Obesity carries a high risk of breast cancer with worse treatment outcome. Different molecular subtype and prognostic factors are linked to high body mass index (BMI) and affects overall and progression-free survival.
All 950 breast cancer patients presented to kasr Alainy oncology center (NEMROCK) from 2004 - 2014 at Al kasr alainy oncology center (NEMROCK) were followed up with a median period of 4.2years till Dec 2018. The body mass index (BMI) was assessed at diagnosis in 760 female patients. Disease-free survival (DFS) and overall survival (OS) were assessed and compared between three groups: non-obese (BMI <30), obese (BMI 30-34.9) and severely obese (BMI >40).
The mean age was 50.1 years with Obesity in 63.29% of cases (23.82% and 39.47% in obese and severely obese respectively). Significant correlations between non-obese and severely obese with age (52 vs.48 years, p < 0.001), menopausal status (31.3 vs.46.9%, p < 0.001), molecular types (non- luminal; 25 vs. 50% p < 0.011), Her2 status (44.4 vs. 27.2%, p = 0.014) and hormonal therapy (Tamoxifen alone, 44.3 vs. 30.4%, p = 0.001). Mean Overall survival(OS) was significantly better in non-obese groups compared to obese and severely obese (102.5, 80, 88months, P=value 0.019), with no impact on DFS (p = 0.40).In multivariate analysis, lymph node stage (p < 0.001; OR: 1; 95% CI: 0.07-0.46), BMI (p = 0.001; OR: 1; 95% CI: 0.14-0.61), and hormonal treatment tamoxifen alone(p = 0.001; OR: 1; 95%CI: 1.4-16.4) remained significantly associated with OS.
severe obesity (BMI >40) have worse overall survival with no impact on disease free survival.
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