THE CORRELATION BETWEEN INCREASING BODY MASS INDEX AND THE INCIDENCE OF LOCAL RECURRENCE AND DISTANT METASTASIS IN BREAST CANCER PATIENTS

Objective: Patients with breast cancer (BC) who are obese or overweight at the time of diag-nosis have a low survival rate and a high death rate. We aimed to investigate if having a higher body mass index (BMI) at diagnosis raised the risk of local recurrence (LR) and distant metastasis. Patients and Methods: Patients were divided into three categories based on their BMI. The patient's BMI was determined by dividing his weight in kilograms by his height in square meters (kg/m2). The WHO defines normal weight as 18.5 <= BMI < 25 kg/m2, overweight as 25 <= BMI < 30 kg/m2, and obesity as BMI >= 30 kg/m2. Results: The mean BMI was 30.27 +/- 6.06 kg/m2. Out of 250 patients, 60 (24.0%), 73 (29.2%) and 117 (46.8%) patients had normal, overweight and obese BMI respectively. No significant difference between BMI and estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor recep-tor (HER2) was found, but there was an association between tumor (T) stage and lymph vascular inva-sion (LVI) (p<0.05). Obese patients had poorer disease-free survival (DFS) and overall survival (OS) than normal and overweight categories (35.38 +/- 1.72 vs. 42.38 +/- 2.79 and 37.82 +/- 2.27 months) (39.65 +/- 1.65 vs. 45.70 +/- 2.53 and 44.31 +/- 2.04 months) (p<0.001). LR occurs more prevalent in over-weight and obese patients than normal (p<0.03) but there is no significant difference for distant metastasis. Conclusions: There is a strong negative association between increased BMI and BC prognosis and patient survival; controlling of this phenomenon may improve the response to treatment and survival, therefore health awareness programs should be implemented.