Effect of Body Mass Index on Recurrence in Hormone Receptor Positive Early Breast Cancer – A Retrospective Exploratory Analysis from the ATAC Trial.

2009 ◽  
Author(s):  
I. Sestak ◽  
W. Distler ◽  
J. Forbes ◽  
A. Howell ◽  
J. Cuzick
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Early Breast Cancer ◽  
Hormone Receptor ◽  
Exploratory Analysis ◽  
Hormone Receptor Positive

Prognostic significance of body mass index in breast cancer patients with hormone receptor-positive tumours after curative surgery

2013 ◽  
Vol 36 (6) ◽  
pp. 297 ◽  
Author(s):  
Peng Xing ◽  
Ji-Guang Li ◽  
Feng Jin ◽  
Ting-Ting Zhao ◽  
Qun Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Hormone Receptor ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Axillary Lymph ◽  
Nodal Stage ◽  
Hormone Receptor Positive ◽  
High Bmi

Purpose: Obesity has been recognized as a significant risk factor for postmenopausal breast cancer. The aim of this study is to investigate the prognostic significance of body mass index (BMI) in hormone receptor-positive, operable breast cancer. Methods: In this retrospective cohort study, 1,192 consecutive patients with curative resection of primary breast cancer were enrolled. Patients were assigned to two groups according to BMI: normal or underweight (BMI < 23.0 kg/m2) and overweight or obese (BMI ≥23.0 kg/m2). Associations among BMI and clinicopathological characteristics and prognosis of patients were assessed. Results: A high BMI was significantly (P < 0.01) correlated with age, nodal stage, ALNR, ER positivity, PR positivity and menopausal status at diagnosis. Univariate analysis revealed that BMI, pathologic T stage, nodal stage, axillary lymph node ratio (ALNR) and adjuvant radiotherapy history were significantly (P < 0.05) associated with disease-free survival and overall survival, irrespective of tumour hormone receptor status. Multivariate analysis revealed BMI as an independent prognostic factor in all cases and in hormone receptor-positive cases. Conclusion: A high BMI (≥23.0 kg/m^2) is independently associated with poor prognosis in hormone receptor-positive breast cancer.

Body Mass Index and Hormone Receptor Status Influence Recurrence Risk in HER2-Positive Early Breast Cancer Patients

2020 ◽  
Vol 20 (1) ◽  
pp. e89-e98 ◽  
Author(s):  
Luca Cantini ◽  
Mirco Pistelli ◽  
Filippo Merloni ◽  
Andrea Fontana ◽  
Ilaria Bertolini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Cancer Patients ◽  
Body Mass ◽  
Early Breast Cancer ◽  
Hormone Receptor ◽  
Recurrence Risk ◽  
Hormone Receptor Status ◽  
Breast Cancer Patients ◽  
Her2 Positive

Response-Guided Neoadjuvant Chemotherapy for Breast Cancer

2013 ◽  
Vol 31 (29) ◽  
pp. 3623-3630 ◽  
Author(s):  
Gunter von Minckwitz ◽  
Jens Uwe Blohmer ◽  
Serban Dan Costa ◽  
Carsten Denkert ◽  
Holger Eidtmann ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Early Breast Cancer ◽  
Hormone Receptor ◽  
Triple Negative ◽  
Pathologic Complete Response ◽  
Exploratory Analysis ◽  
Her2 Positive ◽  
Luminal B ◽  
Hormone Receptor Positive

Purpose We investigated disease-free survival (DFS) and overall survival (OS) after response-guided neoadjuvant chemotherapy in patients with early breast cancer. Patients and Methods We treated 2,072 patients with two cycles of docetaxel, doxorubicin, and cyclophosphamide (TAC) and randomly assigned early responders to four (n = 704) or six (n = 686) additional TAC cycles, and early nonresponders to four cycles of TAC (n = 321) or vinorelbine and capecitabine (NX; n = 301) before surgery. Results DFS was longer in early responders receiving TAC × 8 than in those receiving TAC × 6 (hazard ratio [HR], 0.78; 95% CI, 0.62 to 0.97; P = .026), and in early nonresponders receiving TAC-NX than in those receiving TAC × 6 (HR, 0.59; 95% CI, 0.49 to 0.82; P = .001). Exploratory analysis showed that DFS after response-guided chemotherapy (TAC × 8 or TAC-NX) was significantly longer (HR, 0.71; 95% CI, 0.60 to 0.85; P < .003), as was OS (HR, 0.79; 95% CI, 0.63 to 0.99; P = .048), than on conventional chemotherapy (TAC × 6). DFS was longer after response-guided chemotherapy in all hormone receptor–positive tumors (luminal A HR = 0.55, luminal B [human epidermal growth factor receptor 2 (HER2) negative] HR = 0.40, and luminal B [HER2 positive] HR = 0.56), but not in hormone receptor–negative tumors (HER2 positive [nonluminal] HR = 1.01 and triple negative HR = 0.87). Pathologic complete response did not predict these survival effects. pCR predicted an improved DFS in triple-negative (HR = 6.67), HER2-positive (nonluminal; HR 5.24), or luminal B (HER2-negative) tumors (HR = 3.74). Conclusion This exploratory analysis suggests that response-guided neoadjuvant chemotherapy might improve survival and is most effective in hormone receptor–positive tumors. If confirmed, the response-guided approach could provide a clinically meaningful advantage for the neoadjuvant over the adjuvant approach in early breast cancer.

