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Impact of body mass index (BMI) on the prognosis of high-risk early breast cancer (EBC) patients treated with adjuvant chemotherapy

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Abstract

The association between obesity and prognosis in early breast cancer (EBC) is unclear, especially when aggressive phenotypes are considered. We evaluated the influence of BMI on the prognosis of women with high-risk EBC enrolled in a phase III trial of adjuvant chemotherapy (CT). The association was assessed in 1066 patients with rapidly proliferating tumors, randomized to receive adjuvant CT with or without anthracyclines. Disease-free survival (DFS) and overall survival (OS) were calculated by Kaplan–Meier; multivariate analysis was performed according to age, tumor size, nodal, estrogen receptor (ER), and HER2 status and type of CT. Information on BMI was available for 959 women. Of these, 529 (55.2 %) were overweight or obese. Median age was 52 years. A total of 457 (47.7 %) patients had nodal involvement. Centralized pathology was performed in 850 cases: 522 (61.4 %) were ER positive, and 194 (22.8 %) were HER-2 positive. At a median follow-up of 103 months (range 1–188), 5-year DFS was 81 % (95 % CI 77–85), 82 % (95 % CI 77–86), and 76 % (95 % CI 70–83), in normal, overweight, and obese women, respectively (p = 0.44). Five-year OS was 92 % (95 % CI 89–95), 94 % (95 % CI 91–96), and 89 % (95 % CI 84–93), respectively (p = 0.60). BMI was not associated by multivariate analysis with differences in DFS or OS. Higher BMI had no influence on prognosis in high-risk EBC patients treated with CT. These data are consistent with prior observations and suggest that in aggressive biological subtypes, the impact of host factors on patient prognosis is minor.

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Acknowledgments

The authors thank the following contributors. Patrizia Serra, Ilaria Massa, Monia Dall’Agata, Britt Rudnas, Alessandra Piancastelli, Emanuela Montanari, Bernadette Vertogen, Federica Zumaglini: IRCCS IRST, Meldola, Italy; Davide Tassinari, Barbara Venturini: Department of Oncology, Infermi Hospital, Rimini, Italy; Riccardo Roagna: Mauriziano Hospital “Umberto I,”Turin, Italy.

Funding

AIRC Italian Association for Cancer Research IG 9239.

Author information

Authors and Affiliations

  1. Division of Medical Oncology, Galliera Hospital, Via Volta 6, 16126, Genoa, Italy

    Alessandra Gennari

  2. Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy

    Dino Amadori, Alberto Farolfi, Andrea Rocca & Roberta Maltoni

  3. Unit of Biostatistics and Clinical Trialst, IRST IRCCS, Meldola, Italy

    Emanuela Scarpi & Oriana Nanni

  4. Experimental Medical Oncology, Istituto Tumori IRCCS, Bari, Italy

    Angelo Paradiso

  5. Functional Biomorphology Laboratory, Istituto Tumori IRCCS, Bari, Italy

    Anita Mangia

  6. Department of Obstetrics and Gynaecology, Mauriziano “Umberto I” Hospital, University of Turin, Turin, Italy

    Nicoletta Biglia

  7. Department of Oncology, Infermi Hospital, Rimini, Italy

    Lorenzo Gianni

  8. Oncology Unit, S. Maria delle Croci Hospital, Ravenna, Italy

    Amelia Tienghi

  9. Internal Medicine, Galliera Hospital, Genoa, Italy

    Giancarlo Antonucci

  10. IRCCS - IST San Martino Hospital, Genoa, Italy

    Paolo Bruzzi

Authors
  1. Alessandra Gennari
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  2. Dino Amadori
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  3. Emanuela Scarpi
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  6. Anita Mangia
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  7. Nicoletta Biglia
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  8. Lorenzo Gianni
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  9. Amelia Tienghi
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  10. Andrea Rocca
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  11. Roberta Maltoni
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  12. Giancarlo Antonucci
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Correspondence to Alessandra Gennari.

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Gennari, A., Amadori, D., Scarpi, E. et al. Impact of body mass index (BMI) on the prognosis of high-risk early breast cancer (EBC) patients treated with adjuvant chemotherapy. Breast Cancer Res Treat 159, 79–86 (2016). https://doi.org/10.1007/s10549-016-3923-8

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  • DOI: https://doi.org/10.1007/s10549-016-3923-8

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