Summary
The present study consists of 1,238 women with unilateral breast cancer treated with modified radical mastectomy living in the geographic area of Haukeland Hospital. Their weight and height had been measured years before presentation of the disease. Age-adjusted Quetelet's index (weight/height2) showed that obese women had a 49% higher risk of dying from breast cancer than lean ones. The relative risk decreased slightly when adjusted for tumour diameter, lymph node status, and mean nuclear area of the tumour cells. The prognostic effect of Quetelet's index was examined according to the estrogen and/or progesterone receptor status of the tumour. In patients with a hormone receptor positive tumour, obese women had a risk that was more than three times higher than lean ones. In patients with hormone receptor negative tumour, the effect of obesity was reversed, lean patients having a risk that was more than six times higher than obese ones, even after adjustment for lymph node status, tumour diameter, and mean nuclear area. Quetelet's index, while being a prognostic variable in its own right, thus acts differently in patients with hormone receptor positive and negative tumours.
References
Abe R, Kumagai N, Kimura M, Hirosaki A, Nakamura T: Biological characteristics of breast cancer in obesity. Tohoku J Exp Med 120: 351–359, 1976
Donegan WL, Hartz AJ, Rimm AA: The association of body weight with recurrent cancer of the breast. Cancer 41: 1590–1594, 1978
Boyd NF, Campbell JE, Germanson T, Thomson DB, Sutherland DJ, Meakin JW: Body weight and prognosis in breast cancer. JNCI 67: 785–789, 1981
Tartter PI, Papatestas AE, Ioannovich J, Mulvihill MN, Lesnick G, Aufses AH: Cholesterol and obesity as prognostic factors in breast cancer. Cancer 47: 2222–2227, 1981
Greenberg ER, Vessey MP, McPherson K, Doll R, Yeates D: Body size and survival in premenopausal breast cancer. Br J Cancer 51: 691–697, 1985
Hebert JR, Augustine A, Barone J, Kabat GC, Kinne DW, Wynder EL: Weight, height and body mass index in the prognosis of breast cancer: Early results of a prospective study. Int J Cancer 42: 315–318, 1988
Senie RT, Rosen PP, Rhodes P, Lesser ML, Kinne DW: Obesity at diagnosis of breast carcinoma influences duration of disease-free survival. Ann Intern Med 116: 26–32, 1992
Bastarrachea J, Hortobagyi GN, Smith TL, Kau S-WC, Buzdar AU: Obesity as an adverse prognostic factor for patients receiving adjuvant chemotherapy for breast cancer. Ann Intern Med 119: 18–25, 1993
Sohrabi A, Sandoz J, Spratt JS, Polk HC: Recurrence of breast cancer. Obesity, tumor size, and axillary lymph node metastases. JAMA 244: 264–265, 1980
Tretli S, Haldorsen T, Ottestad L: The effect of pre-morbid height and weight on the survival of breast cancer patients. Br J Cancer 62: 299–303, 1990
Goodwin PJ, Boyd NF: Body size and breast cancer prognosis: a critical review of the evidence. Breast Cancer Res Treat 16: 205–214, 1990
Eberlein T, Simon R, Fisher S, Lippman ME: Height, weight, and risk of breast cancer relapse. Breast Cancer Res Treat 5: 81–86, 1985
Verreault R, Brisson J, Deschênes, Naud F: Body weight and prognostic indicators in breast cancer. Am J Epidemiol 129: 260–268, 1989
Mæhle BO, Skjaerven R, Collett K: Prognosis in node negative breast cancer patients: The importance of tumour diameter and mean nuclear area. Eur J Surg Oncol 14: 21–26, 1988
Cox DR: Regression models and life-tables. J Royal Stat Soc B 34: 187–222, 1972
Tretli S: Height and weight in relation to breast cancer morbidity and mortality. A prospective study of 570,000 women in Norway. Int J Cancer 44: 23–30, 1989
Thorsen T: Occupied and unoccupied oestradiol receptor in human breast tumours: relation to oestradiol and progesterone cytosol receptors. J Steroid Biochem 10: 661–668, 1979
Cleland WH, Mendelson CR, Simpson ER: Effects of aging and obesity on aromatase activity of human adipose cells. J Clin Endocrin Metab 60: 174–177, 1985
Enriori CL, Osini W, Cremona MDC, Etkin AA, Cardillo LR, Reforzo-Membrives J: Decrease of circulating level of SHBG in post-menopausal obese women as a risk factor in breast cancer: Reversible effect of weight loss. Gynecol Oncol 23: 77–86, 1986
Giuffrida D, Lupo L, La Porta GA, La Rosa GL, Padova G, Foti E, Marchese V, Belfiore A: Relation between steroid receptor status and body weight in breast cancer patients. Eur J Cancer 28: 112–115, 1992
Newman SC, Miller AB, Howe GR: A study of the effect of weight and dietary fat on breast cancer survival time. Am J Epidemiol 123: 767–774, 1986
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Mæhle, B.O., Tretli, S. Pre-morbid body-mass-index in breast cancer: Reversed effect on survival in hormone receptor negative patients. Breast Cancer Res Tr 41, 123–130 (1996). https://doi.org/10.1007/BF01807157
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DOI: https://doi.org/10.1007/BF01807157