Does Menopausal Hormone Replacement Therapy Interact With Known Factors to Increase Risk of Breast Cancer?

2002 ◽  
Vol 20 (3) ◽  
pp. 699-706 ◽  
Author(s):  
Giske Ursin ◽  
Chiu-Chen Tseng ◽  
Annlia Paganini-Hill ◽  
Shelley Enger ◽  
Peggy C. Wan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Los Angeles ◽  
Replacement Therapy ◽  
Body Mass ◽  
Hormone Receptor ◽  
Hormone Replacement ◽  
Hormone Receptor Positive ◽  
Increased Risk ◽  
History Of

PURPOSE: We and other investigators have previously shown that postmenopausal combined estrogen and progestin replacement therapy (EPRT) increases the risk of breast cancer and that the risk associated with EPRT is substantially higher than for estrogen replacement therapy (ERT) alone. The present study was conducted to determine whether any particular subgroup of women are at particularly high risk of breast cancer if they use EPRT and whether tumor characteristics in women who develop cancer while on ERT or EPRT are different from those in women not using ERT or EPRT. PATIENTS AND METHODS: We conducted a population-based case-control study in Los Angeles, CA, with patients diagnosed with breast cancer in the late 1980s and early 1990s. Control subjects were matched to patients on age, ethnicity, and neighborhood of residence. We present data on 1,897 postmenopausal patients and 1,637 controls aged 55 to 72 years who had not undergone a simple hysterectomy. RESULTS: Relative risk of breast cancer associated with EPRT use did not vary with body mass index (body mass index at or below v above median [24.6 kg/m2]; P = .98), alcohol intake (≥ one v < one drink per week; P = .16), parity (nulliparous v parous; P = .45), history of benign breast disease (yes v no; P = .99), or family history of breast cancer (first degree v none; P = .57). All of these results were compatible with our previously reported estimate of an increased risk of breast cancer of 5% per year of use of EPRT. Hormone users, principally EPRT users, were more likely to have hormone receptor–positive, especially progesterone-positive, tumors. CONCLUSION: We found no evidence that the risk of breast cancer associated with EPRT is limited to subgroups of women with specific cofactors. Tumors in EPRT users are more often hormone receptor–positive, indicating that they may have a better prognosis than breast cancer overall.

Effect of Body Mass Index on Recurrences in Tamoxifen and Anastrozole Treated Women: An Exploratory Analysis From the ATAC Trial

2010 ◽  
Vol 28 (21) ◽  
pp. 3411-3415 ◽  
Author(s):  
Ivana Sestak ◽  
Wolfgang Distler ◽  
John F. Forbes ◽  
Mitch Dowsett ◽  
Anthony Howell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Postmenopausal Women ◽  
Body Mass ◽  
Aromatase Inhibitors ◽  
Hormone Receptor ◽  
Early Stage ◽  
Double Blind ◽  
Overweight Women ◽  
Hormone Receptor Positive

Purpose Third-generation aromatase inhibitors have been widely used in postmenopausal women for the adjuvant treatment of hormone receptor–positive breast cancer. As aromatase inhibitors work by inhibiting the conversion of androgens to estrogens in adipose tissue, we hypothesized that anastrozole may be more effective in women with a high body mass index (BMI). Patients and Methods The Arimidex, Tamoxifen Alone or in Combination (ATAC) study was a double-blind randomized clinical trial in which postmenopausal women with early-stage breast cancer were randomly assigned to receive oral daily anastrozole (1 mg) alone, tamoxifen (20 mg) alone, or the combination in a double-blind fashion. Analyses were based on the 100-month median follow-up for women with hormone receptor–positive breast cancers (estrogen [ER] and/or progesterone [PgR] positive). Here, we investigate the impact of BMI on recurrence and the relative benefit of anastrozole versus tamoxifen according to baseline BMI. Results Overall, women with a high BMI (BMI > 35 kg/m2) at baseline had more recurrences than those women with a low BMI (BMI < 23 kg/m2; adjusted hazard ratio [HR], 1.39; 95% CI, 1.06 to 1.82; Pheterogeneity = .03) and significantly more distant recurrences (adjusted HR, 1.46; 95% CI, 1.07 to 1.61; Pheterogeneity = .01). Overall, the relative benefit of anastrozole versus tamoxifen was nonsignificantly better in thin women compared to overweight women. Conclusion These results confirm the poorer prognosis of obese women with early-stage breast cancer. Recurrence rates were lower for anastrozole than tamoxifen for all BMI quintiles. Our results suggest that the relative efficacy of anastrozole compared to tamoxifen is greater in thin postmenopausal women and higher doses or more complete inhibitors might be more effective in overweight women, but this requires independent confirmation.

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