What is believed to be the first study investigating the mode of detection of breast cancer in obese women with their disease free survival by a team of Italian researchers has been published in the February issue of The Breast. A research team from the National Cancer Institute “G. Pascale” Foundation in Naples conducted a retrospective study evaluating the effect of body mass indenx (BMI) on breast cancer prognosis in 448 screen-detected or symptomatic breast cancer patients.1
Lead author Dr. Anna Crispo of the Epidemiology Unit and colleagues conducted a follow-up study for a median of 61.8 months of women who were categorized as being of normal weight, being overweight, or being obese based on their BMI. They were also categorized as either having symptomatic tumors (74.5%) or having tumors identified from a mammogram (25.5%). Descriptive characteristics were analyzed. Disease-free survival (DFS) and overall survival (OS) outcomes were analyzed based on method of identifying tumors and also differences in BMI.
As was expected, patients who had tumors identified by mammography had a significant greater percentage of smaller-sized tumors, with 80.8% of these patients having a T1 tumor compared to 51.7% of women whose tumor was identified by clinical exam. Higher BMI was associated with a significantly lower disease-free survival and overall survival for the patients who had a mammogram, but there was no significant difference in the symptomatic patient group.
Statistical analyses had mixed results. With univariate analysis, high BMI levels predicted worse DFS and OS only for patients whose tumors were identified by mammography. But multivariate analysis did not confirm this finding. And a heterogeneity test showed no effect of BMI on either group, but did snow that obesity places a role in breast cancer prognosis independently from the diagnostic mode. The authors hypothesized that symptomatic breast cancer patients may suffer from more aggressive tumors, They are planning a larger prospective study to better define the prognostic role of BMI in breast cancer patients based on mode of detection.
The article may be accessed here by subscription.
Obesity and breast cancer prognosis: weight makes a difference. Appl Radiol.