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Inflammatory Breast Cancer Survival: The Role of Obesity and Menopausal Status at Diagnosis

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Abstract

No previous studies have evaluated the effect of body size and menopausal status at diagnosis on survival from inflammatory breast cancer (IBC). We evaluated whether obesity and menopausal status had an impact on IBC survival in a cohort of 177 female IBC patients seen from 1974 to 1993 at The University of Texas MD Anderson Cancer Center. Survival time was defined as time from diagnosis until death or censorship at last date of contact. We categorized women by body size by using the National Institutes of Health/National Heart, Lung, and Blood Institute's definitions of obesity as body mass index ((BMI) = weight in kg/(height in m)2) ≥ 30, overweight as 25  ≤ BMI < 30 kg/m2, and normal/lean as BMI <25 kg/m2. Cox proportional hazards analysis, adjusting for axillary lymph node involvement and chemotherapy protocol, revealed a modifying effect of menopausal status at diagnosis on the association between obesity and IBC survival (P = 0.02). Relative to postmenopausal women, premenopausal women had significantly worse survival (hazard ratio (HR) = 1.51, 95% confidence interval (CI) = 1.03–2.22). After stratifying by menopausal status, premenopausal obese women had non-significantly better survival than their leaner premenopausal counterparts (HR = 0.63, 95% CI = 0.34–1.15) while postmenopausal obese women had significantly worse survival than their leaner counterparts (HR = 1.86, 95% CI = 1.02–3.40). These findings suggest that factors associated with larger body size at diagnosis may contribute to shorter IBC survival among postmenopausal women but not premenopausal women, who were found to have poorer survival regardless of body size.

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References

  1. Maehle BO, Tretli S: Pre-morbid body mass index in breast cancer: reversed effect on survival in hormone receptor negative patients. Breast Cancer Res Treat 41: 123–130, 1996

    PubMed  Google Scholar 

  2. Nomura AMY, LeMarchand L, Kolonel LN, Hankin JH: The effect of dietary fat on breast cancer survival among Caucasian and Japanese women in Hawaii. Breast Cancer Res Treat 18: S135–S141, 1991

    PubMed  Google Scholar 

  3. Newman SC, Lees AW, Jenkins HJ: The effect of body mass index and oestrogen receptor level on survival of breast cancer patients. Int J Epidemiol 26: 484–490, 1997

    PubMed  Google Scholar 

  4. Rohan TE, Hiller JE, McMichael AJ: Dietary factors and survival from breast cancer. Nutr Cancer 20: 167–177, 1993

    PubMed  Google Scholar 

  5. Vatten LJ, Foss OP, Kvinnsland S: Overall survival of breast cancer patients in relation to preclinically determined total serum cholesterol, body mass index, height and cigarette smoking: a population-based study. Eur J Cancer 27: 641–646, 1991

    PubMed  Google Scholar 

  6. Coates RJ, Clark WS, Eley JW, Greenberg RS, Huguley CM Jr, Brown RL: Race, nutritional status and survival from breast cancer. J Natl Cancer Inst 82: 1684–1692, 1990

    PubMed  Google Scholar 

  7. Kyogoku S, Hirohata T, Takeshita S, Nomura Y, Shigmatsu T, Horie A: Survival of breast-cancer patients and body size indicators. Int J Cancer 46: 824–831, 1990

    PubMed  Google Scholar 

  8. Bastarrachea J, Hortobagyi G, Smith TL, Kau SWC, Buzdar AU: Obesity as an adverse prognostic factor for patients receiving adjuvant chemotherapy for breast cancer. Ann IntMed 119: 18–25, 1993

    Google Scholar 

  9. Gordon NH, Crowe JP, Brumberg DJ, Berger NA: Socioeconomic factors and race in breast cancer recurrence and survival. Am J Epidemiol 135: 609–618, 1992

    PubMed  Google Scholar 

  10. Mason BH, Holdaway IM, Stewart AW, Neave LM, Kay RG: Season of tumor detection influences factors predicting survival of patients with breast cancer. Breast Cancer Res Treat 15: 27–37, 1990

    PubMed  Google Scholar 

  11. Galanis DJ, Kolonel LN, Lee J, LeMarchand L: Anthropometric predictors of breast cancer incidence and survival in a multi-ethnic cohort of female residents of Hawaii, United States. Cancer Causes Control 9: 217–224, 1998

    PubMed  Google Scholar 

  12. Zhang S, Folsom AR, Sellers TA, Kushi LH, Potter JD: Better breast cancer survival for postmenopausal women who are less overweight and eat less fat. Iowa Women's Health Study. Cancer 76: 275–283, 1995

