2nd International Cancer Study & Therapy Conference
Feb 20-22, 2017, Baltimore, USA
Body mass index as a prognostic feature in breast cancer
1SE “Dnipropetrovsk medical academy of Health Ministry of Ukraine”
Department of oncology and medical radiology
VolodymyrVernadskii str., 9, Dnipro, 49044, Ukraine
Background: Breast cancer is the most common cancer diagnosed among women in the world. Current information on the prognostic importance of body mass index (BMI) for patients withbreast cancer is based on a variety of equivocal reports. Few have data on BMI in relationship to systemictreatmenthas not been explored so far. The aim of this retrospective study is to evaluate the relation between patientsʼ Breast cancer to Obesity and the prognosis of treatment.
Materials and Methods: The study included 130 patients with breast cancer between the ages of 30 and 77 (57,6 ± 1) years of age who were treated according to our clinic, department of oncology and medical radiology. Dnipropetrovsk medical academy at Municipal Institution “Dnipropetrovsk City Multi-field Clinical Hospital #4”, Dnepropetrovsk state medical academyfrom 2005-2015. All patients were evaluated according to the following data: stage of the disease, age and BMI at the time of diagnosis, the size, histological typeand metastases. Tumor size was evaluated after measuring its maximal diameter and distributed in accordance with the International TNM-classification (7th edition, 2009). The histological type and degree of differentiation of the tumor was evaluated respectively by the National Standards of diagnostics and treatment of malignant neoplasms, reflecting the recommendations of leading international organizations. BMI is calculated by the formula: I = m×h2, where m - body weight (kg); h - height (m). According to these calculations the patients were divided in accordance with the WHO criteria into the following groups: those with a BMI <25 kg/m2 - normal or underweight; from 25 to 29.9 kg/m2 - overweight; > 30 kg/m2 - obese. The material for the histopathological study was obtained during surgery.We examined the relative risk of relapse and death with regard to the BMIcategories adjusting for eight factors known to be predictors of disease-freesurvival (DFS) and overall survival (OS): menopausal status, nodal status tumor size, vessel invasion, estrogen receptor (ER) status, progesterone receptorstatus, tumor grade and treatment regimens.
Results: In this retrospective study, among 130 patients with breast cancer, 45% were identified with excess body weight, and 31% - of various obesity degree. Patients with a BMI <25 kg/m2 were significantly more diagnosed with stage 2 breast cancer triple negative. BMI> 30 kg/m2, 10% more often associated with metastatic RLN, which is anindirect sign of higher metastatic potentials. Patients with normal BMI had significantly longer overall survival (OS) and disease-free survival (DFS) than patients with intermediate or obese BMI in pairwise comparisons adjusted for other factors.We found a strong correlation betweenobesity and lymph node involvement These observationssuggest that obesity may potentiate the metastatic spread of breast tumors. Distant metastases were also foundmore often in obese patients in bone or visceral sites in patients <45 years of age at diagnosis.
Conclusions: In conclusion, this retrospective investigation our patient demonstrates that BMI is an independent prognostic factor for OS in patients with breast cancer. We have supporting evidencethat obese BMI represents a poor risk feature for outcome, especially in pre-/premenopausal patients, most of whom receivedchemotherapy without hormonal therapy.
Key words: body mass index, breast cancer, obesity, overall survival
Mohammad Hojouj is an Assistant Professor, MD, MSo, Oncologist, Master of medicine, a member of The National Comprehensive Cancer Network NCCN, a member of the European Association of Physicians in Germany (NGO), member of the international conference, Speaker of the international conference in the United Arab Emirates 2015, a member of the Association of Arab doctors in Ukraine. Actual Member of the American Association of Clinical Oncology (ASCO). Has experience of more than 9 international clinical researches as Sub investigator. He gives great attention to the educational process, organization and conduction of clinical trials in oncology practice.