title: Plasma level of LDL-cholesterol at diagnosis is a predictor factor of breast tumor progression.
abstract: BACKGROUND
  Among women, breast cancer (BC) is the leading cancer and the most common cause of cancer-related death between 30 and 69 years. Although lifestyle and diet are considered to have a role in global BC incidence pattern, the specific influence of dyslipidemia in BC onset and progression is not yet completely understood.
  
  
  METHODS
  Fasting lipid profile (total cholesterol, LDL-C, HDL-C, and triglycerides) was prospectively assessed in 244 women with BC who were enrolled according to pre-set inclusion criteria: diagnosis of non-hereditary invasive ductal carcinoma; selection for surgery as first treatment, and no history of treatment with lipid-lowering or anti-diabetic drugs in the previous year. Pathological and clinical follow-up data were recorded for further inclusion in the statistical analysis.
  
  
  RESULTS
  Univariate associations show that BC patients with higher levels of LDL-C at diagnosis have tumors that are larger, with higher differentiation grade, higher proliferative rate (assessed by Ki67 immunostaining), are more frequently Her2-neu positive and are diagnosed in more advanced stages. Cox regression model for disease-free survival (DFS), adjusted to tumor T and N stages of TNM classification, and immunohistochemical subtypes, revealed that high LDL-C at diagnosis is associated with poor DFS. At 25 months of follow up, DFS is 12% higher in BC patients within the third LDL-C tertile compared to those in the first tertile.
  
  
  CONCLUSIONS
  This is a prospective study where LDL-C levels, at diagnosis, emerge as a prognostic factor; and this parameter can be useful in the identification and follow-up of high-risk groups. Our results further support a possible role for systemic cholesterol in BC progression and show that cholesterol metabolism may be an important therapeutic target in BC patients.
authors.affiliation: Gulbenkian Programme for Advanced Medical Education, Lisbon, Portugal. catarinarsantos@hotmail.com.
authors.forename: Catarina
authors.initials: C
authors.lastname: Rodrigues Dos Santos
authors.forename: Isabel
authors.initials: I
authors.lastname: Fonseca
authors.forename: Sérgio
authors.initials: S
authors.lastname: Dias
authors.forename: J C
authors.initials: JC
authors.lastname: Mendes de Almeida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology*; D008078:Cholesterol, LDL / Q000097:blood*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008074:Lipoproteins / Q000097:blood; D008875:Middle Aged; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D008078:Cholesterol, LDL; D008055:Lipids; D008074:Lipoproteins