Share This Article:

The Effect of Overweight on The Risk of Recurrence in Tunisian Patients with Operable Breast Cancer

Abstract Full-Text HTML Download Download as PDF (Size:246KB) PP. 302-307
DOI: 10.4236/jct.2011.23040    4,498 Downloads   8,164 Views  

ABSTRACT

Obesity is associated with worse breast cancer outcomes in Western and Asian women. The present study was to determine the relation of body mass index (BMI) to disease-free survival (DFS) in Tunisian patients with operable breast cancer. We retrospectively reviewed data from 223 patients with operable breast cancer treated with primary surgery and adjuvant epirubicin-based chemotherapy. Patients were categorized into lower-BMI (<27.5 kg/m2; N=114) v higher-BMI (>27.5 kg/m2; N=113). Patients’and disease characteristics, including tumor size and lymph node status, were similar between the 2 groups. With a median follow-up of 56 months, there were 42 and 30 DFS events in the lower- and higher-BMI group, respectively (adjusted hazard ratio (HR): 0.74; 95% CI, 0.43 to 1.26; p=0.26). A significant interaction (p<0.001) was found between BMI category and time, with a significant DFS advantage for the higher-BMI group after 3 years (adjusted HR: 0.28; 95% CI, i to 0.86; p=0.03). We conclude that overweight is associated with a decreased risk of late recurrence in Tunisian patients with operable breast cancer.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

I. Masmoudi, A. Masmoudi, N. Toumi, A. Khanfir, M. Frikha and J. Daoud, "The Effect of Overweight on The Risk of Recurrence in Tunisian Patients with Operable Breast Cancer," Journal of Cancer Therapy, Vol. 2 No. 3, 2011, pp. 302-307. doi: 10.4236/jct.2011.23040.

