title: Metabolic syndrome and breast cancer prognosis.
abstract: Metabolic syndrome (MS), conventionally defined by the presence of at least three out of five dysmetabolic traits (abdominal obesity, hypertension, low plasma HDL-cholesterol, high plasma glucose and high triglycerides), has been associated with an increased risk of several age-related chronic diseases, including breast cancer (BC). This may have prognostic implications for BC survivors. 2,092 early stage BC survivors aged 35-70, recruited in eleven Italian centres 0-5 years after surgical treatment (1.74 years on average), were followed-up over 2.8 years on average for additional BC-related events, including BC-specific mortality, distant metastasis, local recurrences and contralateral BC. At recruitment, 20 % of the patients had MS. Logistic regression models were carried out to generate OR and 95 % confidence intervals (CI) for new BC events associated with MS, adjusting for baseline pathological prognostic factors. New BC events occurred in 164 patients, including 89 distant metastases. The adjusted ORs for women with MS versus women without any MS traits were 2.17 (CI 1.31-3.60) overall, and 2.45 (CI 1.24-4.82) for distant metastasis. The OR of new BC events for women with only one or two MS traits was 1.40 (CI 0.91-2.16). All MS traits were positively associated with new BC events, and significantly so for low HDL and high triglycerides. MS is an important prognostic factor in BC. As MS is reversible through lifestyle changes, interventions to decrease MS traits in BC patients should be implemented in BC clinics.
authors.affiliation: Epidemiology & Prevention Unit, Department of Preventive & Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, 1, 20133, Milan, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Berrino
authors.forename: Anna
authors.initials: A
authors.lastname: Villarini
authors.forename: Adele
authors.initials: A
authors.lastname: Traina
authors.forename: Bernardo
authors.initials: B
authors.lastname: Bonanni
authors.forename: Salvatore
authors.initials: S
authors.lastname: Panico
authors.forename: Maria Piera
authors.initials: MP
authors.lastname: Mano
authors.forename: Angelica
authors.initials: A
authors.lastname: Mercandino
authors.forename: Rocco
authors.initials: R
authors.lastname: Galasso
authors.forename: Maggiorino
authors.initials: M
authors.lastname: Barbero
authors.forename: Milena
authors.initials: M
authors.lastname: Simeoni
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Bassi
authors.forename: Elena
authors.initials: E
authors.lastname: Consolaro
authors.forename: Harriet
authors.initials: H
authors.lastname: Johansson
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zarcone
authors.forename: Eleonora
authors.initials: E
authors.lastname: Bruno
authors.forename: Giuliana
authors.initials: G
authors.lastname: Gargano
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Venturelli
authors.forename: Patrizia
authors.initials: P
authors.lastname: Pasanisi
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000209:etiology* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate