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Metabolic syndrome and outcomes following early-stage breast cancer

  • Epidemiology
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Abstract

The prevalence of risk factors contributing to metabolic syndrome (MetS) is increasing, and numerous components of MetS are associated with increased primary breast cancer (BC) risk. However, less is known about the relationship of MetS to BC outcomes. The aim of this study was to evaluate whether MetS, characterized by increased weight, hypertension, low HDL-cholesterol, high triglycerides, and diabetes or impaired glucose tolerance, is associated with risk of second breast cancer events (SBCE) and BC-specific mortality. Retrospective cohort study of women diagnosed with incident early-stage (I-II) BC between 1990 and 2008, enrolled in an integrated health plan. Outcomes of interest were SBCE, defined as recurrence or second primary BC, and BC-specific mortality. We used multivariable Cox proportional hazards models to estimate adjusted hazard ratios (HR) and 95 % confidence intervals (CI) for time-varying exposure to MetS components while accounting for potential confounders and competing risks. Among 4,216 women in the cohort, 26 % had ≥3 MetS components and 13 % developed SBCE during median follow-up of 6.3 years. Compared to women with no MetS components, presence of MetS (≥3 components) was associated with increased risk of SBCE (HR = 1.50, 95 % CI 1.08–2.07) and BC-specific mortality (HR = 1.65, 95 % CI 1.02–2.69). Of the individual components, only increased weight was associated with increased risk of SBCE (HR = 1.26, 95 % CI 1.06–1.49). MetS is associated with modestly increased risk of SBCE and BC-specific mortality. Given the growing population of BC survivors, further research in larger and more diverse populations is warranted.

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Acknowledgments

This work was supported by a Grant from the National Institutes of Health (R01 CA120562 to D.M.B.) at Group Health Research Institute and the Cancer Prevention Training Grant in Nutrition, Exercise, and Genetics (R25 CA094880) at the University of Washington and Fred Hutchinson Cancer Research Center. The authors are thankful to Ms. Onchee Yu and Dr. Heidi S. Wirtz for their help with statistical analyses.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 S. Wood St. M/C 871, Room 287, Chicago, IL, 60612, USA

    Gregory S. Calip

  2. Department of Epidemiology, University of Washington, Seattle, WA, USA

    Gregory S. Calip, Kathleen E. Malone, Andy Stergachis & Denise M. Boudreau

  3. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Gregory S. Calip & Kathleen E. Malone

  4. Seattle Cancer Care Alliance, Seattle, WA, USA

    Julie R. Gralow

  5. Department of Global Health, University of Washington, Seattle, WA, USA

    Andy Stergachis

  6. Department of Biostatistics, University of Washington, Seattle, WA, USA

    Rebecca A. Hubbard

  7. Group Health Research Institute, Seattle, WA, USA

    Rebecca A. Hubbard & Denise M. Boudreau

  8. School of Pharmacy, University of Washington, Seattle, WA, USA

    Denise M. Boudreau

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Calip, G.S., Malone, K.E., Gralow, J.R. et al. Metabolic syndrome and outcomes following early-stage breast cancer. Breast Cancer Res Treat 148, 363–377 (2014). https://doi.org/10.1007/s10549-014-3157-6

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