Faculty Collaboration Database

Association of Locoregional Control With High Body Mass Index in Women Undergoing Breast Conservation Therapy for Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2016 Sep 01;96(1):65-71

Date

08/12/2016

Pubmed ID

27511848

Pubmed Central ID

PMC4985015

DOI

10.1016/j.ijrobp.2016.04.020

Scopus ID

2-s2.0-84990851944 (requires institutional sign-in at Scopus site)   21 Citations

Abstract

PURPOSE: Obesity, as measured by the body mass index (BMI), is a risk factor for distant recurrence and decreased survival in breast cancer. We sought to determine whether the BMI correlated with local recurrence and reduced survival in a cohort of predominantly obese women treated with breast conservation therapy.

METHODS AND MATERIALS: From 1998 to 2010, 154 women with early-stage invasive breast cancer and 39 patients with ductal carcinoma in situ underwent prone whole breast irradiation. Cox proportional hazards regression, Kaplan-Meier methods with the log-rank test, and multivariate analysis were used to explore the association of the outcomes with the BMI.

RESULTS: The median patient age was 60 years, and the median follow-up duration was 73 months. The median BMI was 33.2 kg/m(2); 91% of the patients were overweight (BMI ≥25 kg/m(2)) and 69% of the patients were clinically obese (BMI ≥30 kg/m(2)). The BMI was significantly associated with the locoregional recurrence-free interval for patients with invasive cancer and ductal carcinoma in situ (hazard ratio [HR], 1.09; P=.047). Also, a trend was seen for increased locoregional recurrence with a higher BMI (P=.09) for patients with invasive disease, which was significant when examining the outcomes with a BMI stratified by the median value of 33.2 kg/m(2) (P=.008). A greater BMI was also significantly associated with decreased distant recurrence-free interval (HR, 1.09; P=.011) and overall survival (HR, 1.09; P=.004); this association remained on multivariate analysis (distant recurrence-free interval, P=.034; overall survival, P=.0007).

CONCLUSIONS: These data suggest that the BMI might affect the rate of locoregional recurrence in breast cancer patients. A higher BMI predicted a worse distant recurrence-free interval and overall survival. The present investigation adds to the increasing evidence that BMI is an important prognostic factor in early-stage breast cancer treated with breast conservation therapy.

Author List

Bergom C, Kelly T, Bedi M, Saeed H, Prior P, Rein LE, Szabo A, Wilson JF, Currey AD, White J

Authors

Manpreet Bedi MD, MS Professor in the Radiation Oncology department at Medical College of Wisconsin
Adam Currey MD Associate Professor in the Radiation Oncology department at Medical College of Wisconsin
Tracy R. Kelly MD Associate Professor in the Radiation Oncology department at Medical College of Wisconsin
Phillip Prior PhD Assistant Professor in the Radiation Oncology department at Medical College of Wisconsin
Lisa E. Rein Biostatistician III in the Institute for Health and Equity department at Medical College of Wisconsin
Aniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
J Frank Wilson MD Professor Emeritus in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Body Mass Index
Breast Neoplasms
Combined Modality Therapy
Comorbidity
Disease-Free Survival
Female
Humans
Mastectomy, Segmental
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local
Neoplasm Staging
Obesity
Prevalence
Retrospective Studies
Risk Factors
Survival Rate
Wisconsin