title: Triple-negative breast cancer and obesity in a rural Appalachian population.
abstract: BACKGROUND
  Our objective was to determine the clinicopathologic features of triple-negative (estrogen receptor, progesterone receptor, and human epidermal growth factor-2 receptor negative) breast cancer and their relationship to obesity in women drawn from a population with one of the highest obesity rates in the United States.
  
  
  METHODS
  This retrospective study involved 620 White patients with invasive breast cancer in West Virginia. Hospital tumor registry, charts, and pathology records provided age at diagnosis, tumor histologic type, size, nodal status, and receptor status. Body mass index was calculated and a value of > or = 30 was considered indicative of obesity.
  
  
  RESULTS
  Triple-negative tumors occurred in 117 (18.9%) of the 620 patients, most often in association with invasive ductal carcinomas. Patients with triple-negative tumors were younger than those with other receptor types, 44.5% and 26.7%, respectively, being diagnosed at age <50 years (P = 0.0004). The triple-negative tumors were larger (P = 0.0003), most notably in the younger women, but small tumors (<2.0 cm) were more often accompanied by lymph node metastases. Obesity was present in 49.6% of those with triple-negative tumors but in only 35.8% of those with non-triple-negative tumors (P = 0.0098). Lymph node metastases were more frequently associated with T(2) tumors in obese patients (P = 0.032) regardless of their receptor status.
  
  
  CONCLUSIONS
  Triple-negative breast cancers within a White, socioeconomically deprived, population occurred in younger women, with later stage at diagnosis, and in association with obesity, which itself has been associated with a poor prognosis in breast cancer.
authors.affiliation: Department of Surgery and Breast Cancer Research Program, Mary Babb Randolph Cancer Center, West Virginia University Robert C. Byrd Health Sciences Center, P.O. Box 9238, Morgantown, WV 26506, USA. lvdavis@hsc.wvu.edu
authors.forename: Linda
authors.initials: L
authors.lastname: Vona-Davis
authors.forename: David P
authors.initials: DP
authors.lastname: Rose
authors.forename: Hannah
authors.initials: H
authors.lastname: Hazard
authors.forename: Marissa
authors.initials: M
authors.lastname: Howard-McNatt
authors.forename: Farrell
authors.initials: F
authors.lastname: Adkins
authors.forename: Jessica
authors.initials: J
authors.lastname: Partin
authors.forename: Gerald
authors.initials: G
authors.lastname: Hobbs
mesh_terms: D000328:Adult; D000368:Aged; D001061:Appalachian Region / Q000453:epidemiology; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009765:Obesity / Q000453:epidemiology* / Q000473:pathology*; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population; D014903:West Virginia / Q000453:epidemiology
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone