Body mass index (BMI) and breast cancer: impact on tumor histopathologic features, cancer subtypes and recurrence rate in pre and postmenopausal women

Gynecol Endocrinol. 2013 Mar;29(3):263-7. doi: 10.3109/09513590.2012.736559. Epub 2012 Nov 23.

Abstract

The study aims to analyze the association between body mass index (BMI) at time of diagnosis, breast cancer histopathologic features (tumor size, nuclear grade, estrogen and progesterone receptor (ER and PgR) and HER-2/neu expression, histological subtypes, Ki-67 index, lymphatic/vascular invasion, axillary nodes involvement) and incidence of different subtypes defined using hormone receptors and HER2/neu expression, according to menopausal status; to evaluate the impact of BMI on disease free survival (DFS) at multivariate analysis. A total of 2148 patients (592 premenopausal, 1556 postmenopausal) were classified into subgroups according to BMI distribution. High BMI was significantly associated with larger size tumor both in pre (p = 0.01) and postmenopausal women (p = 0.00). Obese premenopausal women showed worse histopathologic features (more metastatic axillary lymphnodes, p = 0.017 and presence of vascular invasion, p = 0.006) compared to under/normal weight group. Postmenopausal patients with BMI > 25 developed more frequently ER/PgR positive cancers (87% versus 75%, p 0.017), while no association was found in premenopausal women. We could not found any statistically significant correlation between breast cancer subtypes (luminal A, B, HER-2 and basal-like) and BMI both in pre and postmenopause. Higher BMI was significantly associated with a shorter DR-FS in postmenopausal women but the independent prognostic role of obesity was not confirmed in our analysis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • Breast / blood supply
  • Breast / metabolism
  • Breast / pathology
  • Breast Neoplasms / complications*
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Italy / epidemiology
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Proteins / metabolism
  • Neoplasm Recurrence, Local / complications*
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / metabolism
  • Neoplasm Recurrence, Local / pathology
  • Neovascularization, Pathologic / complications
  • Neovascularization, Pathologic / epidemiology
  • Neovascularization, Pathologic / metabolism
  • Neovascularization, Pathologic / pathology
  • Obesity / complications*
  • Overweight / complications*
  • Postmenopause*
  • Premenopause*
  • Receptors, Estrogen / metabolism
  • Receptors, Progesterone / metabolism
  • Survival Analysis
  • Tumor Burden

Substances

  • Neoplasm Proteins
  • Receptors, Estrogen
  • Receptors, Progesterone