    PubMed  Google Scholar 

  13. Tornberg S, Carstensen J: Serum beta-lipoprotein, serum cholesterol and Quetelet's Index as predictors for survival of breast cancer patients. Eur J Cancer 29A: 2025–2030, 1993

    PubMed  Google Scholar 

  14. Senie RT, Rosen PP, Rhodes P, Lesser ML, Kinne DW: Obesity at diagnosis of breast carcinoma influences duration of disease-free survival. Ann Intern Med 116: 26–32, 1992

    PubMed  Google Scholar 

  15. Holmberg L, Lund E, Bergstrom R, Adami HO, Meirik O: Oral contraceptives and prognosis in breast cancer: effects of duration, latency, recency, age at first use and relation to parity and body mass index in young women with breast cancer. Eur J Cancer 30A: 351–354, 1994

    PubMed  Google Scholar 

  16. denTonkelaar I, deWaard F, Seidell JC, Fracheboud J: Obesity and subcutaneous fat patterning in relation to survival of postmenopausal breast cancer patients participating in the DOM-project. Breast Cancer Res Treat 34: 129–137, 1995

    PubMed  Google Scholar 

  17. Obermair A, Kurz C, Hanzal E, Bancher-Todesca D, Thoma M, Bodisch A, Kubista E, Kyral E, Kaider A, Sevelda P, Gitsch G: Influence of obesity on the disease-free survival in primary breast cancer. Anticancer Res 15: 2265–2270, 1995

    PubMed  Google Scholar 

  18. Kimura M: Obesity as prognostic factors in breast cancer. Diabetes Res Clin Prac 10: S247–S251, 1990

    Google Scholar 

  19. American Joint Committee on Cancer. Clinical staging system for cancer of the breast. In: Beahrs O, Henson D, Hutter R, et al. (eds) Manual for staging of cancer. 4 Edition Philadelphia, Lippincott, 1992

  20. Chang S, Parker SL, Pham T, Buzdar A, Hursting SD: Trends and patterns of inflammatory breast cancer: The experience of the National Cancer Institute's SEER Program from 1975 to 1992. Cancer 82: 2366–2372, 1998

    PubMed  Google Scholar 

  21. Lonnqvist F, Wennlung A, Arner P: Relationship between circulating leptin and peripheral fat distribution in obese subjects. Int J Obes Relat Metab Disord 21: 255–260, 1997

    PubMed  Google Scholar 

  22. Chang S, Buzdar AU, Hursting SD: Inflammatory breast cancer and body mass index. J Clin Oncol 16: 3731–3735, 1998

    PubMed  Google Scholar 

  23. Koh EH, Buzdar AU, Ames FC, Singletary SE, McNeese MD, Frye DK, Holmes FA, Fraschini G, Hug V, Theriault RL, Balch CM, Hortobagyi G: Inflammatory carcinoma of the breast: results of a combined-modality approach-M.D. Anderson Cancer Center experience. Cancer Chemother Pharmacol 27: 94–100, 1990

    PubMed  Google Scholar 

  24. Ueno NT, Buzdar AU, Singletary SE, Ames FC, McNeese MD, Holmes FA, Theriault RL, Strom EA, Wasaff B, Asmar L, Frye DK, Hortobagyi G: Combined-modality treatment of inflammatory breast carcinoma: twenty years of experience at M. D. Anderson Cancer Center. Cancer Chemother Pharmacol 40: 321–329, 1997

    PubMed  Google Scholar 

  25. NCI/NHLBI Obesity Education Initiative Task Force Members. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. NHLBI, 1998

  26. Cox DR, Oakes D: Analysis of survival data. Chapman and Hall, London, 1984

    Google Scholar 

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Authors and Affiliations

  1. Departments of Epidemiology, USA

    Shine Chang

  2. Surgical Oncology, USA

    Julie R. Alderfer

  3. Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Lina Asmar & Aman U. Buzdar

Authors
  1. Shine Chang
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  2. Julie R. Alderfer
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  3. Lina Asmar
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  4. Aman U. Buzdar
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Chang, S., Alderfer, J.R., Asmar, L. et al. Inflammatory Breast Cancer Survival: The Role of Obesity and Menopausal Status at Diagnosis. Breast Cancer Res Treat 64, 157–163 (2000). https://doi.org/10.1023/A:1006489100283

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  • DOI: https://doi.org/10.1023/A:1006489100283

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