title: Relation of body mass index (BMI) to disease free (DFS) and distant disease free survivals (DDFS) among Turkish women with operable breast carcinoma.
abstract: BACKGROUND
  The correlation between body mass index (BMI) and patient and tumor characteristics related to prognosis has not been well explored and may help to elucidate the mechanisms involved in the carcinogenesis. Because of the equivocal, inconsistent and uncertain research results as well as racial and ethnic differences, we aimed to evaluate the prognostic significance of high BMI in Turkish women with operable breast carcinoma.
  
  
  METHODS
  Two hundred and sixty-six patients who had operable invasive breast carcinoma diagnosed from 2000 through 2004 in a single institution were evaluated for their demographic features, BMI, histopathological/immunohistochemical examinations and treatments. Quetelet BMI [weight (kg)/height (m)2] categories were selected according to the World Health Organization definition. Disease free survival (DSF) as well as distant disease free survival (DDSF) analyses were performed to identify independent prognostic factors.
  
  
  RESULTS
  Post-menopausal patients were significantly in the higher quartile of BMI than pre-menopausal patients (P = 0.003). While post-menopausal obese patients had worse DSF and DDFS (P = 0.001), vascular invasion was the independent prognostic factor for both survival indices (P = 0.031).
  
  
  CONCLUSIONS
  Post-menopausal obese Turkish women are at increased risk of developing breast tumors with aggressive phenotype and obesity is a strong predictor of poor DSF and DDFS. Preventive strategies to reduce not only the prevalence of obesity and breast cancer but also the mortality must be recognized as the cost-effective public-health policy for Turkey.
authors.affiliation: Dokuz Eylül University Institute of Oncology, Department of Clinical Oncology, Division of Medical Oncology, Izmir, Turkey. binnaz.demirkan@deu.edu.tr
authors.forename: Binnaz
authors.initials: B
authors.lastname: Demirkan
authors.forename: Ahmet
authors.initials: A
authors.lastname: Alacacioglu
authors.forename: Ugur
authors.initials: U
authors.lastname: Yilmaz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009362:Neoplasm Metastasis; D017698:Postmenopause; D011379:Prognosis; D014421:Turkey / Q000453:epidemiology