Adverse Effects of Being Underweight on Young Female Breast Cancer Patients with Lymph Node Metastases

Overview

Journal J Cancer

Specialty Oncology

Date 2020 Mar 21

PMID 32194809

Citations 7

Authors

Bo Chen

Jianguo Lai

Liping Guo

Danian Dai

Rong Chen

Guangnan Wei

Ning Liao

Affiliations

Soon will be listed here.

Abstract

: This study aimed to examine the effect of underweight in breast cancer. : We performed a retrospective analysis of 3891 female patients diagnosed with primary breast cancer (I-IV stages). Body mass index (BMI) defined by World Health Organization criteria as follow: Underweight (UW; BMI<18.5 kg/m), normal weight (NW; BMI =18.5-24.9 kg/m) and overweight or obese (OW; BMI≥25 kg/m). We performed to evaluate the association between low BMI and clinical outcome in different age (18-40 years and over 40 years) breast cancer. : In our study, about 7% patients suffer from being underweight and 25% patients suffer from being overweight. Underweight is more prominent in young age group. Although no relationship was found between the recurrence rate and being underweight (HR 1.467(95 % CI 0.940-2.291), P=0.092 for disease-free survival), multivariate regression analysis confirmed that low BMI was an independent overall survival (OS) prognostic factor in young patients (HR 1.610(95 % CI 1.028-2.523), P=0.037 for OS). Further analysis showed the prognostic significance of underweight only seen in young patients with axillary lymph node metastasis or III-IV stage patients. : Our results demonstrate the prognostic importance of low BMI in young breast cancer patients (under 40 years old) with lymph node metastases. The role of low BMI in breast cancer might depend on patients' age and clinical stage.

Citing Articles

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References

Chen B, Dai D, Tang H, Ai X, Chen X, Zhang X . Pretreatment Hematocrit Is Superior to Hemoglobin as a Prognostic Factor for Triple Negative Breast Cancer. PLoS One. 2016; 11(11):e0165133. PMC: 5112796. DOI: 10.1371/journal.pone.0165133. View

Guo L, Li N, Wang G, Su K, Li F, Yang L . [Body mass index and cancer incidence:a prospective cohort study in northern China]. Zhonghua Liu Xing Bing Xue Za Zhi. 2014; 35(3):231-6. View

Lavie C, De Schutter A, Milani R . Healthy obese versus unhealthy lean: the obesity paradox. Nat Rev Endocrinol. 2014; 11(1):55-62. DOI: 10.1038/nrendo.2014.165. View

Munsell M, Sprague B, Berry D, Chisholm G, Trentham-Dietz A . Body mass index and breast cancer risk according to postmenopausal estrogen-progestin use and hormone receptor status. Epidemiol Rev. 2013; 36:114-36. PMC: 3873844. DOI: 10.1093/epirev/mxt010. View

Robinson B, Currie M, Phillips E, Dachs G, Strother M, Morrin H . Body mass index (BMI): association with clinicopathological factors and outcome of women with newly diagnosed breast cancer in New Zealand. N Z Med J. 2017; 130(1451):46-56. View

Fontanella C, Lederer B, Gade S, Vanoppen M, Uwe Blohmer J, Costa S . Impact of body mass index on neoadjuvant treatment outcome: a pooled analysis of eight prospective neoadjuvant breast cancer trials. Breast Cancer Res Treat. 2015; 150(1):127-39. DOI: 10.1007/s10549-015-3287-5. View

Moon H, Han W, Noh D . Underweight and breast cancer recurrence and death: a report from the Korean Breast Cancer Society. J Clin Oncol. 2009; 27(35):5899-905. DOI: 10.1200/JCO.2009.22.4436. View

Flegal K, Graubard B, Williamson D, Gail M . Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005; 293(15):1861-7. DOI: 10.1001/jama.293.15.1861. View

Kawai M, Tomotaki A, Miyata H, Iwamoto T, Niikura N, Anan K . Body mass index and survival after diagnosis of invasive breast cancer: a study based on the Japanese National Clinical Database-Breast Cancer Registry. Cancer Med. 2016; 5(6):1328-40. PMC: 4924391. DOI: 10.1002/cam4.678. View

10.

Demicheli R, Retsky M, Hrushesky W, Baum M, Gukas I, Jatoi I . Racial disparities in breast cancer outcome: insights into host-tumor interactions. Cancer. 2007; 110(9):1880-8. DOI: 10.1002/cncr.22998. View

11.

Dawood S, Broglio K, Gonzalez-Angulo A, Kau S, Islam R, Hortobagyi G . Prognostic value of body mass index in locally advanced breast cancer. Clin Cancer Res. 2008; 14(6):1718-25. DOI: 10.1158/1078-0432.CCR-07-1479. View

12.

Bhaskaran K, Douglas I, Forbes H, Dos-Santos-Silva I, Leon D, Smeeth L . Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5·24 million UK adults. Lancet. 2014; 384(9945):755-65. PMC: 4151483. DOI: 10.1016/S0140-6736(14)60892-8. View

13.

Mamun A, Finlay J . Shifting of undernutrition to overnutrition and its determinants among women of reproductive ages in the 36 low to medium income countries. Obes Res Clin Pract. 2014; 9(1):75-86. DOI: 10.1016/j.orcp.2014.03.001. View

14.

Arnold M, Jiang L, Stefanick M, Johnson K, Lane D, LeBlanc E . Duration of Adulthood Overweight, Obesity, and Cancer Risk in the Women's Health Initiative: A Longitudinal Study from the United States. PLoS Med. 2016; 13(8):e1002081. PMC: 4987008. DOI: 10.1371/journal.pmed.1002081. View

15.

Jiralerspong S, Goodwin P . Obesity and Breast Cancer Prognosis: Evidence, Challenges, and Opportunities. J Clin Oncol. 2016; 34(35):4203-4216. DOI: 10.1200/JCO.2016.68.4480. View

16.

Li R, Grimm S, Chrysovergis K, Kosak J, Wang X, Du Y . Obesity, rather than diet, drives epigenomic alterations in colonic epithelium resembling cancer progression. Cell Metab. 2014; 19(4):702-11. PMC: 4050048. DOI: 10.1016/j.cmet.2014.03.012. View

17.

Neuhouser M, Aragaki A, Prentice R, Manson J, Chlebowski R, Carty C . Overweight, Obesity, and Postmenopausal Invasive Breast Cancer Risk: A Secondary Analysis of the Women's Health Initiative Randomized Clinical Trials. JAMA Oncol. 2015; 1(5):611-21. PMC: 5070941. DOI: 10.1001/jamaoncol.2015.1546. View

18.

. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet. 2016; 387(10026):1377-1396. PMC: 7615134. DOI: 10.1016/S0140-6736(16)30054-X. View

19.

Zheng W, McLerran D, Rolland B, Zhang X, Inoue M, Matsuo K . Association between body-mass index and risk of death in more than 1 million Asians. N Engl J Med. 2011; 364(8):719-29. PMC: 4008249. DOI: 10.1056/NEJMoa1010679. View

20.

Chen B, Tang H, Chen X, Zhang G, Wang Y, Xie X . Transcriptomic analyses identify key differentially expressed genes and clinical outcomes between triple-negative and non-triple-negative breast cancer. Cancer Manag Res. 2019; 11:179-190. PMC: 6306052. DOI: 10.2147/CMAR.S187151. View