage BC patients.
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Affiliation(s)
- Hongmei Wen
- Department of General Practice, Zhangyan Community Healthcare Center
| | - Tao Xu
- Department of Health Check-Up Center, Jinshan Hospital, Fudan University, Shanghai, China
| | - Qinhua Huang
- Department of Health Check-Up Center, Jinshan Hospital, Fudan University, Shanghai, China
| | - Chumiao Zhang
- Department of Health Check-Up Center, Jinshan Hospital, Fudan University, Shanghai, China
| | - Qi Zhang
- Department of Health Check-Up Center, Jinshan Hospital, Fudan University, Shanghai, China
| | - Haiyan Chen
- Department of Health Check-Up Center, Jinshan Hospital, Fudan University, Shanghai, China
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Qin CX, Yang XQ, Zhan ZY. Connection between SOX7 Expression and Breast Cancer Prognosis. Med Sci Monit 2020; 26:e921510. [PMID: 32238796 PMCID: PMC7152737 DOI: 10.12659/msm.921510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background SOX7 exerts a repressing effect against tumors and imposes vital influences on malignancies. Our research discussed the importance of SOX7 in breast cancer prognoses. Material/Methods SOX7 mRNA expression in breast cancer tissues samples and matched adjacent normal controls of breast cancer patients was measured by quantitative real-time-polymerase chain reaction (qRT-PCR). The relationship of SOX7 with clinicopathological characteristics were analyzed via chi-square test. The association of SOX7 levels with clinical outcomes was evaluated adopting the Kaplan-Meier method and multivariate Cox proportional hazards regression model. Results SOX7 mRNA degree of expression exhibited a declining tendency in breast cancer tissue compared to paired bordering normal tissue specimens (P<0.001). In addition, the reduced SOX7 degree of expression had a strong correlation to larger cancer mass dimension (P=0.006) and lymph node metastasis (P=0.001). Survival analysis revealed that the overall survival (OS) time was much shorter among cases harboring low SOX7 degree of expression compared to high degree of expression (P=0.005). Moreover, SOX7 expression alone could predict OS among breast cancer patients (hazard ratio=3.956, 95% confidence interval=1.330–11.772, P=0.013). Conclusions SOX7 expression was downregulated in breast cancer tissues, and it could function as a useful prognostic marker in breast cancer.
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Affiliation(s)
- Chun-Xin Qin
- Department of Thyroid Breast Surgery, Weihai Municipal Hospital, Weihai, Shandong, China (mainland)
| | - Xiao-Qing Yang
- Department of Thyroid Breast Surgery, Weihai Municipal Hospital, Weihai, Shandong, China (mainland)
| | - Zhi-Yong Zhan
- Department of Thyroid Breast Surgery, Weihai Municipal Hospital, Weihai, Shandong, China (mainland)
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Phytosterols Inhibit Side-Chain Oxysterol Mediated Activation of LXR in Breast Cancer Cells. Int J Mol Sci 2019; 20:ijms20133241. [PMID: 31269628 PMCID: PMC6651815 DOI: 10.3390/ijms20133241] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 01/12/2023] Open
Abstract
Low fruit and vegetable consumption and high saturated fat consumption causes elevated circulating cholesterol and are breast cancer risk factors. During cholesterol metabolism, oxysterols form that bind and activate the liver X receptors (LXRs). Oxysterols halt breast cancer cell proliferation but enhance metastatic colonization, indicating tumour suppressing and promoting roles. Phytosterols and phytostanols in plants, like cholesterol in mammals, are essential components of the plasma membrane and biochemical precursors, and in human cells can alter LXR transcriptional activity. Here, a panel of breast cancer cell lines were treated with four dietary plant sterols and a stanol, alone or in combination with oxysterols. LXR activation and repression were measured by gene expression and LXR-luciferase reporter assays. Oxysterols activated LXR in all cell lines, but surprisingly phytosterols failed to modulate LXR activity. However, phytosterols significantly inhibited the ability of oxysterols to drive LXR transcription. These data support a role for phytosterols in modulating cancer cell behaviour via LXR, and therefore suggest merit in accurate dietary recordings of these molecules in cancer patients during treatment and perhaps supplementation to benefit recovery.
