J Cancer 2020; 11(7):1976-1984. doi:10.7150/jca.38567 This issue

Research Paper

Adverse effects of being underweight on young female breast cancer patients with lymph node metastases

Bo Chen1*✉, Jianguo Lai1*, Liping Guo1*, Danian Dai2,3, Rong Chen4, Guangnan Wei1, Ning Liao1✉

1. Department of Breast Cancer, Cancer Center, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
2. Department of Gynecology and Obstetrics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong, 519000, China
3. Department of Gynecologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, 510060, China
4. Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
* contributed equally to this work.

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Citation:
Chen B, Lai J, Guo L, Dai D, Chen R, Wei G, Liao N. Adverse effects of being underweight on young female breast cancer patients with lymph node metastases. J Cancer 2020; 11(7):1976-1984. doi:10.7150/jca.38567. Available from https://www.jcancer.org/v11p1976.htm

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Abstract

Background: This study aimed to examine the effect of underweight in breast cancer.

Methods: We performed a retrospective analysis of 3891 female patients diagnosed with primary breast cancer (I-IV stages). Body mass index (BMI) defined by World Health Organization criteria as follow: Underweight (UW; BMI<18.5 kg/m2), normal weight (NW; BMI =18.5-24.9 kg/m2) and overweight or obese (OW; BMI≥25 kg/m2). We performed to evaluate the association between low BMI and clinical outcome in different age (18-40 years and over 40 years) breast cancer.

Results: In our study, about 7% patients suffer from being underweight and 25% patients suffer from being overweight. Underweight is more prominent in young age group. Although no relationship was found between the recurrence rate and being underweight (HR 1.467(95 % CI 0.940-2.291), P=0.092 for disease-free survival), multivariate regression analysis confirmed that low BMI was an independent overall survival (OS) prognostic factor in young patients (HR 1.610(95 % CI 1.028-2.523), P=0.037 for OS). Further analysis showed the prognostic significance of underweight only seen in young patients with axillary lymph node metastasis or III-IV stage patients.

Conclusions: Our results demonstrate the prognostic importance of low BMI in young breast cancer patients (under 40 years old) with lymph node metastases. The role of low BMI in breast cancer might depend on patients' age and clinical stage.

Keywords: breast cancer, underweight, body mass index, prognosis