Breast Cancer Research and Treatment

, Volume 157, Issue 1, pp 179–189 | Cite as

Association of adiposity, dysmetabolisms, and inflammation with aggressive breast cancer subtypes: a cross-sectional study

  • Roberto Agresti
  • Elisabetta MeneghiniEmail author
  • Paolo Baili
  • Pamela Minicozzi
  • Alberto Turco
  • Ilaria Cavallo
  • Francesco Funaro
  • Hade Amash
  • Franco Berrino
  • Elda Tagliabue
  • Milena Sant


Obesity and metabolic syndrome are risk and prognostic factors for breast cancer (BC) and are associated with chronic inflammation. We investigated the association between distinct BC subtypes and markers of adiposity, dysmetabolisms, and inflammation. We analyzed 1779 patients with primary invasive BC treated at a single institution, for whom anthropometric and clinical-pathological data were archived. BC subtypes were classified by immunohistochemical staining of ER, PR, HER2, and Ki67, and their relations with the study markers were assessed by multinomial logistic regression. Adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated taking luminal A as reference. All subtypes more aggressive than luminal A were significantly more frequent in younger (<45 years) than older women. Before menopause, luminal B HER2-negative tumors were positively associated with large waist (OR 2.55, 95 % CI 1.53–4.24) and insulin resistance (OR 1.90, 95 % CI 1.05–3.41); luminal B HER2-positive tumors with large waist (OR 2.11, 95 % CI 1.03–4.35) and triple-negative tumors with overweight (OR 3.04, 95 % CI 1.43–6.43) and high C-reactive protein (p trend = 0.026). In postmenopausal women aged <65, luminal B HER2-negative (OR 1.94, 95 % CI 1.16–3.24) and luminal B HER2-positive tumors (OR 2.48, 95 % CI 1.16–5.27) were positively related with metabolic syndrome. Dysmetabolisms and inflammation may be related to different BC subtypes. Before menopause, triple-negative cancers were related to obesity and chronic inflammation, and aggressive luminal subtypes to abdominal adiposity. After menopause, in women aged <65 these latter subtypes were related to metabolic syndrome. Control of adiposity and dysmetabolism can reduce the risk of aggressive BC subtypes, improving the prognosis.


Breast cancer subtype Adiposity Insulin resistance Metabolic syndrome Inflammation 



Breast cancer


Body mass index


Confidence interval


C-reactive protein


Estrogen receptor


Fluorescence in situ hybridization


Human epidermal growth factor receptor 2


Homeostatic model assessment index


Infiltrating ductal carcinoma




Infiltrating lobular carcinoma


Interquartile range


Insulin resistance


Odds ratio


Progesterone receptor



The authors thank Judith Baggott for help with the English.

Authors’ contributions

Conception and design: R. Agresti, M. Sant, E. Meneghini, F. Berrino. Acquisition of data: H. Amash, A.Turco. Analysis and interpretation of data: E. Meneghini, M. Sant, R. Agresti, P. Minicozzi, F. Berrino, E. Tagliabue. Writing, review and/or revision of the manuscript: M. Sant, R. Agresti, E. Meneghini, P. Minicozzi, F. Berrino, E. Tagliabue. Administrative, technical, or material support: P. Baili, I. Cavallo, F. Funaro. Study supervision: M. Sant, R. Agresti, F. Berrino, E. Tagliabue.

Financial support

The INT breast cancer registry is subsidized by the project INT 5 × 1000-year 2012 B52I1200057001 “Implementation of breast cancer clinical registry.”

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study has been approved by the Ethical Committee of the National Cancer Institute.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Roberto Agresti
    • 1
  • Elisabetta Meneghini
    • 2
    Email author
  • Paolo Baili
    • 2
  • Pamela Minicozzi
    • 2
  • Alberto Turco
    • 2
  • Ilaria Cavallo
    • 2
  • Francesco Funaro
    • 2
  • Hade Amash
    • 2
  • Franco Berrino
    • 3
  • Elda Tagliabue
    • 4
  • Milena Sant
    • 2
  1. 1.Breast Surgery UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  2. 2.Analytic Epidemiology and Health Impact UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  3. 3.Epidemiology and Prevention UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  4. 4.Molecular Targeting UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly

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