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
. 2020 Apr 1;21(4):953-960.
doi: 10.31557/APJCP.2020.21.4.953.

Impact of Obesity on Outcomes of Operable Breast Cancer: A Retrospective Cohort Study

Tanapat Engkakul  1 , Nuntakorn Thnogtang  2 , Akarin Nimmannit  3 , Suebwong Chuthapisith  4 , Charuwan Akewanlop  1
Affiliations

Impact of Obesity on Outcomes of Operable Breast Cancer: A Retrospective Cohort Study

Tanapat Engkakul et al. Asian Pac J Cancer Prev. .

Abstract

Objective: Obesity is increasing worldwide. Previous studies of the impact of obesity on breast cancer outcomes have reported conflicting results. We investigated the association of obesity and breast cancer survival in Thai patients.

Methods: Medical records of operable breast cancer patients diagnosed and treated at Siriraj Hospital between January 2004 and December 2011 were reviewed. Demographic data, tumor characteristics, stage, treatment and adverse event were described. Obesity was defined as body mass index (BMI) ≥ 25 kg/m2 using Asian's cutoff value. Survivals in both obese and non-obese patient groups were analyzed.

Results: A total of 400 patients were included, 200 in each group. Obese patients were older and associated with more comorbidity. Obesity was associated with larger tumor size (p = 0.011), greater numbers of lymph node involvement (p = 0.003) and more advanced stage (p = 0.01). Obese patients were more likely to receive less adjuvant chemotherapy and hormonal treatment. There was no statistically significant difference in disease-free survival (DFS) (Hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.46 to 1.13) and overall survival (OS) (HR 0.77, 95% CI 0.43 to 1.39) between obese and non-obese patients. Interestingly, obesity was associated with fewer complications from chemotherapy than non-obese patients (p = 0.047).

Conclusion: Obesity had no adverse prognostic impact association on both DFS and OS in Thai patients with operable breast cancer, although obese patients more often presented with larger tumor and higher numbers of lymph node involvement.<br />.

Keywords: Body mass index; Obesity; Prognosis; breast cancer; disease-free survival.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kaplan Meier Survival Curve of Disease-free Survival According to BMI group (Non-obese, BMI < 25 kg/m2; Obese, BMI ≥ 25 kg/m2)
Figure 2
Figure 2
Kaplan Meier Survival Curve of Overall Survival According to BMI group. (Non-obese, BMI < 25 kg/m2, Obese, BMI ≥ 25 kg/m2)
See this image and copyright information in PMC

References

    1. Anuurad E, Shiwaku K, Nogi A, et al. The new BMI criteria for Asians by the regional office for the western pacific region of WHO are suitable for screening of overweight to prevent metabolic syndrome in elder Japanese workers. J Occup Health. 2003;45:335–43. - PubMed
    1. Berrigan D, Troiano RP, Graubard BI. BMI and mortality: the limits of epidemiological evidence. Lancet. 2016;388:734–6. - PMC - PubMed
    1. Carroll JP, Protani M, Walpole E, Martin JH. Effect of obesity on toxicity in women treated with adjuvant chemotherapy for early-stage breast cancer: a systematic review. Breast Cancer Res Treat. 2012;136:323–30. - PubMed
    1. Carroll JP, Protani MM, Nguyen L, et al. Toxicity and tolerability of adjuvant breast cancer chemotherapy in obese women. Med Oncol. 2014;31:881. - PubMed
    1. Chan DS, Vieira AR, Aune D, et al. Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol. 2014;25:1901–14. - PMC - PubMed