Introduction: The epidemic of obesity has risen many health concerns, beneath the metabolic syndrome. One of these problems is the effect of obesity on cancer evolution. Populational studies have shown a direct correlation of BMI with worse prognostic, life quality and occurrence of comorbidities in neoplastic diseases, one of the most studied being breast cancer.
Patients and methods: We retrospectively analysed the evolution of postmenopausal obese and overweight women with non-metastatic breast cancer with antioestrogen treatment (selective oestrogen receptor modulators and/or aromatase inhibitors). From the 235 patients who received this treatment we selected) 62 with regular records of BMI. Excluding criteria were previous hormonal treatment of menopause, diabetes mellitus at the diagnostic, and smoking. Mean age at the diagnostic was 57.5±12 years, mean BMI 28.5±4.6 kg/m2. Survival was between 3 months and 20 years.
Results: Pearson correlation showed a negative correlation between BMI and survival time (r=−0.357, P=0.04), however, there were no statistical differences between normal (N), overweight (OW), and obese (O) women respectively (t-test N vs OW P=0.33. N vs O P=0.41, OW vs O P=0.46). No modifications of life style could be noticed, at least in the OW and O women, since their weight remained practically unchanged. Women with longer survival were included in a quality of life study and, also all had a slight deterioration of role functions, emotional and cognitive functions, no differences associated with higher BMI could be observed.
Conclusions: Breast cancer is a multifactorial disease. Obesity is considered a predisposing factor, especially in postmenopausal women. However, many studies showed that not the obesity per se but that associated with sarcopenia has a most deleterious effect. Our study is limited by its retrospective design and the absence of body composition evaluation but had demonstrated direct association between obesity and a poor survival rate.