References

[1] M. Ben Abdallah, S. Zehani, M. Maalej, M. Hsairi, M. Hechiche, K. Ben Romdane, H. Boussen, A. Saadi, N. Achour and F. Ben Ayed, “Cancer du sein en Tunisie: Carctéristiques Epidémiologiques et Tendance Evolutive de l’Incidence, ” Tunisie Médicale, Vol. 87, No. 7, 2009, pp. 417-425.
[2] A. Khanfir, M. Frikha, F. Kallel, M. Meziou, K. Trabelsi, T. Boudawara, J. Mnif and J. Daoud, “Le Cancer du sein de la Femme Jeune Dans le sud Tunisien,” Cancer Radiother, Vol. 10, No. 8, 2006, pp. 565-571. doi:10.1016/j.canrad.2006.09.115
[3] N. Mokhtar, J. Elati, R. Chabir, A. Bour, K. Elkari, N. P. Schossman, B. Caballero and H. Aguenaou, “Diet Culture and Obesity in Northern Africa,” Journal of Nutrition, Vol. 131, No. 3, 2001, pp. 887S-892S.
[4] J. J. Dignam and E. P. Mamounas, “Obesity and Breast Cancer Prognosis: An Expanding Body of Evidence,” Annals of Oncology, Vol. 15, No. 6, 2004, pp. 850-851. doi:10.1093/annonc/mdh241
[5] International Breast Cancer Study Group, G. Berclaz, S. Li, K. N. Price, A. S. Coates, M. castiglione-Gertsch, C. M. Denstam, S. B. Holmberg, J. Lindtner, D. Erzen, J. Collins, R. Synder, et al., “Body Mass Index as a Prognostic Feature in Operable Breast Cancer: The International Breast Cancer Study Group Experience,” Annals of Oncology, Vol. 15, No. 6, 2004, pp. 875-884. doi:10.1093/annonc/mdh222
[6] S. Loi, R. L. Milne, M. L. Friedlander, M. R. E. McCredie, G. G. Giles, J. L. Hopper and K. A. Phillipps, “Obesity and Outcomes in Premenopausal and Postm-enopausal Breast Cancer,” Cancer Epidemiology, Biomarkers & Prevention, Vol. 14, No. 7, 2005, pp. 1686-1691. doi:10.1158/1055-9965.EPI-05-0042
[7] P. E. Abrahamson, M. D. Gammon, M. J. Lund, E. W. Flagg, P. L. Porter, J. Stevens, S. A. Swanson, L. A. Brinton, J. W. Eley and R. J. Coates, “General and Abdominal Obesity and Survival among Young Women with Breast Cancer,” Cancer Epidemiology, Biomarkers & Prevention, Vol. 15, No. 10, 2006, pp. 1871-1877. doi:10.1158/1055-9965.EPI-06-0356
[8] S. Dawood, K. Broglio, A. M. Gonzalez-Angulo, S. W. Kau, R. Islam, G. N. Hortobagyi and M. Cristofanilli, “Prognostic Value of Body Mass Index in Locally Advanced Breast Cancer,” Clinical Cancer Research, Vol. 14, No. 6, 2008, pp. 1718-1725. doi:10.1158/1078-0432.CCR-07-1479
[9] M. H. Tao, X. O. Shu, Z. X. Ruan, Y. T. Gao and W. Zheng, “Association of Overweight with Breast Cancer Survival,” American Journal of Epidemiology, Vol. 163, No. 2, 2006, pp. 101-107. doi:10.1093/aje/kwj017
[10] D. P. Rose, E. M. Gilhooly and D. W. Nixon, “Adverse Effects of Obesity on Breast Cancer Prognosis, and the Biological Actions of Leptin (Review),” International Journal of Oncology, Vol. 21, No. 6, 2002, pp. 1285- 1292.
[11] P. J. Goodwin, M. Ennis, I. G. Fantus, K. I. Pritchard M. E. Trudeau, J. Koo and N. Hood, “Is Leptin a Mediator of Adverse Prognostic Effects of Obesity in Breast Cancer?” Journal of Clinical Oncology, Vol. 23, No. 25, 2005, pp. 6037-6042. doi:10.1200/JCO.2005.02.048
[12] K. Snoussi, A. D. Strosberg, N. Bouaouina, S. Ben Ahmed, A. N. helal and L. chouchane, “Leptin and Leptin Receptor Polymorphisms Are Associated with Increased Risk and Poor Prognosis of Breast Carcinoma,” BMC Cancer, Vol. 20, 2006, pp. 6-38.
[13] M. F. Mnif, A. Zouari, S. Sessi, M. Elleuch, M. Fourati, K. Makni, N. Charfi and M. Abid, “Association du Polymorphisme G-2548 A de la Région 5 du Gène de la Leptine avec l’Obésité dans la Région de Sfax en Tunisie,” Diabetes Metabolism, Vol. 35, No. S1, 2009, pp. 56-57. doi:10.1016/S1262-3636(09)71920-2
[14] S. I. Labidi, K. Mrad, A. Mezlini, M. Ayadi Warda, J. D. Coombs, M. Ben Abdallah, K. Ben Romdhane, P. Viens and F. Ben Ayed, “Inflammatory Breast Cancer in Tunisia in the Era of Multimodality Therapy,” Annals of Oncology, Vol. 19, No. 3, 2008, pp. 473-480. doi:10.1093/annonc/mdm480
