title: BMI and breast cancer prognosis benefit: mammography screening reveals differences between normal weight and overweight women.
abstract: OBJECTIVE
  Few studies are available on the potential impact of body weight on breast cancer prognosis in screen-detected patients. Moreover, it is not known whether body mass index (BMI) could have a different prognostic impact in screen-detected versus symptomatic breast cancer patients. To investigate these unsolved issues, we carried out a retrospective study evaluating the effect of BMI on breast cancer prognosis in screen-detected vs symptomatic breast cancer patients.
  
  
  METHODS
  We conducted a follow-up study on 448 women diagnosed with incident, histologically-confirmed breast cancer. Patients were categorized according to their BMI as normal weight, overweight and obese. Disease free survival (DFS), overall survival (OS), and BMI curves were compared according to mode of cancer detection.
  
  
  RESULTS
  Among screen-detected patients, higher BMI was associated with a significant lower DFS, whereas no significant difference was observed among symptomatic patients. OS showed similar results. In the multivariate analysis adjusting for age, education, tumor size, nodal status, estrogen receptor (ER), progesterone receptor (PR) and menopausal status, the risk for high level of BMI among screen-detected patients did not reach the statistical significance for either recurrence or survival.
  
  
  CONCLUSIONS
  Our study highlights the potential impact of high bodyweight in breast cancer prognosis, the findings confirm that obesity plays a role in women breast cancer prognosis independently from diagnosis mode.
authors.affiliation: Epidemiology Unit, National Cancer Institute, "G. Pascale" Foundation, Via M. Semmola, 80131 Naples, Italy. Electronic address: anna.crispo@tin.it.
authors.forename: Anna
authors.initials: A
authors.lastname: Crispo
authors.affiliation: Epidemiology Unit, National Cancer Institute, "G. Pascale" Foundation, Via M. Semmola, 80131 Naples, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Grimaldi
authors.affiliation: Department of Surgery, National Cancer Institute, "G. Pascale" Foundation, Via M. Semmola, 80131 Naples, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: D'Aiuto
authors.affiliation: Department of Surgery, National Cancer Institute, "G. Pascale" Foundation, Via M. Semmola, 80131 Naples, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Rinaldo
authors.affiliation: Department of Surgery, National Cancer Institute, "G. Pascale" Foundation, Via M. Semmola, 80131 Naples, Italy.
authors.forename: Immacolata
authors.initials: I
authors.lastname: Capasso
authors.affiliation: Department of Surgery, National Cancer Institute, "G. Pascale" Foundation, Via M. Semmola, 80131 Naples, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Amore
authors.affiliation: Department of Surgery, National Cancer Institute, "G. Pascale" Foundation, Via M. Semmola, 80131 Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Aiuto
authors.affiliation: Epidemiology Unit, National Cancer Institute, "G. Pascale" Foundation, Via M. Semmola, 80131 Naples, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Giudice
authors.affiliation: National Cancer Institute, "G. Pascale" Foundation, Via M. Semmola, 80131 Naples, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Ciliberto
authors.affiliation: Epidemiology Unit, National Cancer Institute, "G. Pascale" Foundation, Via M. Semmola, 80131 Naples, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Montella
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D055088:Early Detection of Cancer; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D056865:Ideal Body Weight; D008327:Mammography; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D050177:Overweight / Q000150:complications; D011379:Prognosis; D012189:Retrospective Studies
keywords: Body mass index; DFS; Detection mode; Survival