Jung Youn Kim1,2, Dae-Won Lee3, Kyung-Hun Lee4,5,6, Ahrum Min1,2, Han Suk Ryu7, Han-Byoel Lee1,8, Hyeong-Gon Moon1,8, Tae-Yong Kim1,2,3, Sae-Won Han1,2,3, Do-Youn Oh1,2,3, Wonshik Han1,8, In Ae Park7, Dong-Young Noh1,8, Seock-Ah Im1,2,3, Sukil Kim9. 1. College of Medicine, Cancer Research Institute, Seoul National University, Seoul, South Korea. 2. Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea. 3. Department of Internal Medicine, Seoul National University Hospital, 101 Daehang-Ro, Jongno-Gu, Seoul, 110-744, South Korea. 4. College of Medicine, Cancer Research Institute, Seoul National University, Seoul, South Korea. kyunghunlee@snu.ac.kr. 5. Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea. kyunghunlee@snu.ac.kr. 6. Department of Internal Medicine, Seoul National University Hospital, 101 Daehang-Ro, Jongno-Gu, Seoul, 110-744, South Korea. kyunghunlee@snu.ac.kr. 7. Department of Pathology, Seoul National University Hospital, Seoul, South Korea. 8. Department of Surgery, Seoul National University Hospital, Seoul, South Korea. 9. Department of Preventive Medicine, The Catholic University of Korea, Seoul, South Korea.
Abstract
PURPOSE: Although controversial, obesity and underweight may have a negative impact on breast cancer outcome. However, the relationship between body mass index (BMI) and breast cancer outcomes according to tumor subtype and menopausal status remains unclear. METHODS: This study investigated the association between BMI and breast cancer outcome in stage I-III breast cancer patients. The relationships were further evaluated according to tumor subtype and menopausal status. RESULTS: A total of 5919 patients, 3475 (58.7%) hormone receptor (HR)(+) human epidermal growth factor receptor 2 (HER2)(-), 608 (10.3%) HR(+)HER2(+), 621 (10.5%) HR(-)HER2(+), and 1079 (18.2%) HR(-)HER2(-) were included. Underweight and obesity had a negative impact on relapse-free survival but did not affect overall survival. Importantly, the prognostic role of BMI was different according to tumor subtype and menopausal status. In HR(+)HER2(-) patients, underweight was associated with poor relapse-free survival and overall survival in pre-menopausal women. In contrast, obesity had negative impact on relapse-free survival and overall survival in HR(+)HER2(-) post-menopausal patients. Underweight may have a negative prognostic role in HR(+)HER2(+) patients. However, BMI did not impact the outcome of HR(-)HER2(+) and HR(-)HER2(-) patients. CONCLUSIONS: The impact of BMI on breast cancer outcome was dependent on tumor subtype and menopausal status. In HR(+)HER2(-) patients, underweight and obesity had a negative prognostic role in pre-menopausal and post-menopausal women, respectively. These findings in Asian population should be further evaluated and compared in Western population.
PURPOSE: Although controversial, obesity and underweight may have a negative impact on breast cancer outcome. However, the relationship between body mass index (BMI) and breast cancer outcomes according to tumor subtype and menopausal status remains unclear. METHODS: This study investigated the association between BMI and breast cancer outcome in stage I-III breast cancerpatients. The relationships were further evaluated according to tumor subtype and menopausal status. RESULTS: A total of 5919 patients, 3475 (58.7%) hormone receptor (HR)(+) humanepidermal growth factor receptor 2 (HER2)(-), 608 (10.3%) HR(+)HER2(+), 621 (10.5%) HR(-)HER2(+), and 1079 (18.2%) HR(-)HER2(-) were included. Underweight and obesity had a negative impact on relapse-free survival but did not affect overall survival. Importantly, the prognostic role of BMI was different according to tumor subtype and menopausal status. In HR(+)HER2(-) patients, underweight was associated with poor relapse-free survival and overall survival in pre-menopausal women. In contrast, obesity had negative impact on relapse-free survival and overall survival in HR(+)HER2(-) post-menopausal patients. Underweight may have a negative prognostic role in HR(+)HER2(+) patients. However, BMI did not impact the outcome of HR(-)HER2(+) and HR(-)HER2(-) patients. CONCLUSIONS: The impact of BMI on breast cancer outcome was dependent on tumor subtype and menopausal status. In HR(+)HER2(-) patients, underweight and obesity had a negative prognostic role in pre-menopausal and post-menopausal women, respectively. These findings in Asian population should be further evaluated and compared in Western population.
Entities:
Keywords:
Body mass index; Breast cancer; Menopausal status; Tumor subtype