Survival Outcome in Obese Breast Cancer Patients According to Menopausal Status

Abstract

Background: Breast cancer is the most frequent cancer among women. The correlation between obesity and prognosis of breast cancer is still debatable and differs by menopausal status. Aim:To investigate the impact of obesity on prognosis of breast cancer patients according to menopausal status. Patients and Methods: we recruited all obese breast cancer patients who fulfilled the criteria in a retrospective cohort study, using clinical data in medical records at the Clinical Oncology Department of Suez Canal university hospital in period between January 2013 till December 2018, then we stratified them according to menopausal status into two groups: premenopausal and postmenopausal, and compared these groups regarding clinicopathological characteristics, disease free survival and 10-year overall survival. Results: A total of 188 obese breast cancer patients were included; 38.3% were premenopausal and 61.7% were postmenopausal. Obese patients who received Letrozole showed an absence of local recurrence. However, 2.1% of obese patients who didn’t receive Letrozole developed local recurrence. The 10-year total survival rate was 80% for obese patients who received tamoxifen and 55.1% for didn’t receive tamoxifen. We found no significant difference in staging parameters, disease progression, or 10-year overall survival between pre- and postmenopausal obese patients. However, there was a higher prevalence of lympho-vascular invasion in premenopausal obese patients (37.5%) compared to postmenopausal obese patients (23.3%). Conclusion: the impact of obesity on breast cancer prognosis is still controversial. Obese patients tend to be postmenopausal and may benefit from using Tamoxifen and Letrozole. Premenopausal patients had a higher prevalence of lympho-vascular invasion.