The association of metabolic syndrome with triple-negative breast cancer

1038 Background: Metabolic syndrome, a conglomerate of obesity, insulin resistance, hypertriglyceridemia, low HDL (high density lipoprotein), and hypertension is associated with an increased risk of breast cancer. However, no clear association has been shown between the highly aggressive triple-negative breast cancer and metabolic syndrome. Methods: In a retrospective review we compared triple-negative and non-triple-negative breast cancer cases for the presence of metabolic syndrome by NCEP (National Cholesterol Education Program) or AACE (American Association of Clinical Endocrinologists) definitions. Data on metabolic syndrome criteria, tumor size, grade, lymph node status, and ductal carcinoma in situ (DCIS) were reviewed. Chi-square test or Student's t-test was used for data analysis. Results: The entire cohort of 176 patients (12.5% African-American) with median age 56.5 years (range 26–91 years) comprised of 86 triple-negative cases and 90 non-triple-negative cases. A statistically significant association of triple-negative breast cancer with metabolic syndrome was observed. According to the NCEP criteria 58.1% of triple negative patients had metabolic syndrome as compared to only 36.7% of non-triple negative patients (p = 0.004). Consistently, by the AACE criteria 52.3% of triple negative patients had metabolic syndrome as compared to 34.4% of non-triple negative patients (p = 0.017). Contrary to blood glucose, triglyceride, or HDL levels, which independently showed significant association with triple-negative breast cancer, hypertension, or BMI showed no independent association. Additionally, triple-negative tumors displayed a significantly higher histologic grade and relative paucity of ductal carcinoma in situ (DCIS) when compared to the non-triple negative tumors (p < 0.001). Conclusions: The data suggests that the metabolic syndrome is significantly more prevalent in triple-negative breast cancer patients when compared to the non-triple-negative patients. Additionally, triple-negative breast cancer showed a significantly higher histologic grade and a relative absence of DCIS. Whether the presence of metabolic syndrome preferentially increases the risk of developing triple-negative-breast cancer needs to be elucidated by future prospective studies. No significant financial relationships to disclose.