The effect of the interaction between body mass index and age on the prognosis of breast cancer

Jialong XIAO; Miao MO; Changming ZHOU; Zezhou WANG; Jie SHEN; Jing YUAN; Keda YU; Guangyu LIU; Jiong WU; Zhenzhou SHEN; Zhimin SHAO; Ying ZHENG

doi:10.19401/j.cnki.1007-3639.2022.08.007

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The effect of the interaction between body mass index and age on the prognosis of breast cancer

Article | 更新时间：2025-12-31

- The effect of the interaction between body mass index and age on the prognosis of breast cancer
- China Oncology Vol. 32, Issue 8, Pages: 719-726(2022)
- 作者机构：
  
  1. 复旦大学附属肿瘤医院肿瘤预防部,复旦大学上海医学院肿瘤学系,上海 200032
  2. 复旦大学附属肿瘤医院乳腺外科,复旦大学上海医学院肿瘤学系,上海 200032
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2022.08.007
  CLC： R737.9
- Received：05 May 2022，
  
  Revised：2022-07-19，
  
  Published：30 August 2022
- 稿件说明：
移动端阅览
Jialong XIAO, Miao MO, Changming ZHOU, et al. The effect of the interaction between body mass index and age on the prognosis of breast cancer[J]. China Oncology, 2022, 32(8): 719-726.
DOI：

Jialong XIAO, Miao MO, Changming ZHOU, et al. The effect of the interaction between body mass index and age on the prognosis of breast cancer[J]. China Oncology, 2022, 32(8): 719-726. DOI： 10.19401/j.cnki.1007-3639.2022.08.007.

摘要

背景与目的：

目前已有研究表明体重指数（body mass index

BMI）是乳腺癌患者预后的影响因素。本研究旨在分析不同年龄段的乳腺癌患者的BMI与其死亡风险的关联。

方法：

回顾性收集2008年1月1日

#x02014;2016年12月31日在复旦大学附属肿瘤医院住院治疗的25 629例初诊乳腺癌患者的临床特征和生存状况

经调整主要预后影响因素

以限制性立方样条Cox比例风险回归模型分析在不同年龄亚组中BMI与乳腺癌患者预后的关联。

结果：

BMI与年龄均为乳腺癌预后的影响因素

且存在显著的交互作用。不同年龄组患者的死亡风险与BMI的关联模式有所不同。在年龄小于35岁组观察到死亡风险与BMI呈现

#x0201c;J

#x0201d;型的关联

BMI为20.16 kg/m

的患者死亡风险最低;在年龄35 ~ 60岁组观察到BMI在23 kg/m

以下的患者死亡风险随着BMI的增加没有明显变化

BMI在23 kg/m

以上的患者死亡风险随着BMI的增加而增加;而在年龄大于60岁组观察到死亡风险与BMI呈现

#x0201c;U

#x0201d;型的关联

BMI为23.86 kg/m

的女性死亡风险最低。年龄小于35岁组患者的死亡风险对BMI变化的敏感程度相较于年龄35 ~ 60岁组和大于60岁组更高。

结论：

在校正了相关预后因素后

BMI与年龄对乳腺癌患者预后的影响有显著的交互作用

不同年龄组患者的死亡风险与BMI的关联模式有所不同

对于年轻患者

死亡风险最低对应的诊断时BMI约为20 kg/ m

而对于60岁以上患者

死亡风险最低对应的诊断时BMI约为24 kg/m

。

Abstract

Background and purpose:

Currently

several studies have demonstrated that body mass index (BMI) is a prognostic factor in breast cancer. The study aimed to assess the association pattern of BMI with mortality risk among patients of different age groups.

Methods:

This retrospective cohort study included the clinical characteristics and survival status of 25 629 patients diagnosed with breast cancer and subsequently hospitalized in Fudan University Shanghai Cancer Center between January 1

2008 and December 31

2016. The association between BMI and prognosis of breast cancer patients in different age subgroups was analyzed using Cox proportional hazards regression model with restricted cubic splines adjusting the main prognostic factors.

Results:

BMI and age were both influencing factors of breast cancer prognosis

and there was a significant interaction (

= 0.011). The pattern of association between risk of death and BMI differed among different age groups. A "J-shaped" associa

tion between risk of death and BMI was observed in the patients younger than 35 years

with a BMI of 20.16 kg/m

corresponding to the lowest risk of death. In the age group of 35-60 years

no significant change in the risk of death was observed in patients with BMI below 23 kg/m

and the risk of death in patients with BMI above 23 kg/m

increased with increasing BMI; A "U-shaped" association between risk of death and BMI was observed in the patients older than 60 years

with a BMI of 23.86 kg/m

being the lowest. The risk of death was more sensitive to changes in BMI in patients aged less than 35 years than in those aged 35-60 years and those aged more than 60 years.

