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Clinics in Oncology
2021 | Volume 6 | Article 1836 1
Overview of Obesity and Breast Cancer in Brazil: 24 Years
of Follow-Up
OPEN ACCESS
*Correspondence:
Andrea Z Pereira, Department of
Oncology and Hematology, Albert
Einstein Hospital, Av. Albert Einstein,
627/520, São Paulo (SP), CEP 05651-
901, Brazil, Tel: (55 11)-3773-6590, (55
11)-2151-3203; Fax: (55 11)-2151-3522;
E-mail: andreap_pereira@hotmail.com
Received Date: 21 Jun 2021
Accepted Date: 12 Jul 2021
Published Date: 15 Jul 2021
Citation:
Pereira AZ, de Almeida-Pitito B, do
Prado RR, Mattar A, Hegg R, Yoshinori
Shida J, et al. Overview of Obesity and
Breast Cancer in Brazil: 24 Years of
Follow-Up. Clin Oncol. 2021; 6: 1836.
ISSN: 2474-1663
Copyright © 2021 Andrea Z
Pereira. This is an open access
article distributed under the Creative
Commons Attribution License, which
permits unrestricted use, distribution,
and reproduction in any medium,
provided the original work is properly
cited.
Research Article
Published: 15 Jul, 2021
Abstract
Background: Tere is a higher risk of Breast Cancer (BC) in postmenopausal obese women and
with a worse outcome of all ages.
Objectives: To evaluate obesity prevalence in BC patients and its association with survival, age,
Surgery Complications (SC), and molecular BC subtypes.
Methods: A retrospective cohort study was performed with 5925 between 1994 and 2018. Survival
analysis was performed according to Body Mass Index (BMI) groups. Te database contains
information about molecular BC subtypes and SC.
Results: Tey had a mean (SD) age of 54 (12.0) years. Tere were 769 (13%) deaths, and the mean
survival was 20 (2.0) years. 1,787 (30%) patients with obesity and 4,138 (70%) without obesity.
Patients with obesity were older (56 (11.0) years) (p<0.001) and they had lower frequencies of
luminal B (33 vs. 67%, p=0.02) and HER2- (31 vs. 69%, p=0.04) subtypes. Tere was a diference
between obesity in BC patients and the Brazilian population (p<0.005). Patients with obesity had
more infections as a SC (p=0.01). Te Kaplan-Meier curve shows the estimates of survival for
patients with obesity and patients without obesity with BC.
Conclusion: We found a high prevalence of obesity in BC patients, more than in the general
Brazilian women population. Our patients with obesity were older and had lower frequencies of
luminal B and HER2-subtypes than women without obesity. Besides that, patients with obesity had
more infections afer surgery, mainly in HER2+, Negative triple, and HER2+ Hybrid.
Keywords: Breast cancer; BMI; Obesity; Follow-up-infection
Andrea Z Pereira
1
*, Bianca de Almeida-Pitito
2
, Rogério Ruscitto do Prado
1
, Andre Mattar
3
,
Roberto Hegg
3
, Jorge Yoshinori Shida
3
and Luiz Henrique Gebrim
3
1
Department of Oncology and Hematology, Albert Einstein Hospital, Brazil
2
Department of Preventive Medicine, UNIFESP, Brazil
3
Department of Breast Cancer, São Paulo State Government Women's Health Reference Center (Pérola Byington
Hospital), Brazil
Introduction
Obesity is one of the signifcant public health problems of this century, being a signifcant global
health epidemic in developed and developing countries [1-3]. Te future of obesity prevalence
in the USA in 2030 will rise to adult obesity and severe obesity, respectively, 49% and 24%, with
considerable variation across states [4]. In Brazil, among women, there was an increase in obesity
over the last 25 years, from 13% to 20% [5-7].
Besides the well-established efects on type 2 diabetes and cardiovascular disease, there is
convincing evidence today that obesity also increases the risk of several types of cancer, including
colorectal cancer, endometrial cancer, renal cell carcinoma, esophageal adenocarcinoma, pancreatic
cancer, and liver cancer [8]. Existing literature suggests a relationship between increased BMI and
an increased risk for developing breast cancer [9-13], especially postmenopausal breast cancer [8].
Obesity is a risk factor for several types of cancer, including breast cancer [14]. In the world
and Brazil, Breast Cancer (BC) is the primary cancer and cause of cancer deaths among the female
population [15,16]. Obesity is associated with an increased risk of postmenopausal breast cancer,
and some reports suggest central obesity may be associated with an increased risk of premenopausal
breast cancer [12,17,18].
Many mechanisms have associated BC with obesity, mainly in the postmenopausal period, such
as increased levels of estrogens due to excessive aromatization by adipose tissue; central adiposity as