Sk. Haidar Ali, MBBS, MD, Rahi Das, MBBS, MD, Sumana Maiti Das, MBBS, MD, Ananya Mahalanabish, MBBS, MD, Saikat Mondal, MBBS, Siddhartha Das, MBBS, MD.
Abstract
Objectives: Triple negative breast cancer (TNBC) lacks expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), making it more aggressive and less responsive to targeted therapies. Our retrospective study aimed to investigate the impact of body mass index (BMI) on the survival of TNBC patients in Eastern India.
Material and Methods: 42 TNBC patients were included from January 2016 to December 2020 and were followed up until December 2023. Baseline characteristics were summarized using percentages and frequencies. The Chi-square test was used for clinicopathologic characteristics, and the Kaplan-Meier method evaluated survival functions. Log-rank tests conducted (p ≤ 0.05).
Results: The median age of the population was 45 years. The majority (92.98%) had no family history. 67.7% were of Grade 2, and 27.69% were Grade 3. The mean BMI was 23.95 [ range 14.2 – 37.56 (95% CI 23.49;24.4)]. 62.81% were of a healthy weight, 28.51% were overweight, 4.55% were underweight, and 4.13% were obese. Metastasis-free survival (MFS) rates were 90.91% for underweight, 84.06% for overweight, 76.32% for healthy weight, and 70% for obese patients (p value .376). DFS, considering both local recurrence and metastases as an event, were 94.2% for overweight, 94.08% for healthy weight, 90% for obese, and 54.55% for underweight individuals (p value <0.001). OS was 65.22% for overweight, 61.84% for healthy weight, 60% for obese, and 30.36% for underweight individuals (p value 0.44).
Conclusion: This study’s findings highlight significant implications of BMI on survival outcomes. It also reinforces the intricate link between obesity and prognosis, emphasizing the need for weight management strategies in patient care. Further mechanistic research is warranted.
Body mass index, Survival outcomes and Triple negative breast cancerReference:
1. Perou CM, Sørlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, et al. Molecular portraits of human breast tumours. Nature 2000;406:747-52.
2. Foulkes WD, Smith IE, Reis-Filho JS. Triple-negative breast cancer. N Engl J Med 2010;363:1938-48.
3. Dent R, Trudeau M, Pritchard KI, Hanna WM, Kahn HK, Sawka CA, et al. Triple-negative breast cancer: Clinical features and patterns of recurrence. Clin Cancer Res 2007;13:4429-34.
4. Pal SK, Childs BH, Pegram M. Triple negative breast cancer:Unmet medical needs. Breast Cancer Res Treat 2011;125:627-36.
5. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: A systematic analysis for the global burden of disease study 2013. The Lancet 2014;384:766-81.
6. Calle EE, Kaaks R. Overweight, obesity and cancer: Epidemiological evidence and proposed mechanisms. Nat Rev
Cancer 2004;4:579-91.
7. Iyengar NM, Gucalp A, Dannenberg AJ, Hudis CA. Obesity and cancer mechanisms: Tumor microenvironment and
inflammation. JCO 2016;34:4270-6.
8. Ligibel JA, Alfano CM, Courneya KS, Demark-Wahnefried W, Burger RA, Chlebowski RT, et al. American society of clinical oncology position statement on obesity and cancer. JCO 2014;32:3568-74.
9. World health organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i-xii,1-253.
10. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958;53:457-81.
11. Cox DR. Regression models and life-tables. J R Stat Soc Series B Stat Methodol 1972;34:187-202.
12. Tait S, Pacheco JM, Gao F, Bumb C, Ellis MJ, Ma CX. Body mass index, diabetes, and triple-negative breast cancer prognosis. Breast Cancer Res Treat 2014;146:189-97.
13. Kumar N, Ehsan S, Banerjee S, Fernandez Perez C, Lhuilier I, Neuner J, et al. The unique risk factor profile of triple-negative breast cancer: A comprehensive meta-analysis. J Natl Cancer Inst 2024;116:1210-9.
14. Harborg S, Zachariae R, Olsen J, Johannsen M, Cronin-Fenton D, Bøggild H, et al. Overweight and prognosis in triple-negative breast cancer patients: A systematic review and meta-analysis. NPJ Breast Cancer 2021;7:119.
15. Dehesh T, Fadaghi S, Seyedi M, Abolhadi E, Ilaghi M, Shams P, et al. The relation between obesity and breast cancer risk in women by considering menstruation status and geographical variations: A systematic review and meta-analysis. BMC Womens Health 2023;23:392.
16. Devericks EN, Carson MS, McCullough LE, Coleman MF, Hursting SD. The obesity-breast cancer link: A multidisciplinary perspective. Cancer Metastasis Rev 2022;41:607.