Conclusion:

BMI and age have a significant interaction in the prognosis of breast cancer when adjusted for potential confounding factors. The association pattern between the risk of death and BMI of patients in different age groups is different. For patients under 35 years old

the lowest risk of death corresponds to BMI at diagnosis of about 20 kg/m

while for patients over 60 years old

the lowest risk of death corresponds to a BMI at diagnosis of about 24 kg/m

关键词

Keywords

references

BRAY F , FERLAY J , SOERJOMATARAM I , et al . Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J ] . CA Cancer J Clin , 2018 , 68 ( 6 ): 394 - 424 . DOI: 10.3322/caac.21492 http://doi.org/10.3322/caac.21492 http://doi.wiley.com/10.3322/caac.21492 http://doi.wiley.com/10.3322/caac.21492

ROCK C L , DOYLE C , DEMARK-WAHNEFRIED W , et al . Nutrition and physical activity guidelines for cancer survivors [J ] . CA Cancer J Clin , 2012 , 62 ( 4 ): 243 - 274 .

PROTANI M , COORY M , MARTIN J H . Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis [J ] . Breast Cancer Res Treat , 2010 , 123 ( 3 ): 627 - 635 . DOI: 10.1007/s10549-010-0990-0 http://doi.org/10.1007/s10549-010-0990-0 http://link.springer.com/10.1007/s10549-010-0990-0 http://link.springer.com/10.1007/s10549-010-0990-0

CHAN D S M , VIEIRA A R , AUNE D , et al . Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies [J ] . Ann Oncol , 2014 , 25 ( 10 ): 1901 - 1914 . DOI: 10.1093/annonc/mdu042 http://doi.org/10.1093/annonc/mdu042 https://linkinghub.elsevier.com/retrieve/pii/S0923753419365950 https://linkinghub.elsevier.com/retrieve/pii/S0923753419365950

ZHANG M L , CAI H , BAO P P , et al . Body mass index, waist-to-hip ratio and late outcomes: a report from the Shanghai Breast Cancer Survival Study [J ] . Sci Rep , 2017 , 7 ( 1 ): 6996 . DOI: 10.1038/s41598-017-07320-7 http://doi.org/10.1038/s41598-017-07320-7 http://www.nature.com/articles/s41598-017-07320-7 http://www.nature.com/articles/s41598-017-07320-7

CHLEBOWSKI R T , AIELLO E , MCTIERNAN A . Weight loss in breast cancer patient management [J ] . J Clin Oncol , 2002 , 20 ( 4 ): 1128 - 1143 . DOI: 10.1200/JCO.2002.20.4.1128 http://doi.org/10.1200/JCO.2002.20.4.1128 https://ascopubs.org/doi/10.1200/JCO.2002.20.4.1128 https://ascopubs.org/doi/10.1200/JCO.2002.20.4.1128

RYU S Y , KIM C B , NAM C M , et al . Is body mass index the prognostic factor in breast cancer? A meta-analysis [J ] . J Korean Med Sci , 2001 , 16 ( 5 ): 610 - 614 . DOI: 10.3346/jkms.2001.16.5.610 http://doi.org/10.3346/jkms.2001.16.5.610 https://jkms.org/DOIx.php?id=10.3346/jkms.2001.16.5.610 https://jkms.org/DOIx.php?id=10.3346/jkms.2001.16.5.610

MOON H G , HAN W , NOH D Y . Underweight and breast cancer recurrence and death: a report from the Korean Breast Cancer Society [J ] . J Clin Oncol , 2009 , 27 ( 35 ): 5899 - 5905 . DOI: 10.1200/JCO.2009.22.4436 http://doi.org/10.1200/JCO.2009.22.4436 https://ascopubs.org/doi/10.1200/JCO.2009.22.4436 https://ascopubs.org/doi/10.1200/JCO.2009.22.4436

CHOLLET-HINTON L , OLSHAN A F , NICHOLS H B , et al . Biology and etiology of young-onset breast cancers among premenopausal African American women: results from the AMBER consortium [J ] . Cancer Epidemiol Biomarkers Prev , 2017 , 26 ( 12 ): 1722 - 1729 . DOI: 10.1158/1055-9965.EPI-17-0450 http://doi.org/10.1158/1055-9965.EPI-17-0450 https://aacrjournals.org/cebp/article/26/12/1722/71246/Biology-and-Etiology-of-Young-Onset-Breast-Cancers https://aacrjournals.org/cebp/article/26/12/1722/71246/Biology-and-Etiology-of-Young-Onset-Breast-Cancers

赵翠翠 , 刘红 . 年轻乳腺癌的分子生物学发病机制 [J ] . 肿瘤防治研究 , 2020 , 47 ( 3 ): 213 - 217 .

ZHAO C C , LIU H . Molecular biological pathogenesis of young breast cancer [J ] . Cancer Res Prev Treat , 2020 , 47 ( 3 ): 213 - 217 .

AZIM H A Jr , NGUYEN B , BROHÉE S , et al . Genomic aberrations in young and elderly breast cancer patients [J ] . BMC Med , 2015 , 13 : 266 . DOI: 10.1186/s12916-015-0504-3 http://doi.org/10.1186/s12916-015-0504-3 https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-015-0504-3 https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-015-0504-3

周昌明 , 莫淼 , 袁晶 , 等 . 以医院登记为基础的20万例恶性肿瘤患者生存报告 [J ] . 中国癌症杂志 , 2020 , 30 ( 1 ): 11 - 24 .

