| BACKGROUND AND PURPOSE The prevalence of risk factors contributing to metabolic syndrome(Met S)is increasing,and numerous components of Met S are associated with increased primary breast cancer(BC)risk.However,less is known about the relationship of metabolic syndrome to BC outcomes.In this paper,we will study the status of blood lipid among breast cancer patients and normal cohorts and also the breast cancer patients before and after undergoing chemotherapy.Also the incidence of metabolic syndrome and its components among normal populace and breast cancer group were comparatively analyzed.METHOD 1.The clinical data of 1054 cases of initially diagnosed breast cancer patients and 2484 cases of normal women(as controls)with the reports of their blood lipid levels were collected from the Electronic Medical Records in the Breast Cancer Center of Chongqing and Medical Examination Center of the First Affiliated Hospital of Chongqing Medical University,from July 2015 to October 2016.The data were comparatively analysed and stratified according to their age.Also the status of lipidemia among 446 breast cancer patients were comparatively analyzed before and after undergoing chemotherapy.We obtained age,sex,pathological diagnosis,menstrual status,and the status of various lipid components in those subejects from our medical record system.2.The clinical data of 605 initially diagnosed breast cancer patients and 3212 general population with the reports of their metabolic components were collected for comparitive analysis from Chongqing Breast Cancer Center of Chongqing and Medical Centre of the First Affiliated Hospital of Chongqing Medical University.In this study we calculated the stauts of BMI and metabolic components and stratified them according to their age between breast cancer group and normal population group.At the end,the metabolic components were also stratified according to the number of components present in those groups.RESULT 1.The total incidence of dyslipidemia in breast cancer group was 42.98%(453/1054),which was significantly lower than in normal population(58.30%,1448/2484)p<0.01.However,among below 40 years age females,dyslipidemia in breast cancer patients(25.58%)was slightly higher than that among normal population group(22.41%,78/348),but no significant statistical difference was observed(p = 0.558).With age groups of 40-49 years,50-59 years old and above 60 years old,breast cancer patients had significantly lower incidence 34.88%(150/430),52.84%(149/282)and 56.81%(121/213)of dyslipidemia compared to the normal population group 49.72%,74.11%(541/730),75.35%(382/507)and the difference was statistically significant(p <.001).2.The total serum cholesterol levels(4.47 ± 0.93 mmol/L),triglyceride(1.27 ± 1.02 mmol/L),high density lipoprotein(1.43 ± 0.36 mmol/L)and low density lipoprotein(2.80 ± 0.81 mmol/L)were significantly lower in breast cancer group than among normal population(5.01 ± 0.95 mmol/L),(1.34 ± 0.95 mmol/L),(1.48 ± 0.32 mmol/L),(3.19 ± 0.87 mmol/L)(p <0.05).The total cholesterol level among lower than 40 years,40-49 years,50-59 years and above 60 years old breast cancer patients was significantly lower than the normal population group(P <0.05);The triglyceride level among 40-49 years old breast cancer patients was significantly lower than the normal population group(P <0.05);HDL-C levels among 40 to 49 years old and 50-59 years old patients with breast cancer was significantly lower than the normal population(p<0.05);LDL-C levels among breast cancer patients aged 40 to 49 years,50-59 years over 60 years old were significantly lower than the normal population(p <0.05)3.The pre-chemoetherapeutic incidence of dyslipidemia(45.1%,201/446)w as significantly lower than post-chemotherapy(68.6%,306/446)(p <0.01).The pr e-chemoetherapeutic levels of total cholesterol,triglyceride and LDL-C were signi ficantly lower than post-chemotherapeutic levels(p <0.05).The pre-chemoetherap eutic HDL-C level was significantly higher than post-chemotherapeutic levels and the difference between them was statistically significant(p <0.05),p <0.01.4.The prevalence of metabolic syndrome among breast cancer patient group and general population were 32.6% & 18.2%,respectively and the difference between both groups was statistically significant(P<0.001).This suggests that metabolic syndrome is a risk factor for breast cancer.With age stratification,the rates of metabolic syndrome among breast cancer patients above or below 60 years age were significantly compared to the general population group(P<0.001).However,in females between 30 to 39 years old,the difference was not statistically significant.Meanwhile with BMI stratification,statistical difference was observed only in the normal BMI subgroup(18.5?BMI<25)among breast cancer group 85(22.1%)and general population group(10.1%)with metabolic syndrome(p<0.001).However among other subgroups no statistical difference was observed between breast cancer patients and general population group.Moreover,a trend was observed that with higher the BMI in ascending order(Underweight(BMI<18.5),Normal(18.5?BMI<25),Preobese(25?BMI<30)and Obesity(BMI?30),subjects were more likely to have metabolic syndrome regardless in both the breast cancer patients 0%,221.