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Liu F, Chen F, Huang J, Yan L, Liu F, Wu J, Qiu Y, Zheng X, Zhang R, Lin L, He B. Prospective study on factors affecting the prognosis of oral cancer in a Chinese population. Oncotarget 2018; 8:4352-4359. [PMID: 28032596 PMCID: PMC5354837 DOI: 10.18632/oncotarget.13842] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 12/01/2016] [Indexed: 12/19/2022] Open
Abstract
This study was performed to identify the factors affecting prognosis of oral cancer patients. 1240 pathologically confirmed oral cancer patients were included. The sociodemographic and clinical characteristics of all patients were collected. Univariate and multivariate Cox proportional hazards models were used to assess potential prognostic factors for survival. 1240 oral cancer patients were followed up for 49235.00 person months, and the 5-year overall survival rate was 64.38%. Both univariate and multivariate Cox regression analysis indicated that Body Mass Index < 18.5 kg/m2 (vs 18.5–23.9 kg/m2), age ≥ 55 years (vs < 55 years), clinical stages of II-IV (vs stage I), and poor differentiation (vs well differentiation) were associated with worse survival of oral cancer patients. While surgery (vs non-surgery) and origin of urban area (vs rural area) were protective factors. However, no significant association was found between adjuvant therapy and survival in oral cancer patients.
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Affiliation(s)
- Fengqiong Liu
- Department of Epidemiology and Health Statistic, Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China
| | - Fa Chen
- Department of Epidemiology and Health Statistic, Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China
| | - Jiangfeng Huang
- Department of Epidemiology and Health Statistic, Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China
| | - Lingjun Yan
- Department of Epidemiology and Health Statistic, Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China
| | - Fangping Liu
- Department of Epidemiology and Health Statistic, Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China
| | - Junfeng Wu
- Department of Epidemiology and Health Statistic, Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China
| | - Yu Qiu
- Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Xiaoyan Zheng
- Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Rongzhao Zhang
- Department of Epidemiology and Health Statistic, Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China
| | - Lisong Lin
- Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Baochang He
- Department of Epidemiology and Health Statistic, Fujian Provincial Key Laboratory of Environment factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China
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[Outcomes of patients with breast cancer in function of their body mass index]. ACTA ACUST UNITED AC 2017; 45:215-223. [PMID: 28359803 DOI: 10.1016/j.gofs.2017.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 02/22/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate outcomes of patients with breast cancer in function of the body mass index (BMI). METHODS The study cohort consisted of consecutive women undergoing surgery for breast cancer in our institution between January 2009, and September 2013. Individual records of all patients were reviewed and analyzed. Patient BMI was categorized as underweight, normal, overweight and obese. RESULTS A total of 1599 patients were evaluated. Patients were followed for one to 265months with a mean of 36.4months. The number of patients in each of the BMI categories was 66, 779, 463 and 291 for underweight, normal, overweight and obese women respectively. Women with higher BMI were more frequently affected by hypertension (18, 21, 35 and 47% respectively, P<0.0001) and diabetes (3, 2, 7 and 7% respectively, P<0.0001). Obese women had more frequently an inflammatory presentation (P=0.006), larger tumour size (P=0.038) and axillary lymph node involvement (P=0.03) with much more positive lymph nodes (P=0.02). Patients had the same protocols of treatment (surgery and adjuvant treatment). There was no statistically significant difference in overall 5-years survival between groups (P=0.30). CONCLUSIONS Our study demonstrate a more aggressive clinical and histological presentation for obese women with breast cancer.
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Kim YJ, Lee E, Lee HS, Kim M, Park MS. High prevalence of breast cancer in light polluted areas in urban and rural regions of South Korea: An ecologic study on the treatment prevalence of female cancers based on National Health Insurance data. Chronobiol Int 2015; 32:657-67. [DOI: 10.3109/07420528.2015.1032413] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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