Metabolic syndrome in breast cancer patients: An observational study

Abstract

Background: With significant increase in the prevalence of overweight population in India, there might be a similar increase in the prevalence of metabolic syndrome. Positive association between metabolic syndrome in Indian subjects, if any, may translate into significant changes in the risk factors for breast cancer and may have a significant impact on the incidence and mortality related to breast cancer in India. Hence, we undertook this study to find any correlation between metabolic syndrome and breast cancer. Method(s): We did a prospective study from August, 2016 to July, 2017. Measurements of height, weight, BMI and waist circumference and fasting blood sugar, fasting triglycerides, fasting HDL and HBA1c were done. Metabolic syndrome was defined according to International Diabetes Federation consensus statement 2006. TNM staging, type and grade of tumour, hormone receptor status, Her2 neu status and Ki67 index along with other known risk factors of breast cancer like age at menarche, age at first child birth (FCB), breastfeeding, presence or absence of family history of breast cancer and mammographic density were recorded. K-S test was used to check the normality of the data. Student's t test and Mann Whitney U test, Chi Square test or Fisher exact test (whichever was applicable) was used for comparison. Result(s): Total of 305 patients were recruited into the study with 191 (62.6%) patients having metabolic syndrome. The mean age was of 50.7+/-12.4 years. There was no correlation of metabolic syndrome to any of the known risk factors (Age, age at menarche, age at FCB, early menarche, parity, no breast feeding, breast density on mammography or family history of breast cancer). Patients with metabolic syndrome were found to be less likely to have hormone receptor positive tumours (p=0.025), more likely to have Her2 positive tumours (p=0.011). They were also more likely to have Her2 enriched and basal like subtype and less likely to have Luminal A and B subtypes (p=0.027). There was no correlation between metabolic syndrome and T, N,Mor overall staging. It also had no relation to type of tumour (IDC vs No IDC), grade or Ki67. Conclusion(s): Metabolic Syndrome may emerge as a significant prognostic factor in breast cancer in the future.