%,57.6% and 61.8% and the general population group 1.9%,10.1%,52.7% and 72.4%.This suggests that BMI when reduced could help in preventing metabolic syndrome.5.Breast cancer patients with BMI of 25 or above were more likely to have metabolic syndrome 112(58.3%)in comparision to the patients with BMI below 25 85(22.1%)(OR: 0.203;95%CI: 0.140-0.295).Thus it suggests that BMI?25 is a risk factor for breast cancer patients to have metabolic syndrome.Similar results wereobserved in general population,where BMI of 25 or above were prone to have metabolic syndrome 340(54.5%)compared to without MS 240(10.1%).6.With relation to metabolic syndrome components,breast cancer patients were more likely to have broader waist circumference,high blood pressure,low HDL –C levels,high fasting blood glucose levels and lower triglyceride levels(460(76.0%),165(27.3%),226(37.4%),151(25.0%)and 517(85.5%))compared to the general population group(951(29.6%),457(14.2%),977(30.4%),646(20.1%)and 2624(81.7%)).The difference between the two groups were found to be statistically significant(p<0.05).7.Metabolic components were totally absent in 1246(38.8%)& 74(12.2%)cases in general population group and breast cancer group,a single metabolic syndrome component was detected among 851(26.5%)& 150(24.8%)cases,two of the components were found in 531(16.5%)& 184(30.4%),three components or above were found in 584(18.2%)& 197(32.6%)cases of general population group and breast cancer patients group,respectively.The difference between the two groups were found to be statistically significant(p<0.05).CONCLUSION 1.The incidence of dyslipidemia in breast cancer patients was significantly lower than in the normal population.However it was found to be significantly higher in patients with breast cancer after chemotherapy,except for high-density lipoprotein cholesterol,the other indicators of dyslipidemia were significantly increased.2.Studies have shown mixed results for breast cancer patients with dyslipidemia.Further research need to be carried out why the breast cancer patients have normal lipid levels than normal patients.In our study,the incidence of dyslipidemia increased in post-chemotherapeutic patients compared to pre-chemotherapeutic patients.This suggests that with cancer cell damage and repression of their metabolism led to decreased intake of cholesterol for their energy needs,which in turn shows that decreased prechemotherapeutic cholesterol levels is not a true decrease but could be a false decrease.Thus when investigating cholesterol levels,other factors such as BMI and the average metabolic rate of body(amount ofcholesterol intake and release by the body)should be taken into consideration and compared to find the true free cholesterol levels in breast cancer patients 3.More attention should be paid for screening lipid levels among post chemotherapeutic breast cancer patients so that early intervention might be adopted to protect females from exposure to risk factors.With studies showing statins to reduce cancer mortality,early detection of dyslipidemia in breast cancer patients could lead to better prognosis.4.Regardless of menopausal status,metabolic syndrome is a risk factor for breast cancer,with comparatively more number of metabolic patients found in breast cancer patients compared to normal populace 5.Obesity leads to increased risk of developing breast cancer among the females of all ages.Higher the BMI,more the breast cancer patients were likely to have metabolic syndrome.6.There is a close and direct relationship between hypertension and breast cancer.Hypertension could be the exacerbating factor for breast cancer and should lead to rise in mortality.7.Hyperglycemia is a major risk factor for breast cancer which increases mortality by enhancing tumour growth.When timely detected could prevent the tumoral metastasis and growth and improve prognosis.8.Breast cancer patients when compared to general population had maximum number of metabolic components present.Thus suggesting metabolic syndrome is closely related to breast cancer.Each of the major components of MS is associated with the risk of breast cancer and its adverse prognosis.The more the metabolic component present,higher the risk of having breast cancer.The prognosis of breast cancer patients is not only associated with breast cancer type,condition,stage,patient's age and treatment modes but is also closely related with their metabolic state,therefore,the treatment of patients should also take into the account of metabolic causes,its influence on the disease process and how the various components of MS affect the occurrence and development of breast cancer.Thus correcting metabolic disorders could lead to improved survival rate. |
PDF Full Text Request