The relationship between women's body mass index and breast cancer outcomes was U-shaped

Wensong Wei; Suosu Wei; Zhen Huang; Qiuhuan Zhang; Fei Liu; Yujie Xie; Jing Wei; Chongde Mo; Ying Zhou; Shengpeng Qin; Quanqing Zou; Jianrong Yang

doi:10.3389/fonc.2023.1191093

The relationship between women's body mass index and breast cancer outcomes was U-shaped

Front Oncol. 2023 May 25:13:1191093. doi: 10.3389/fonc.2023.1191093. eCollection 2023.

Authors

Wensong Wei¹, Suosu Wei², Zhen Huang¹, Qiuhuan Zhang³, Fei Liu⁴, Yujie Xie¹, Jing Wei¹, Chongde Mo¹, Ying Zhou¹, Shengpeng Qin¹, Quanqing Zou¹, Jianrong Yang¹

Affiliations

¹ Department of Breast and Thyroid Surgery, Guangxi Academy of Medical Sciences, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
² Department of Scientific Cooperation of Guangxi Academy of Medical Sciences, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
³ Department of Colorectal and Anal Surgery, Guangxi Academy of Medical Sciences, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
⁴ Research Center of Medical Sciences, The People's Hospital of Guangxi Zhuang Autonomous Region, Guang-xi Academy of Medical Sciences, Nanning, Guangxi, China.

Abstract

Background: Several studies have analyzed the relationship between body mass index (BMI) and the prognosis of breast cancer (BC). However, whether their relationship is linear or curvilinear remains unclear. This cohort study examined the specific relationship between BMI and BC outcomes.

Methods: This retrospective cohort study included 1049 BC patients from March 7, 2013 through December 31, 2019 in a hospital. Kaplan-Meier curves, multivariate Cox proportional models, and restricted cubic spline (RCS) was used to analysis the relationship between BMI and overall survival (OS) and breast cancer-specific survival (BCSS) was analyzed.

Results: During a median of 4.87 (IQR:3.26-6.84) years of follow-up period, 71 patients (6.77%) died, of which 50 (70.42%) were attributed to BC. RCS analysis revealed a U- shaped relationship between BMI levels and OS and BCSS after adjusting for other variables. The turning points of the U-shaped curves were 23 kg/m2. On the left side of the turning point, the risk of OS (HR, 0.83; 95% CI, 0.70, 0.98) and BCSS (HR, 0.80; 95% CI, 0.65, 0.98) were adversely correlated with BMI. In contrast, to the right of the turning point, the risk of OS (HR, 1.22; 95% CI, 1.10, 1.37) and BCSS (HR, 1.28; 95% CI, 1.13, 1.46) was positively related to BMI. Kaplan-Meier curves and multivariate Cox regression analyses shown consistent results with RCS analyses.

Conclusion: BMI was an independent prognostic factor for BC, and had a U-shaped relationship with OS and BCSS. Interventions should be designed to improve patient outcomes based on BMI.

Keywords: body mass index; breast cancer; prognostic factor; survival; u-shaped association.

Grants and funding

This work was supported by the Guangxi Zhuang Autonomous Region Science and Technology Major Project (Grant No. AA22096018), the National Natural Science Foundation of China (Grant No. 82160589) and the Guangxi Zhuang Autonomous Region Health and Health Commission Self-financed Scientific Research Project (Contract No. Z20190749).