TY - JOUR
T1 - Biologic features and prognosis of ductal carcinoma in situ are not adversely impacted by initial large body mass
AU - Kuerer, Henry M.
AU - Lari, Sara A.
AU - Arun, Banu K.
AU - Hu, Chung Yuan
AU - Brewster, Abenaa
AU - Mittendorf, Elizabeth A.
AU - Albarracin, Constance T.
AU - Babiera, Gildy V.
AU - Caudle, Abigail S.
AU - Wagner, Jamie L.
AU - Litton, Jennifer K.
AU - Bedrosian, Isabelle
AU - Meric-Bernstam, Funda
AU - Lucci, Anthony
AU - Hunt, Kelly K.
N1 - Funding Information:
Acknowledgment Stephanie P. Deming of MD Anderson’s Department of Scientific Publications provided editorial assistance. This research is supported by National Institutes of Health through MD Anderson’s Cancer Center Support Grant, CA016672 and Ran-dalls Food Markets.
PY - 2012/6
Y1 - 2012/6
N2 - Obesity is associated with adverse biologic features and poor outcome in patients with invasive breast cancer, yet this relationship has not been evaluated in patients with ductal carcinoma in situ (DCIS). From 1996 to 2009, body mass index (BMI) was recorded at initial diagnosis for 1,885 patients with DCIS treated at our institution. Patients were categorized as obese (BMI ≥ 30 kg/m 2), overweight (BMI 25 to < 30 kg/m 2), or of normal weight or underweight (BMI < 25 kg/m 2). Logistic regression was used to examine associations between BMI and patient, clinical, and pathologic features and treatment. Local- regional recurrence was calculated using the Kaplan-Meier method. All statistical tests were two-sided. Of the 1,885 patients, 514 (27.7%) were obese, 510 (27.5%) were overweight, and 831 (44.8%) were normal/underweight. In multivariate analysis, overweight and obese patients were significantly more likely to be African American (odds ratio [OR], 3.93; 95% confidence interval [CI], 2.66-5.80) or Hispanic (OR, 1.44; CI, 1.02-2.04), be postmenopausal (OR, 1.63; CI, 1.28-2.07), have diabetes (OR, 4.60; CI, 2.60-8.12), have estrogen-receptor-positive DCIS (OR, 1.39; CI, 1.00-192), and present with a radiologic abnormality rather than clinical symptoms (OR, 1.35; CI, 1.01-1.80). At a median follow-up time of 4.96 years (range, 1.0-14.34 years), no significant differences in local recurrence rates were detected based on patients' initial BMI category. Furthermore, there was no significant difference in risk of recurrence between diabetic patients receiving metformin or not. In conclusion, higher BMI is not associated with adverse biologic features or prognosis in patients with DCIS.
AB - Obesity is associated with adverse biologic features and poor outcome in patients with invasive breast cancer, yet this relationship has not been evaluated in patients with ductal carcinoma in situ (DCIS). From 1996 to 2009, body mass index (BMI) was recorded at initial diagnosis for 1,885 patients with DCIS treated at our institution. Patients were categorized as obese (BMI ≥ 30 kg/m 2), overweight (BMI 25 to < 30 kg/m 2), or of normal weight or underweight (BMI < 25 kg/m 2). Logistic regression was used to examine associations between BMI and patient, clinical, and pathologic features and treatment. Local- regional recurrence was calculated using the Kaplan-Meier method. All statistical tests were two-sided. Of the 1,885 patients, 514 (27.7%) were obese, 510 (27.5%) were overweight, and 831 (44.8%) were normal/underweight. In multivariate analysis, overweight and obese patients were significantly more likely to be African American (odds ratio [OR], 3.93; 95% confidence interval [CI], 2.66-5.80) or Hispanic (OR, 1.44; CI, 1.02-2.04), be postmenopausal (OR, 1.63; CI, 1.28-2.07), have diabetes (OR, 4.60; CI, 2.60-8.12), have estrogen-receptor-positive DCIS (OR, 1.39; CI, 1.00-192), and present with a radiologic abnormality rather than clinical symptoms (OR, 1.35; CI, 1.01-1.80). At a median follow-up time of 4.96 years (range, 1.0-14.34 years), no significant differences in local recurrence rates were detected based on patients' initial BMI category. Furthermore, there was no significant difference in risk of recurrence between diabetic patients receiving metformin or not. In conclusion, higher BMI is not associated with adverse biologic features or prognosis in patients with DCIS.
KW - Body mass index
KW - Breast cancer
KW - DCIS
KW - Metformin
KW - Obesity
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U2 - 10.1007/s10549-012-1999-3
DO - 10.1007/s10549-012-1999-3
M3 - Article
C2 - 22392043
AN - SCOPUS:84863727061
SN - 0167-6806
VL - 133
SP - 1131
EP - 1141
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 3
ER -