Body Mass Index and Hormone Receptor Status Influence Recurrence Risk in HER2-Positive Early Breast Cancer Patients |
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| Institution: | 1. Clinica Oncologica, Università Politecnica delle Marche, AOU Ospedali Riuniti, Ancona, Italy;2. Oncology Unit II, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy;3. Anatomia Patologica e Citologia, AO Ospedali Riuniti Marche Nord, Pesaro, Italy;1. Department of Radiation Oncology, Rhode Island Hospital, Providence, RI;2. Department of Hematology Oncology, Rhode Island Hospital, Providence, RI;3. Department of Radiation Oncology, Tufts Medical Center, Boston, MA;1. Department of Surgery, John Wayne Cancer Institute, Santa Monica, CA;2. Department of Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA;3. Present affiliation: Department of Surgery, Eisenhower Army Medical Center, Augusta, CA;4. Present affiliation: Department of Surgery, Carolina Medical Center, Charlotte, NC;5. Present affiliation: Department of Surgery, William Beaumont Army Medical Center, El Paso, TX;1. Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA;2. Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, CA;1. Department of Hematology and Medical Oncology, Emory University, Atlanta, GA;2. Biostatistics and Bioinformatics Shared Resource, Emory University, Atlanta, GA;3. Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA;4. Department of Pharmacology, Emory University, Atlanta, GA;5. Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China;6. Department of Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China;7. Department of Biology, Georgia State University, Atlanta, GA;8. Department of Pathology, Ohio State University, Columbus, OH;9. Department of Medicine, University of Wisconsin, Madison, WI;1. Department of Chest Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei, 112, Taiwan;2. School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan |
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| Abstract: | IntroductionA reliable risk stratification on the basis of tumor biology and host factors of HER2-positive (HER2+) early breast cancer (eBC) patients is needed. The aim of our study was to assess the prognostic role of body mass index (BMI) and hormone receptor (HR) expression in this setting.Patients and MethodsWe retrospectively evaluated 238 women with stage I to III HER2+ breast cancer who completed adjuvant chemotherapy (CHT) and 1 year of treatment with trastuzumab. The end point was 3-year distant disease-free survival (3yDDFS). Survival analysis was evaluated using the Kaplan–Meier method. Multivariate analysis was performed using Cox proportional-hazards model adjusting for HR status, BMI, tumor staging, size, nodal status, and type of adjuvant CHT. Association among categorical variables was assessed using χ2 test.ResultsThe early recurrence rate after 3 years resulted as 4.2% (40% HR+ patients and 60% HR? patients). Neither HR status nor BMI alone showed an association with 3yDDFS in multivariate analysis. However, the hazard ratios for patients with HR? tumors who had also BMI ≥25 (3yDDFS 86.9%; 95% confidence interval CI], 75.0%-97.7%) were amplified compared with patients with HR+ tumors and with BMI <25 (3yDDFS 98%; 95% CI, 94.8%-100.0%) and other subgroups (P = .003). This observation was confirmed in multivariate analysis (hazard ratio, 1.79; 95% CI, 1.04-3.07; P = .03).ConclusionOur real-life data highlight a different risk of eBC recurrence after grouping patients according to HR status and BMI. These results might help clinicians to identify correct treatment strategies. Patients who are HR? and have BMI ≥25 might benefit from escalation approaches, whereas those who are HR+ and have BMI <25 might be eligible for a shorter duration of adjuvant treatment with anti-HER2 agents. |
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| Keywords: | Body mass index Early breast cancer HER2 Hormone receptors Trastuzumab |
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