체질량지수와 유방암의 위험도 및 예후와의 상관성
Body Mass Index as a Risk and Prognostic Factor of Breast Cancer
고승상, 김승기, 김승일, 박병우, 이경식,
소속 상세정보
고승상 ( Ko Seung-Sang )
연세대학교 의과대학 외과학교실
김승기 ( Kim Seung-Ki )
연세대학교 의과대학 외과학교실
김승일 ( Kim Seung-Il )
한림대학교 의과대학 외과학교실
박병우 ( Park Byeong-Woo )
연세대학교 의과대학 외과학교실
이경식 ( Lee Kyung-Sik )
포천중문의과대학교 외과학교실
KMID : 0371320020630060449
Abstract
PURPOSE: In order to study the effect of body mass index (BMI) on the risk and the prognosis of breast cancers, we analyzed the BMI and clinico-pathological data of the breast cancer patients. We compared the BMIs of breast cancer patients to those of
normal women and investigated the association of the BMI with the clinico-pathological data. Then the overall and disease-free survial probabilities were analyzed according to the BMI groups. METHODS: 1,201 breast cancer patients were available for the
analysis of BMI and the BMI of the normal control women was adopted from the report of the National Health, Nutrition Survey of 1998. We classified the BMI groups by he World Health Organization classification as follows; BMI under 18.5 as under-weight
group, 18.5~24.9 as the normal weight group, 25~30 as the overweight group, and over 30 as the obesity group. BMI was compared between the patient group and the control group by age, while the correlation between BMI and the clinico-pathological
characteristics and the recurrence and survival rates for each BMI group were comparatively analyzed. The statistical analysis were performed using chi-square test, one-way ANOVA, independent T-test, and one sample T test, and the survival probabilities
were generated by Kaplan-Meier methods. RESULTS: The means of BMI increased by aging in both the patients and the control group. The means of BMI of the 30s and 50s were significantly lower in breast cancer patients than those of normal women (P=0.001,
0.002). However, those of 60s and 70s were higher in breast cancer patients with marginal significance (P=0.159). In the premenopausal patient group, BMI was associated with the tumor size (P=0.012) and the tumor stage (P=0.018). In the post-menopausal
patients, on the other hand, BMI had positive relationship with well-differentiation of the tumor (P=0.025), and also showed a marginal association with estrogen receptor positivity (P=0.074). BMI did not influence on the outcome of premenopausal breast
cancer patients but lower BMI (underweight group) showed poorer outcome in postmenopausal patients in terms of overall survival (P=0.278), locoregional relapse-free survival (P=0.581), and distant relapse-free survival (P=0.040). CONCLUSIONS: As a
breast cancer risk factor, BMI seems to have a different association by the age. Higher BMI for the 60s and 70s but lower BMI for the younger age group seems to be a risk factor for the breast cancer development. In terms of the relationship with the
clinico-pathological characteristics, BMI has different association by the menopausal status. BMI did not influence on the outcome of premenopausal breast cancer patients but lower BMI (underweight group) showed significantly poorer outcome in
postmenopausal patients.
키워드
체질량지수; 위험인자; 예후인자; 유방암; Body mass index (BMI); Risk factor; Prognostic factor; Breast cancer;
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