Breast Cancer Research and Treatment

, Volume 121, Issue 2, pp 479–483 | Cite as

The association of metabolic syndrome with triple-negative breast cancer

  • B. MaitiEmail author
  • M. N. Kundranda
  • T. P. Spiro
  • H. A. Daw


Metabolic syndrome, a conglomerate of obesity, insulin resistance, dyslipidemia, and hypertension has been linked with an increased risk of breast cancer. We investigated the possible association of highly aggressive triple-negative breast cancer and the metabolic syndrome. Information on metabolic syndrome components and tumor characteristics were reviewed in a cohort of 176 patients (including 86 triple-negatives). Retrospective comparison was performed using Pearson Chi-square test or Student’s t test for data analysis. A statistically significant association of triple-negative breast cancer with the metabolic syndrome was observed. In accordance with the NCEP (National Cholesterol Education Program) definition, 58.1% of triple-negative patients had metabolic syndrome compared to only 36.7% of non-triple-negative patients (P = 0.004). Consistently, by the AACE (American Association of Clinical Endocrinologists) criteria, 52.3% of triple-negative patients had metabolic syndrome as compared to 34.4% of non-triple-negative patients (P = 0.017). Blood glucose, triglyceride, and HDL levels but not hypertension or BMI (body mass index) showed significant independent association with triple-negative breast cancer. Additionally, triple-negative tumors displayed a significantly higher histological grade and relative paucity of ductal carcinoma in situ (DCIS) when compared to the non-triple-negative tumors (P < 0.001). Our study suggests that metabolic syndrome is significantly more prevalent in triple-negative breast cancer patients as opposed to non-triple-negative patients. Furthermore, triple-negative breast cancer showed a significantly higher histological grade and a relative absence of DCIS. Whether the presence of metabolic syndrome preferentially increases the risk of developing triple-negative-breast cancer remains to be elucidated with future prospective studies.


