Abstract 266P
Background
Obesity, dyslipidemia, and high blood pressure have affected more than 25% of breast cancer survivors and are commonly associated with worse prognosis. Metabolic comorbidities vary according to ethnic groups, regions, socioeconomic status. Limited studies have addressed frequency and relative impacts on breast cancer survivors in low- and middle-income countries, including Indonesia.
Methods
Non-metastatic breast cancer at diagnosis (N=1081) admitted to our institute (2014-2018) were followed-up for the presence of high BMI at risk, impaired glucose intolerance, dyslipidemia, and high blood pressure during a median follow up of 3.9 years.
Results
BMI at risk, glucose intolerance, dyslipidemia, and hypertension were found in 23.3%, 26.5%, 27.7%, 42.6% of patients, respectively. Glucose intolerance and in combination with dyslipidemia were significantly correlated with a higher risk of distant metastasis, OR=1.442 (95%CI=1.071-1.943, p=0.016) and OR=1.495 (95%CI=1.090-2.049, p=0.010); respectively. Patients who had 3 or more metabolic comorbidities compared to those without any comorbidity were significantly associated with disease progression OR=1.647 (95%CI=1.139-2.382, p=0.008). Metabolic comorbidities distributed unevenly among intrinsic breast cancer subtypes and a significant correlation with cancer progression was found in Luminal B. In postmenopausal patients, the effects of having more than 3 comorbidities on the frequency of distant metastasis were higher (OR=2.000 95%CI=1.035-3.067, p=0.001). In addition, sociodemographic determinants such as being obese and living in urban areas as well as receiving treatment of aromatase inhibitors were associated with an elevated risk to have 3 or more metabolic comorbidities.
Conclusions
Clustering of metabolic comorbidities was associated with greater risks of distant metastasis, particularly in Luminal B-like and post-menopausal women. Larger studies are required to extend the understanding of their correlation with the quality of life and survival, as well as the potential application of lifestyle modification and clinical intervention to reduce the impact of metabolic comorbidities in breast cancer survivors.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Universitas Gadjah Mada.
Funding
NUS-UGM-Tahir Foundation, Ministry of Research - Republic of Indonesia, internal funding Universitas Gadjah Mada.
Disclosure
All authors have declared no conflicts of interest.