ZHOU C M , MO M , YUAN J , et al . Report on 200 thousand cancer patients' survival from a hospital-based cancer registry database [J ] . China Oncol , 2020 , 30 ( 1 ): 11 - 24 .

中国年轻乳腺癌诊疗与生育管理专家共识专家委员会 . 年轻乳腺癌诊疗与生育管理专家共识 [J ] . 中华肿瘤杂志 , 2019 , 41 ( 7 ): 486 - 495 .

Expert Committee of Consensus on Diagnosis and Treatment of Young Breast Cancer and Fertility Management in China . Chinese consensus guideline for breast cancer in young women: clinical practice and fertility preservation [J ] . Chin J Oncol , 2019 , 41 ( 7 ): 486 - 495 .

ORGANIZATION W H . World Health Day 2012: ageing and health: toolkit for event organizers [J ] . World Health Organization , 2012 .

陈春明 , 孔灵芝 , 主编. 中华人民共和国卫生部疾病控制司编著. 中国成人超重和肥胖症预防控制指南 [M ] . 北京 : 人民卫生出版社 , 2006 .

CHEN C M , KONG L Z , editor-in-chief. Edited by the Department of Disease Control of the Ministry of Health of the People's Republic of China guidelines for the prevention and control of overweight and obesity in Chinese adults [M ] . Beijing : People's Health Publishing House , 2006 .

EDGE S B , BYRD D R , COMPTON C C , et al . AJCC cancer staging manual [M ] . New York, NY : Springer New York , 2010 .

KAWAI M , MINAMI Y , NISHINO Y , et al . Body mass index and survival after breast cancer diagnosis in Japanese women [J ] . BMC Cancer , 2012 , 12 : 149 . DOI: 10.1186/1471-2407-12-149 http://doi.org/10.1186/1471-2407-12-149 http://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-12-149 http://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-12-149

DE VISSER K E , EICHTEN A , COUSSENS L M . Paradoxical roles of the immune system during cancer development [J ] . Nat Rev Cancer , 2006 , 6 ( 1 ): 24 - 37 . DOI: 10.1038/nrc1782 http://doi.org/10.1038/nrc1782 https://doi.org/10.1038/nrc1782 https://doi.org/10.1038/nrc1782

MUELLER M M , FUSENIG N E . Friends or foes-bipolar effects of the tumour stroma in cancer [J ] . Nat Rev Cancer , 2004 , 4 ( 11 ): 839 - 849 . DOI: 10.1038/nrc1477 http://doi.org/10.1038/nrc1477 https://doi.org/10.1038/nrc1477 https://doi.org/10.1038/nrc1477

DENARDO D G , JOHANSSON M , COUSSENS L M . Immune cells as mediators of solid tumor metastasis [J ] . Cancer Metastasis Rev , 2008 , 27 ( 1 ): 11 - 18 . DOI: 10.1007/s10555-007-9100-0 http://doi.org/10.1007/s10555-007-9100-0 http://link.springer.com/10.1007/s10555-007-9100-0 http://link.springer.com/10.1007/s10555-007-9100-0

CUNNINGHAM-RUNDLES S , MCNEELEY D F , MOON A . Mechanisms of nutrient modulation of the immune response [J ] . J Allergy Clin Immunol , 2005 , 115 ( 6 ): 1119 - 1128 ; quiz1129. DOI: 10.1016/j.jaci.2005.04.036 http://doi.org/10.1016/j.jaci.2005.04.036 https://linkinghub.elsevier.com/retrieve/pii/S0091674905012741 https://linkinghub.elsevier.com/retrieve/pii/S0091674905012741

SCHOLZ C , ANDERGASSEN U , HEPP P , et al . Obesity as an independent risk factor for decreased survival in node-positive high-risk breast cancer [J ] . Breast Cancer Res Treat , 2015 , 151 ( 3 ): 569 - 576 . DOI: 10.1007/s10549-015-3422-3 http://doi.org/10.1007/s10549-015-3422-3 http://link.springer.com/10.1007/s10549-015-3422-3 http://link.springer.com/10.1007/s10549-015-3422-3

TANG B , HAN C T , ZHANG G M , et al . Waist-hip ratio (WHR), a better predictor for prostate cancer than body mass index (BMI): results from a Chinese hospital-based biopsy cohort [J ] . Sci Rep , 2017 , 7 : 43551 . DOI: 10.1038/srep43551 http://doi.org/10.1038/srep43551 https://doi.org/10.1038/srep43551 https://doi.org/10.1038/srep43551

中国抗癌协会乳腺癌专业委员会 . 中国抗癌协会乳腺癌诊治指南与规范(2021年版) [J ] . 中国癌症杂志 , 2021 , 31 ( 10 ): 954 - 1040 .

The Society of Breast Cancer China Anti-Cancer Association . Guidelines for breast cancer diagnosis and treatment by China Anti-Cancer Association (2021 edition) [J ] . China Oncol , 2021 , 31 ( 10 ): 954 - 1040 .

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