Breast cancer Triple-negative Metabolic syndrome Epidemiology 


  1. 1.
    Anders C, Carey LA (2008) Understanding, treating triple-negative breast cancer. Oncology (Williston Park) 22(11):1233–1239 discussion 1239–1240, 1243Google Scholar
  2. 2.
    Rakha EA, Ellis IO (2009) Triple-negative/basal-like breast cancer: review. Pathology 41(1):40–47CrossRefPubMedGoogle Scholar
  3. 3.
    Schneider BP, Winer EP, Foulkes WD et al (2008) Triple-negative breast cancer: risk factors to potential targets. Clin Cancer Res 14(24):8010–8018CrossRefPubMedGoogle Scholar
  4. 4.
    Irvin WJ Jr, Carey LA (2008) What is triple-negative breast cancer? Eur J Cancer 44(18):2799–2805CrossRefPubMedGoogle Scholar
  5. 5.
    Millikan RC, Newman B, Tse CK et al (2008) Epidemiology of basal-like breast cancer. Breast Cancer Res Treat 109(1):123–139CrossRefPubMedGoogle Scholar
  6. 6.
    Vona-Davis L, Howard-McNatt M, Rose DP (2007) Adiposity, type 2 diabetes and the metabolic syndrome in breast cancer. Obes Rev 8(5):395–408CrossRefPubMedGoogle Scholar
  7. 7.
    Giovannucci E (2007) Metabolic syndrome, hyperinsulinemia, and colon cancer: a review. Am J Clin Nutr 86(3):s836–s842PubMedGoogle Scholar
  8. 8.
    Rose DP, Haffner SM, Baillargeon J (2007) Adiposity, the metabolic syndrome, and breast cancer in African-American and white American women. Endocr Rev 28(7):763–777CrossRefPubMedGoogle Scholar
  9. 9.
    Beebe-Dimmer JL, Nock NL, Neslund-Dudas C (2009) Racial differences in risk of prostate cancer associated with metabolic syndrome. Urology 74(1):185–190CrossRefPubMedGoogle Scholar
  10. 10.
    Hsing AW, Sakoda LC, Chua S Jr (2007) Obesity, metabolic syndrome, and prostate cancer. Am J Clin Nutr 86(3):s843–s857PubMedGoogle Scholar
  11. 11.
    Kaaks R, Berrino F, Key T et al (2005) Serum sex steroids in premenopausal women and breast cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). J Natl Cancer Inst 97:755–765PubMedCrossRefGoogle Scholar
  12. 12.
    Helzlsouer KJ, Alberg AJ, Bush TL et al (1994) A prospective study of endogenous hormones and breast cancer. Cancer Detect Prev 18:79–85PubMedGoogle Scholar
  13. 13.
    Kabuto M, Akiba S, Stevens RG, Neriishi K, Land CE (2000) A prospective study of estradiol and breast cancer in Japanese women. Cancer Epidemiol Biomarkers Prev 9:575–579PubMedGoogle Scholar
  14. 14.
    Wysowski DK, Comstock GW, Helsing KJ, Lau HL (1987) Sex hormone levels in serum in relation to the development of breast cancer. Am J Epidemiol 125:791–799PubMedGoogle Scholar
  15. 15.
    Eliassen AH, Missmer SA, Tworoger SS, Hankinson SE (2006) Endogenous steroid hormone concentrations and risk of breast cancer: does the association vary by a woman’s predicted breast cancer risk? J Clin Oncol 24:1823–1830CrossRefPubMedGoogle Scholar
  16. 16.
    Rosenberg CR, Pasternack BS, Shore RE, Koenig KL, Toniolo PG (1994) Premenopausal estradiol levels and the risk of breast cancer: a new method of controlling for day of the menstrual cycle. Am J Epidemiol 140:518–525PubMedGoogle Scholar
  17. 17.
    Meigs J (2006) Metabolic syndrome and the risk for type 2 diabetes. Expert Rev Endocrin Metab 1:57, table 1Google Scholar
  18. 18.
    Murthy NS, Mukherjee S, Ray G et al (2009) Dietary factors and cancer chemoprevention: an overview of obesity-related malignancies. J Postgrad Med 55(1):45–54CrossRefPubMedGoogle Scholar
  19. 19.
    Jardé T, Caldefie-Chézet F, Goncalves-Mendes N et al (2009) Involvement of adiponectin and leptin in breast cancer: clinical and in vitro studies. Endocr Relat Cancer (Epub ahead of print)Google Scholar
  20. 20.
    Werner H, Bruchim I (2009) The insulin-like growth factor-I receptor as an oncogene. Arch Physiol Biochem 115(2):58–71PubMedGoogle Scholar
  21. 21.
    Arai Y, Kojima T, Takayama M et al (2009) The metabolic syndrome, IGF-1, and insulin action. Mol Cell Endocrinol 299(1):124–128CrossRefPubMedGoogle Scholar
  22. 22.
    Roberts CK, Sindhu KK (2009) Oxidative stress and metabolic syndrome. Life Sci 84(21–22):705–712CrossRefPubMedGoogle Scholar
  23. 23.
    Halmos T, Suba I (2008) The metabolic syndrome and type-2 diabetes mellitus as conditions predisposing for malignant tumors. Orv Hetil 149(51):2403–2411CrossRefPubMedGoogle Scholar
  24. 24.
    Andre F, Dessen P, Job BS et al (2009) Functional pathways analyses to identify candidate therapeutic targets in triple-negative breast cancer. J Clin Oncol 27:15s (suppl; abstr 569)CrossRefGoogle Scholar
  25. 25.
    Walter O, Prasad M, Lu S et al (2009) IMP3 is a novel biomarker for triple negative invasive mammary carcinoma associated with a more aggressive phenotype. Hum Pathol (Epub ahead of print)Google Scholar
  26. 26.
    Yamamoto Y, Ibusuki M, Nakano M et al (2009) Clinical significance of basal-like subtype in triple-negative breast cancer. Breast Cancer 16(4):260–267Google Scholar

Copyright information

© Springer Science+Business Media, LLC. 2009

Authors and Affiliations

  • B. Maiti
    • 1
    Email author
  • M. N. Kundranda
    • 1
  • T. P. Spiro
    • 2
  • H. A. Daw
    • 2
  1. 1.Department of Internal MedicineFairview Hospital, a Cleveland Clinic HospitalClevelandUSA
  2. 2.Cleveland Clinic Cancer Center at Fairview HospitalClevelandUSA

Personalised recommendations