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Obesity and the outcome of young breast cancer patients in the UK: the POSH study

Obesity and the outcome of young breast cancer patients in the UK: the POSH study
Obesity and the outcome of young breast cancer patients in the UK: the POSH study
Background

Obese breast cancer patients have a poorer prognosis than non-obese patients. We examined data from a large prospective cohort study to explore the associations of obesity with tumour pathology, treatment and outcome in young British breast cancer patients receiving modern oncological treatments.

Patients and methods

A total of 2956 patients aged ?40 at breast cancer diagnosis were recruited from 126 UK hospitals from 2001 to 2007. Height and weight were measured at registration. Tumour pathology and treatment details were collected. Follow-up data were collected at 6, 12 months, and annually.

Results

A total of 2843 eligible patients (96.2%) had a body mass index (BMI) recorded: 1526 (53.7%) were under/healthy-weight (U/H, BMI <25 kg/m2), 784 (27.6%) were overweight (ov, BMI ?25 to <30), and 533 (18.7%) were obese (ob, BMI ?30). The median tumour size was significantly higher in obese and overweight patients than U/H patients (Ob 26 mm versus U/H 20 mm, P < 0.001; Ov 24 mm versus U/H 20 mm, P < 0.001). Obese and overweight patients had significantly more grade 3 tumours (63.9% versus 59.0%, P = 0.048; Ov 63.6% versus U/H 59.0% P = 0.034) and node-positive tumours (Ob 54.6% versus U/H 49.0%, P = 0.027; Ov 54.2% versus U/H 49%, P = 0.019) than U/H patients. Obese patients had more ER/PR/HER2-negative tumours than healthy-weight patients (25.0% versus 18.3%, P = 0.001). Eight-year overall survival (OS) and distant disease-free interval (DDFI) were significantly lower in obese patients than healthy-weight patients [OS: hazard ratio (HR) 1.65, P < 0.001; DDFI: HR 1.44, P < 0.001]. Multivariable analyses adjusting for tumour grade, size, nodal, and HER2 status indicated that obesity was a significant independent predictor of OS and DDFI in patients with ER-positive disease.

Conclusions

Young obese breast cancer patients present with adverse tumour characteristics. Despite adjustment for this, obesity still independently predicts DDFI and OS.
breast cancer, obesity, prognosis
1569-8041
101-112
Copson, E.R.
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Cutress, R.I.
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Maishman, T.
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Eccles, B.K.
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Gerty, S.
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Stanton, L.
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Altman, D.G.
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Durcan, L.
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Wong, C.
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Simmonds, P.D.
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Jones, L.
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Copson, E.R.
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Cutress, R.I.
68ae4f86-e8cf-411f-a335-cdba51797406
Maishman, T.
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Eccles, B.K.
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Gerty, S.
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Stanton, L.
8b827763-d839-4b4b-bbf2-358a84110294
Altman, D.G.
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Durcan, L.
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Wong, C.
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Simmonds, P.D.
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Jones, L.
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Copson, E.R., Cutress, R.I., Maishman, T., Eccles, B.K., Gerty, S., Stanton, L., Altman, D.G., Durcan, L., Wong, C., Simmonds, P.D. and Jones, L. (2015) Obesity and the outcome of young breast cancer patients in the UK: the POSH study Annals of Oncology, 26, (1), pp. 101-112. (doi:10.1093/annonc/mdu509). (PMID:25361993).

Record type: Article

Abstract

Background

Obese breast cancer patients have a poorer prognosis than non-obese patients. We examined data from a large prospective cohort study to explore the associations of obesity with tumour pathology, treatment and outcome in young British breast cancer patients receiving modern oncological treatments.

Patients and methods

A total of 2956 patients aged ?40 at breast cancer diagnosis were recruited from 126 UK hospitals from 2001 to 2007. Height and weight were measured at registration. Tumour pathology and treatment details were collected. Follow-up data were collected at 6, 12 months, and annually.

Results

A total of 2843 eligible patients (96.2%) had a body mass index (BMI) recorded: 1526 (53.7%) were under/healthy-weight (U/H, BMI <25 kg/m2), 784 (27.6%) were overweight (ov, BMI ?25 to <30), and 533 (18.7%) were obese (ob, BMI ?30). The median tumour size was significantly higher in obese and overweight patients than U/H patients (Ob 26 mm versus U/H 20 mm, P < 0.001; Ov 24 mm versus U/H 20 mm, P < 0.001). Obese and overweight patients had significantly more grade 3 tumours (63.9% versus 59.0%, P = 0.048; Ov 63.6% versus U/H 59.0% P = 0.034) and node-positive tumours (Ob 54.6% versus U/H 49.0%, P = 0.027; Ov 54.2% versus U/H 49%, P = 0.019) than U/H patients. Obese patients had more ER/PR/HER2-negative tumours than healthy-weight patients (25.0% versus 18.3%, P = 0.001). Eight-year overall survival (OS) and distant disease-free interval (DDFI) were significantly lower in obese patients than healthy-weight patients [OS: hazard ratio (HR) 1.65, P < 0.001; DDFI: HR 1.44, P < 0.001]. Multivariable analyses adjusting for tumour grade, size, nodal, and HER2 status indicated that obesity was a significant independent predictor of OS and DDFI in patients with ER-positive disease.

Conclusions

Young obese breast cancer patients present with adverse tumour characteristics. Despite adjustment for this, obesity still independently predicts DDFI and OS.

Full text not available from this repository.

More information

e-pub ahead of print date: 30 October 2014
Published date: January 2015
Keywords: breast cancer, obesity, prognosis
Organisations: Cancer Sciences, Clinical Trials Unit

Identifiers

Local EPrints ID: 373300
URI: http://eprints.soton.ac.uk/id/eprint/373300
ISSN: 1569-8041
PURE UUID: ee8c7c55-f03b-4727-a823-a5dee02578eb

Catalogue record

Date deposited: 14 Jan 2015 17:05
Last modified: 17 Jul 2017 21:34

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Contributors

Author: E.R. Copson
Author: R.I. Cutress
Author: T. Maishman
Author: B.K. Eccles
Author: S. Gerty
Author: L. Stanton
Author: D.G. Altman
Author: L. Durcan
Author: C. Wong
Author: P.D. Simmonds
Author: L. Jones

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