| Objective: To compare the clinical and pathological features of breast cancer patients with different BMI and to explore the factors affecting the prognosis of breast cancer patients with different BMI.In order to guide the individual diagnosis and treatment of clinical breast cancer,to provide a reference for predicting the prognosis of breast cancer patients with different BMI.Methods:The clinical data of newly diagnosed female breast cancer patients from January 2007 to January 2013 were retrospectively analyzed.They were divided into three groups according to different BMIs: normal weight(18.5≤BMI<24.0).),Overweight(24.0 ≤ BMI <28.0)and Obesity(BMI ≥ 28.0);Analysis of menopausal status,tumor size,axillary lymph node metastasis,postoperative pathological staging,histological grade,and Clinical and pathological features such as hormone receptor status,and postoperative treatment options were analyzed.Kaplan-Meier method was used to calculate the disease-free survival rate and overall survival rate of follow-up patients.Log-rank test was used to compare survival.The COX proportional hazards regression model was used for univariate and multivariate analysis of relevantclinical and pathological factors.Results:Of the 270 patients included in the study,89(40.0%)were obese,97(35.9%)were overweighted,84(31.1%)were normal,and 171(59.6)were postmenopausal.In the obese group,61 patients were postmenopausal patients,52 patients were over-recombined,and 43 were normal subjects.The difference was statistically significant(P<0.05).Among 270 patients,there were 226 tumor diameters ≤5.0cm;69 of them were obese,84 were overweighted,and 75 were normal;tumor diameter was >5.0cm and skin and/or chest wall invasion was 25;obesity was 14 7 cases were over-recombined and 4 cases were normal body reorganization;the difference was statistically significant(P<0.05).Axillary lymph node metastasis was positive in 127 cases(43.0%),and axillary lymph node metastasis was negative in 143 cases(57.0%);in the obese group,58 cases were positive for axillary lymph node metastasis,37 cases were super-unified,and 32 cases were normal body reorganization.The difference was statistically significant(P<0.05).Postoperative pathological stage: There were 230 cases(85.2%)in stage I-II,and 23 cases(8.5%)in stage III-IV;among them 69 cases were stage I-II patients in obesity group,and 84 cases were overweighted.Seventy-seven patients in the obese group had 15 postoperative pathological stages III to IV,6super-recombination and 2 normal body reorganization.The difference was statistically significant(P<0.05).In this study,206 cases(76.3%)were graded from stage I to II in the study,and 64 cases(23.7%)were in grade III.In the obese group,there were 28 cases with grade III pathology,20 cases with super-reorganization,and 16 cases with normal body reorganization.The difference was statistically significant(P<0.05).Hormone receptor examination:198 cases(73.2%)were positive for ER,of which ER positive rate was 82.0%(73/89)in overweight group,71.1%(69/97)in overweight group,and 66.7% in normal group(56/84).),the difference was statistically significant(P<0.05).In 270 cases,the 5-year disease-free survival rate was 75.6%,and the 10-year disease-free survival rate was 72.2%;among them,the 5-year DFS in the obese group was 75.3%,and the 10-year DFS was 71.9%;the 5-year DFS overweight was 77.3%,10 The annual DFS was 74.2%;normal body reorganization was73.8% for 5 years DFS and 70.2% for 10 years DFS;the difference was not statistically significant(P>0.05).The 5-year overall survival rate was 85.9% in270 cases,and the overall 10-year survival rate was 83.3%.The 5-year survival rate in the obese group was 80.9%,the 10-year survival rate was 77.5%,and the5-year survival rate was 88.7%.The 10-year survival rate was 87.6%;the 5-year survival rate in the normal group was 88.1% and the 10-year survival rate was84.5%;Log-rank tests between different BMI groups showed differences in survival time between the three groups(P<0.05).The COX univariate analysis showed that each variable had no effect on DFS;multiple factor COX analysis showed that ER-negative,Ki67-positive and BMI ≥ 28 were the factors affecting the survival time of breast cancer patients with different BMI.The Kaplan-Meier survival curve suggests that The higher the BMI,the shorter the survival time was.Conclusions: Obese women with postmenopausal women have a higher risk of breast cancer.Obese women with breast cancer have larger tumors,more axillary lymph node involvement,and later pathological staging.The pathological grade is grade III and the proportion of ER receptor positive rate is higher;ER-negative,Ki67-positive and BMI ≥ 28 were the factors affecting the survival time of breast cancer patients with different BMI.The higher the BMI,the shorter the survival time was. |
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