Metabolic syndrome is a risk factor for breast cancer patients receiving neoadjuvant chemotherapy: A case-control study

Abstract

PurposeTo investigate the impact of metabolic syndrome (MetS) on pathologic complete response (pCR) and clinical outcomes in breast cancer (BC) patients who received neoadjuvant chemotherapy (NAC).MethodsWe analyzed 221 female BC patients at Harbin Medical University Cancer Hospital who received NAC and divided them into MetS and non-MetS groups according to National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria to investigate the association between MetS and clinicopathological characteristics, pathologic response, and long-term survival and to observe the changes in metabolic parameters after NAC.ResultsA total of 53 (24.0%) BC patients achieved pCR after NAC in our study. MetS status was an independent predictor of pCR, and pCR was more difficult to obtain in the MetS group than the non-MetS group (P=0.028). All metabolic parameters deteriorated significantly after NAC, especially the blood lipid index (P<0.010). The median follow-up time was 6 years. After adjusting for other prognostic factors, MetS was found to be strongly associated with an increased risk of recurrence (P=0.007) and mortality (P=0.004) in BC patients receiving NAC. Compared to individuals without any MetS component, the risk of death and disease progression increased sharply as the number of MetS components increased.ConclusionsIn BC patients who received NAC, MetS was associated with poor outcomes, including a lower pCR rate and increased risks of recurrence and mortality.