caa a22 4500 605491917 CHVBK 20210128100512.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s10147-014-0712-4 doi (NATIONALLICENCE)springer-10.1007/s10147-014-0712-4 Aggressive estrogen-receptor-positive breast cancer arising in patients with elevated body mass index [Elektronische Daten] [Cesar Santa-Maria, Jingsheng Yan, Xian-Jin Xie, David Euhus] Background: Obese women with estrogen receptor (ER)-positive breast cancer may experience worse disease-free and overall survival. We hypothesize that this observation is due to intrinsically aggressive disease and that obesity will be associated with higher histologic grade and Ki67. Methods: A sequential cohort of women with breast cancer diagnosed over 2years was assembled from institutional tumor registries. Patient and tumor characteristics were abstracted from medical records; those with non-invasive tumors, or lacking body mass index (BMI), Ki67 or histologic grade data, were excluded. Univariate and multivariate analysis was performed to investigate the relationship between markers of aggressive disease (grade and Ki67) and multiple variables associated with obesity. A subgroup analysis was performed to investigate further whether ER and menopausal status influenced associations between BMI and aggressive phenotypes. Results: Of the 1007 patients initially identified, 668 (68%) met the eligibility criteria. In univariate analysis, histologic grade and Ki67 were strongly associated with increased BMI, younger age, and African-American race, but less so with diabetes, hypertension, and hyperlipidemia. Multivariate analysis confirmed that higher histologic grade was associated with increased BMI (p=0.02), and that increased Ki67 was associated with younger age (p=0.0003) and African-American race (p=0.002). Additional analysis found that the association between increased BMI and higher-grade tumors was particularly significant in premenopausal women with ER-positive disease. Conclusion: This study concludes that increased BMI is associated with aggressive-phenotype breast cancer and may be particularly relevant to ER-positive breast cancer developing in premenopausal African-American women. Japan Society of Clinical Oncology, 2014 Breast cancer nationallicence Obesity nationallicence Aggressive phenotype nationallicence Histologic grade nationallicence Ki67 nationallicence Santa-Maria Cesar Department of Medical Oncology, Sidney Kimmel Comprehensive Cancer Center, Bunting-Blaustein Cancer Research Bldg, Johns Hopkins University, 1650 Orleans St., Rm. 144, 21287-0013, Baltimore, MD, USA aut Yan Jingsheng Department of Clinical Sciences, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, 75390-8551, Dallas, TX, USA aut Xie Xian-Jin Department of Clinical Sciences, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, 75390-8551, Dallas, TX, USA aut Euhus David Department of Surgery, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, 600 N. Wolfe Street, 21287, Baltimore, MD, USA aut International Journal of Clinical Oncology Springer Japan 20/2(2015-04-01), 317-323 1341-9625 20:2<317 2015 20 10147 https://doi.org/10.1007/s10147-014-0712-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10147-014-0712-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Santa-Maria Cesar Department of Medical Oncology, Sidney Kimmel Comprehensive Cancer Center, Bunting-Blaustein Cancer Research Bldg, Johns Hopkins University, 1650 Orleans St., Rm. 144, 21287-0013, Baltimore, MD, USA aut NATIONALLICENCE 700 1- Yan Jingsheng Department of Clinical Sciences, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, 75390-8551, Dallas, TX, USA aut NATIONALLICENCE 700 1- Xie Xian-Jin Department of Clinical Sciences, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, 75390-8551, Dallas, TX, USA aut NATIONALLICENCE 700 1- Euhus David Department of Surgery, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, 600 N. Wolfe Street, 21287, Baltimore, MD, USA aut NATIONALLICENCE 773 0- International Journal of Clinical Oncology Springer Japan 20/2(2015-04-01), 317-323 1341-9625 20:2<317 2015 20 10147