[15] S. Chang, J. R. Alderfer, L. Asmar and A. U. Buzdar, “Inflammatory Breast Cancer Survival: The Role of Obesity and Menopausal Status at Diagnosis,” Breast Cancer Research and Treatment, Vol. 64, No. 2, 2000, pp. 157- 163. doi:10.1023/A:1006489100283
[16] K. L. Van Golen, Z. F. Wu, X. T. Qiao, L. W. Bao and S. D. Merajver, “RhoC GTPase, a Novel Transforming Oncogene for Human Mammary Epithelial Cells That Partially Recapitulates the Inflammatory Breast Cancer Phenotype,” Cancer Research, Vol. 60, No. 20, 2000, pp. 5832-5838.
[17] P. Singh, T. E. Peterson, A. Romero-Corral, D. E. Davidson, M. D. Jensen and V. K. Somers, “Identification of Caveolin-1 as an Inhibitor of Leptin Signaling: Implications for Leptin Resistance in a Human Weight Gain Model,” Circulation, Vol. 118, 2008, p. S278.
[18] M. Lin, M. M. DiVito, S. D. Merajver, M. Boyanapalli and K. L. Van Golen, “Regulation of Pancreatic Cancer Cell Migration and Invasion by RhoC GTPase and Caveolin-1,” Molecular Cancer, Vol. 4, 2005, pp. 4-21. doi:10.1186/1476-4598-4-21
[19] S. Van Laere, I. Van der Auwera, G. Van den Eynden, P. Van Hummelen, P. Van Dam, E. Van Marck, P. B. Vermeulen and L. Dirix, “Distinct Molecular Phenotype of Inflammatory Breast Cancer Compared to Non-Inflammatory Breast Cancer Using Affymetrix-Based Genome-Wide Gene-Expression Analysis,” British Journal of Cancer, Vol. 97, No. 8, 2007, pp. 1165-1174. doi:10.1038/sj.bjc.6603967
[20] X. Zhang, M. Lin, K. L. Van Golen, K. Yoshioka, K. Itoh and D. Yee, “Multiple Signalling Pathways Are Activated during Insulin-Like Growth Factor-I (IGF-I) Stimulated Breast Cancer Cell Migration,” Breast Cancer Research and Treatment, Vol. 93, No. 2, 2005, pp. 159-168. doi:10.1007/s10549-005-4626-8
[21] I. T. Gram, T. Norat, S. Rinaldi, L. Dossus, A. Lukanova, B. Tehard, F. Clavel-Chapelon, C. H. Van Gils, P. A. H. Van Noord, P. H. M. Peeters, H. B. Bueno-De-Mesquita, G. Nagel, J. Linseisen, P. H. Lahamann, et al., “Body Mass Index, Waist Circumference and Waist-Hip Ratio and Serum Levels of IGF-I and IGFBP-3 in European Women,” International Journal of Obesity (Lond), Vol. 30, No. 11, 2006, pp. 1623-1631. doi:10.1038/sj.ijo.0803324
[22] L. Ayadi, A. Khabir, H. Amouri, S. Karray, A. Dammak, M. Guermazi and T. Boudawara, “Correlation of HER-2 over-Expression with Clinico-Pathological Parameters in Tunisian Breast Carcinoma,” World Journal of Surgical Oncology, Vol. 6, No. 1, 2008, p. 112. doi:10.1186/1477-7819-6-112
[23] E. Charafe-Jauffret, K. Mrad, S. Labidi, A. Ben Hamida, K. Ben Romdhane, M. Ben Abdallah, C. Ginestier, B. Esterni, D. Birnbaum, F. Ben Ayed, L. Xerri, A. Mezlini and J. Jacquemier, “Inflammatory Breast Cancers in Tunisia and France Show Similar Immunophenotypes,” Breast, Vol. 16, No. 4, 2007, pp. 352-358. doi:10.1016/j.breast.2007.01.002
[24] K. W. Hance, W. F. Anderson, S. S. Devesa, H. A. Young and P. H. Levine, “Trends in Inflammatory Breast Carcinoma Incidence and Survival: The Surveillance, Epidemiology, and End Results Program at the National Cancer Institute,” Journal of the National Cancer Institute, Vol. 97, No. 13, 2005, pp. 966-975. doi:10.1093/jnci/dji172
[25] F. Puglisi, A. Follador, A. M. Minisini, G. G. Cardellino, S. Russo, C. Andreetta, S. Di Terlizzi and A. Piga, “Baseline Staging Tests after a New Diagnosis of Breast Cancer: Further Evidence of Their Limited Indications,” Annals of Oncology, Vol. 16, No. 2, 2005, pp. 263-266. doi:10.1093/annonc/mdi063
[26] S. Low, M. C. Chin, S. Ma, D. Heng, M. Deurenberg-Yap, et al., “Rationale for Redefining Obesity in Asians,” Annals Academy of Medicine Singapore, Vol. 38, No. 1, 2009, pp. 66-69.

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.