Skip to main content

Overweight and obesity as poor prognostic factors in locally advanced breast cancer patients


Obesity and overweight are established risk factors for the development of breast cancer. They are also associated with poor prognosis for higher risk of disease recurrence and lower overall survival (OS). The aim of this study was to evaluate the influence of overweight and obesity in OS in patients with locally advanced breast cancer (LABC) treated with neoadjuvant chemotherapy. This is a retrospective analysis that included 819 patients diagnosed with LABC between January 2004 and December 2008. The patients were treated with neoadjuvant chemotherapy (NAT) based on anthracyclines, taxanes, or both, followed by surgery. For comparison, patients were divided into the normal weight (NW) group or the overweight/obesity (OW/OB) group. The prevalence of overweight/obesity was 74 %. General characteristics of the patients, including age, tumor size, clinical stage, nuclear grade, hormone receptors, and HER2 expression, were similar between both groups. At a median follow-up of 28 months, we found a statistically significant difference in OS between the two groups, achieving a 91.5 % in NW patients versus 85.9 % in the OW/OB group (P = 0.050). Cox multivariate analysis demonstrated that obesity was an independent factor for poor prognosis, with a hazard ratio of 1.79 (95 % CI (Confidence Interval) 1.09–2.96; P = 0.022). This is the first Mexican study that confirms the role of OW/OB as a risk factor for poor outcome among patients with LABC. Obesity in our country is a public health problem and requires strong preventive intervention strategies for its control, especially among patients diagnosed with breast cancer.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2


  1. (INEGI. Statistics about the world day against cancer national data. Sep 16, 2013. (accessed Feb 24, 2013 [in Spanish])

  2. International Agency for Research on Cancer, WHO. GLOBOCAN 2008: cancer incidence and mortality worldwide in 2008. (accessed Feb 24, 2013)

  3. Shulman LN, Willett W, Sievers A, Knaul FM (2010) Breast cancer in developing countries: opportunities for improved survival. J Oncol 2010:595167

    PubMed Central  PubMed  Article  Google Scholar 

  4. Lopez-Carrillo L, Torres-Sanchez L, Lopez-Cervantes M, Rueda-Neria C (2001) Identification of malignant breast lesions in Mexico. Salud Publica Mex 43:199–202

    CAS  PubMed  Article  Google Scholar 

  5. Mohar A, Bargallo E, Ramirez MT, Lara F, Beltran-Ortega A (2009) Available resources for the treatment of breast cancer in Mexico. Salud Publica Mex 51:s263–s269

    PubMed  Article  Google Scholar 

  6. Instituto Nacional de Salud Pública. Encuesta Nacional de Salud y Nutrición 2006. 2006.pdf (accesado septiembre 21, 2013)

  7. Sobrepeso y obesidad, Gobierno Del Distrito Federal. (accessed Sep 16, 2013)

  8. (2013 The State of Food and Agriculture. (accessed Sep 16, 2013)

  9. Haslam DW, James WP (2005) Obesity. Lancet 366:1197

    PubMed  Article  Google Scholar 

  10. Carmichael AR, Bates T (2004) Obesity and breast cancer: a review of the literature. Breast 13:85–92

    CAS  PubMed  Article  Google Scholar 

  11. Ceschi M, Gutzwiller F, Moch H et al (2007) Epidemiology and pathophysiology of obesity as a cause of cancer. Swiss Med Wkly 137:50–56

    CAS  PubMed  Google Scholar 

  12. Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52,705 women with breast cancer and 108,411 women without breast cancer. Collaborative Group on Hormonal Factors in Breast Cancer. Lancet 1997; 350:1047-1059

  13. Borugian MJ, Sheps SB, Kim-Sing C et al (2003) Waist-to-hip ratio and breast cancer mortality. Am J Epidemiol 158:963–968

    PubMed  Article  Google Scholar 

  14. Aguilar JL, Martinez IA, Villarreal-Garza CM et al (2012) Impact of obesity and overweight in the prognosis of women diagnosed with non metastatic breast cancer in a Mexican cohort. ASCO Meeting Abstracts 30:1607

    Google Scholar 

  15. Haakinson DJ, Leeds SG, Dueck AC, et al. The impact of obesity on breast cancer: retrospective review. Ann Surg Oncol 2012; Mar 27 [epub ahead of print]

  16. Cui Y, Whiteman MK, Flaws JA et al (2002) Body mass and stage of breast cancer at diagnosis. Int J Cancer 98:279–283

    CAS  PubMed  Article  Google Scholar 

  17. Deglise C, Bouchardy C, Burri M et al (2010) Impact of obesity on diagnosis and treatment of breast cancer. Breast Cancer Res Treat 120:185–193

    PubMed  Article  Google Scholar 

  18. Erickson K, Patterson RE, Flatt SW et al (2010) clinically defined type 2 diabetes mellitus and prognosis in early breast cancer. J Clin Oncol 29:54–60

    PubMed Central  PubMed  Article  Google Scholar 

  19. Giordano SH, Jiralerspong S, López A, et al. Diabetes, obesity, and survival in a large cohort of early-stage breast cancer patients. Proc Am Soc Clin Oncol 2010; Abs 1503

  20. Litton JK, González-Angulo AM, Wrneke CL et al (2008) Relationship between obesity and pathologic response to neoadjuvant chemotherapy among women with operable breast cancer. J Clin Oncol 26:4072–4077

    PubMed  Article  Google Scholar 

  21. Berclaz G, Li S, Price KN et al (2004) Body mass index as a prognostic feature in operable breast cancer: the International Breast Cancer Study Group experience. Ann Oncol 15:875–884

    CAS  PubMed  Article  Google Scholar 

  22. De Azambuja E, McCaskill-Stevens W, Francis P et al (2010) The effect of body mass index on overall and disease free survival in node-positive breast cancer patients treated with docetaxel and doxorubicin-containing adjuvant chemotherapy: the experience of the BIG 02-98 trial. Breast Cancer Res Treat 119:145–153

    PubMed  Article  Google Scholar 

  23. Bernstein L, Allen M, Anton-Culver H, Deapen D, Horn-Ross PL et al (2002) High breast cancer incidence rates among California teachers: results from the California Teachers Study (United States). Cancer Causes Control 13:625–635

    PubMed  Article  Google Scholar 

  24. Von Drygalski A, Tran TB, Messer K, Pu M, Corringham C, et al. Obesity is and independent predictor of poor survival in metastatic breast cancer: retrospective analysis of a patient cohort whose treatment included high-dose chemotherapy and autologous stem cell support. Int J Breast Cancer 2011; article ID 523276, 8 pages doi:10.4061/2011/523276

  25. Chlebowski R, Blackburn G, Elashoff R et al (2006) Mature analysis from the women’s intervention nutrition study (WINS) evaluating dietary fat reduction and breast cancer outcome. Breast Cancer Res Treat 100(Suppl1):S16

    Google Scholar 

  26. Pierce J, Natarajan L, Caan B et al (2007) Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women’s Healthy Eating and Living (WHEL) randomized trial. JAMA 298:289–298

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  27. Romieu I, Lajous M. The role of obesity, physical activity and dietary factors on the risk for breast cancer: Mexican experience. Salud Publica Mex 2009; 51 supl 2:S172-S180

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to A. Mohar.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Arce-Salinas, C., Aguilar-Ponce, J.L., Villarreal-Garza, C. et al. Overweight and obesity as poor prognostic factors in locally advanced breast cancer patients. Breast Cancer Res Treat 146, 183–188 (2014).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Obesity
  • Locally advanced breast cancer (LABC)
  • Overall Survival