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Old 05-19-2014, 10:25 AM   #1
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Post Breast cancer subtypes according to body mass index and insulin resistance.

Breast cancer subtypes according to body mass index and insulin resistance.

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2014 ASCO Annual Meeting!

Session: Breast Cancer - HER2/ER
Type: General Poster Session
Time: Monday June 2, 8:00 AM to 11:45 AM
Location: S Hall A2
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Author(s): Grazia Arpino, Anna Crispo, Mario Giuliano, Carmine De Angelis, Maria Grimaldi, Ernesta Cavalcanti, Flaviano Di Paola, Immacolata Capasso, Emanuela Esposito, Massimiliano D'Aiuto, Giuseppe D'Aiuto, Flavia Nocerino, Giuseppe Buono, Gerardo Botti, Michelino De Laurentiis, Sabino De Placido, Maurizio Montella; Medical Oncology, AOU Federico II, Naples, Italy; Struttura Semplice Dipartimentale di Epidemiologia, Istituto Nazionale Tumori Pascale, Naples, Italy; AOU Federico II, Naples, Italy; Istituto Nazionale per lo Studio e la Cura dei Tumori, Naples, Italy; Division of Laboratory Medicine. Department of Diagnostic Pathology and Laboratory. Istituto Nazionale Tumori, Naples, Italy; National Cancer Institute, G. Pascale Foundation, Naples, Italy; Istituto Nazionale Tumori Pascale, Naples, Italy; Epidemiology Unit, Istituto Nazionale Tumori, Naples, Italy; Medical Oncology, AOU, Naples, Italy; Department of Pathology, Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy; INT Pascale, Naples, Italy; Medical Oncology, Endocrinology and Oncology Department, University Federico II of Napoli, Naples, Italy
Abstract Disclosures


Background: High body mass index (BMI) is considered a risk factor for breast cancer (BC) onset and is correlated with bad prognosis and resistance to endocrine therapy in BC patients. Obesity is also cause of insulin resistance (IR), often associated to resistance to anti human epidermal growth factor receptor (HER) inhibitors. The aim of the present study was to assess the association of BMI levels and IR with BC immunohistochemically-defined subtypes. Methods: One thousand consecutive post-menopausal patients with early BC were included in our study. Clinical, metabolic and tumor characteristics were prospectively collected at the time of diagnosis. IR was defined by the homeostatic model assessment (HOMA), with a cut off value to define IR ≥ 3,4. BMI was categorized as low: ≤25; intermediate: 26-30; high: >25. Data were analysed by logistic regression model. Results: Patients with luminal (A and B) BC were more likely to be overweight (BMI = 26-30) (OR=2.96 95% CI 1.53-5.74; p=0.006) although they had low HOMA scores (< 3.4) (OR=0.57 95% CI 0.35-0.93; p=0.02). In contrast, patients with HER2+ subtype were at increased risk for elevated HOMA score (OR= 2.36 95% CI 1.27-4.4; p=0.007), whereas the association with BMI was not statistically significant. In additional, no significant association was found between triple negative (TN) BC and anthropometric and metabolic variables. Conclusions: Our data suggest that high BMI may be associated with endocrine sensitive BC, whereas high HOMA score, may be more frequent in patients with HER2+ subtype. These findings support the hypothesis that high estrogen exposure of breast tissue in women with higher BMI may drive growth of luminal cancers while insulin an resistance environment may increase the risk of growth factor receptor-dependent BC. If further confirmed, our data suggests that body weight reduction and glycemic control, respectively in these two subsets of women may help to prevent cancer development.
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