한빛사 논문
Abstract
Hyeong-Gon Moon, Wonshik Han, Dong-Young Noh
From the Department of Surgery, Gyeongsang National University Hospital, Gyeongsang Institute of Health Sciences, Jinju; Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Corresponding author: Dong-Young Noh, MD, PhD, Department of Surgery, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea
Purpose The association between body mass index and breast cancer outcome is controversial. Furthermore, the impact of underweight on breast cancer recurrence and death has not been adequately addressed.
Patients and Methods We investigated this issue using a large nationwide database of 24,698 Korean breast cancer patients. The association between body weight status and breast cancer recurrence was further explored using a single-institution database containing information on 4,345 patients.
Results The results from the nationwide database showed significantly lower overall survival (OS) and breast cancer-specific survival (BCSS) in underweight patients compared with survival in patients of normal weight after adjusting for known prognostic factors such as age, tumor size, lymph node metastasis, hormone receptor status, histologic grade, and lymphovascular invasion (hazard ratio [HR], 1.48; 95% CI, 1.15 to 1.90 for OS; HR, 1.49; 95% CI, 1.15 to 1.93 for BCSS), which were not observed in obese patients. In an analysis of recurrence data from the single institution, underweight women had a significantly higher risk of both distant metastasis and local recurrence of breast cancer (HR, 1.93; 95% CI, 1.04 to 3.58 and HR, 5.13; 95% CI, 2.66 to 9.90, respectively).
Conclusion Our study suggests that underweight should be considered to be a high risk factor for death and recurrence after breast cancer surgery, especially in Asian breast cancer patients.
H.-G.M. and W.H. contributed equally to this work.
Supported by Grant No. 01-PJ3-PG6-01GN07-0004 from the Korea Health 21 Research and Development Project, Ministry of Health and Welfare (R.O.K.).
Presented in part at the 45th Annual Meeting of the American Society of Clinical Oncology, May 29-June 2, 2009, Orlando, FL.
Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.
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