Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Oct;24(10):2506-2514.
doi: 10.1093/annonc/mdt224. Epub 2013 Jun 21.

Obesity, diabetes, and survival outcomes in a large cohort of early-stage breast cancer patients

S Jiralerspong  1 , E S Kim  2 , W Dong  3 , L Feng  3 , G N Hortobagyi  4 , S H Giordano  4
Affiliations

Obesity, diabetes, and survival outcomes in a large cohort of early-stage breast cancer patients

S Jiralerspong et al. Ann Oncol. 2013 Oct.

Abstract

Background: To determine the relationship between obesity, diabetes, and survival in a large cohort of breast cancer patients receiving modern chemotherapy and endocrine therapy.

Patients and methods: We identified 6342 patients with stage I-III breast cancer treated between 1996 and 2005. Patients were evaluated according to body mass index (BMI) category and diabetes status.

Results: In a multivariate model adjusted for body mass index, diabetes, medical comorbidities, patient- and tumor-related variables, and adjuvant therapies, relative to the normal weight, hazard ratios (HRs) for recurrence-free survival (RFS), overall survival (OS), and breast cancer-specific survival (BCSS) for the overweight were 1.18 [95% confidence interval (CI) 1.02-1.36], 1.20 (95% CI 1.00-1.42), and 1.21 (95% CI 0.98-1.48), respectively. HRs for RFS, OS, and BCSS for the obese were 1.13 (95% CI 0.98-1.31), 1.24 (95% CI 1.04-1.48), and 1.23 (95% CI 1.00-1.52), respectively. Subset analyses showed these differences were significant for the ER-positive, but not ER-negative or HER2-positive, groups. Relative to nondiabetics, HRs for diabetics for RFS, OS, and BCSS were 1.21 (95% CI 0.98-1.49), 1.39 (95% CI 1.10-1.77), and 1.04 (95% CI 0.75-1.45), respectively.

Conclusions: In patients receiving modern adjuvant therapies, obesity has a negative impact on RFS, OS, and BCSS; and diabetes has a negative impact on RFS and OS. Control of both may be important to improving survival in obese and diabetic breast cancer patients.

Keywords: body mass index; breast cancer; diabetes; obesity; prognosis; survival outcomes.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Survival outcomes by BMI category (A–C) and diabetes status (D–F). RFS, recurrence-free survival; OS, overall survival; BCSS, breast cancer-specific survival.
Figure 2.
Figure 2.
Survival outcomes by BMI category for hormone receptor-positive patients.
Figure 3.
Figure 3.
Survival outcomes by BMI category for hormone receptor-positive patients treated with tamoxifen alone (A–C) or AI alone (D–F).
See this image and copyright information in PMC

References

    1. Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999–2008. JAMA. 2010;303:235–241. - PubMed
    1. van den Brandt PA, Spiegelman D, Yaun SS, et al. Pooled analysis of prospective cohort studies on height, weight, and breast cancer risk. Am J Epidemiol. 2000;152:514–527. - PubMed
    1. Trentham-Dietz A, Newcomb PA, Storer BE, et al. Body size and risk of breast cancer. Am J Epidemiol. 1997;145:1011–1019. - PubMed
    1. Key TJ, Appleby PN, Reeves GK, et al. Body mass index, serum sex hormones, and breast cancer risk in postmenopausal women. J Natl Cancer Inst. 2003;95:1218–1226. - PubMed
    1. Ewertz M, Jensen MB, Gunnarsdottir KA, et al. Effect of obesity on prognosis after early-stage breast cancer. J Clin Oncol. 2011;29:25–31. - PubMed

Publication types

MeSH terms