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Obesity and survival among a cohort of breast cancer patients is partially mediated by tumor characteristics.
Blair, Cindy K; Wiggins, Charles L; Nibbe, Andrea M; Storlie, Curt B; Prossnitz, Eric R; Royce, Melanie; Lomo, Lesley C; Hill, Deirdre A.
Afiliación
  • Blair CK; 1Department of Internal Medicine, University of New Mexico, Albuquerque, NM USA.
  • Wiggins CL; 2University of New Mexico Comprehensive Cancer Center, Albuquerque, NM USA.
  • Nibbe AM; 1Department of Internal Medicine, University of New Mexico, Albuquerque, NM USA.
  • Storlie CB; 2University of New Mexico Comprehensive Cancer Center, Albuquerque, NM USA.
  • Prossnitz ER; 1Department of Internal Medicine, University of New Mexico, Albuquerque, NM USA.
  • Royce M; 2University of New Mexico Comprehensive Cancer Center, Albuquerque, NM USA.
  • Lomo LC; 3Department of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, MN USA.
  • Hill DA; 1Department of Internal Medicine, University of New Mexico, Albuquerque, NM USA.
NPJ Breast Cancer ; 5: 33, 2019.
Article en En | MEDLINE | ID: mdl-31602394
Obesity exerts adverse effects on breast cancer survival, but the means have not been fully elucidated. We evaluated obesity as a contributor to breast cancer survival according to tumor molecular subtypes in a population-based case-cohort study using data from the Surveillance Epidemiology and End Results (SEER) program. We determined whether obese women were more likely to be diagnosed with poor prognosis tumor characteristics and quantified the contribution of obesity to survival. Hazard ratios (HRs) and 95% confidence intervals (CI) were calculated via Cox multivariate models. The effect of obesity on survival was evaluated among 859 incident breast cancers (subcohort; 15% random sample; median survival 7.8 years) and 697 deaths from breast cancer (cases; 100% sample). Obese women had a 1.7- and 1.8-fold increased risk of stage III/IV disease and grade 3/4 tumors, respectively. Obese women with Luminal A- and Luminal B-like breast cancer were 1.8 (95% CI 1.3-2.5) and 2.2 (95% CI 0.9-5.0) times more likely to die from their cancer compared to normal weight women. In mediation analyses, the proportion of excess mortality attributable to tumor characteristics was 36.1% overall and 41% and 38% for Luminal A- and Luminal B-like disease, respectively. Obesity was not associated with breast cancer-specific mortality among women who had Her2-overexpressing or triple-negative tumors. Obesity may influence hormone-positive breast cancer-specific mortality in part through fostering poor prognosis tumors. When tumor biology is considered as part of the causal pathway, the public health impact of obesity on breast cancer survival may be greater than previously estimated.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: NPJ Breast Cancer Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: NPJ Breast Cancer Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos