Affiliation:
1. University of Miami Miller School of Medicine: University of Miami School of Medicine
Abstract
Abstract
Purpose
Obesity is associated with an increased breast cancer risk in postmenopausal women and may contribute to worse outcomes. Black women experience higher obesity and breast cancer mortality rates than non-Black women. We examined associations between race, obesity, and clinical tumor stage with breast cancer prognosis.
Methods
We conducted a prospective cohort study in 1,110 breast cancer patients, using univariable and multivariable Cox regression analyses to evaluate the effects of obesity, race/ethnicity, and clinical tumor stage on progression-free and overall survival (PFS and OS).
Results
22% of participants were Black, 64% were Hispanic White, and 14% were non-Hispanic White or another race. 39% of participants were obese (body mass index [BMI] ≥ 30 kg/m2). In univariable analyses, tumor stage III-IV was associated with worse PFS and OS compared to tumor stage 0-II (hazard ratio [HR] = 4.68, 95% confidence interval [CI] = 3.52–6.22 for PFS and HR = 5.92, 95% CI = 4.00-8.77 for OS). Multivariable analysis revealed an association between Black race and worse PFS in obese (HR = 2.19, 95% CI = 1.06–4.51) and non-obese (HR = 2.11, 95% CI = 1.05–4.21) women with tumors staged 0-II. Obesity alone was not associated with worse PFS or OS.
Conclusion
Results suggest a complex interrelationship between obesity and race in breast cancer prognosis. The association between Black race and worse PFS in tumor stages 0-II underscores the importance of early intervention in this group. Future studies are warranted to evaluate whether alternative measures of body composition and biomarkers are better prognostic indicators than BMI among Black breast cancer survivors.
Publisher
Research Square Platform LLC
Reference35 articles.
1. Hales CMCM, Fryar CD, Ogden CL (2020) Prevalence of obesity and severe obesity among adults: United States, 2017–2018. In: Statistics NCfH (ed) NCHS Data Brief, no 360. Hyattsville, MD
2. Guidelines (2013) for managing overweight and obesity in adults. Preface to the Expert Panel Report (comprehensive version which includes systematic evidence review, evidence statements, and recommendations);NHLBI;Obes (Silver Spring),2014
3. The weight of obesity in breast cancer progression and metastasis: Clinical and molecular perspectives;Barone I;Sem Cancer Biol,2020
4. Impact of obesity on breast cancer recurrence and minimal residual disease;Ecker BL;Breast Cancer Res,2019
5. The Impact of Obesity on Breast Cancer Diagnosis and Treatment;Lee K;Curr Oncol Rep,2019