Influence of Obesity and Other Comorbidities on Breast Cancer Survival – Analysis of a Hospital Cohort

Breast cancer is the second most common neoplasm globally, the fourth leading cause of cancer death, and the leading cause of cancer death in women (BRAY et al. CA Cancer J Clin. 2024; 74: 229). Obesity has been linked to worse prognosis, especially in postmenopausal women (CRISPO et al. Sci Rep 2023;13: 21208). The present study evaluates the influence of obesity and other comorbidities on survival outcomes of women with breast cancer. A prospective cohort was conducted at the National Cancer Institute (INCA) from February 2009 to April 2013. Women diagnosed with unilateral breast carcinoma without distant metastases were recruited when assigned for either curative surgery (N = 713) or neoadjuvant chemotherapy (N = 325). The study adhered to international research ethics, with approval from the INCA Ethics Committee (#129/08) and registration in Plataforma Brasil (CAAE 55929416.8.0000.5240). All patients provided written consent and were interviewed about their medical history and lifestyle. Variables included age at diagnosis, menopausal status, and comorbidities, such as hypertension, diabetes, and obesity. Follow-up data were collected from electronic records. The influence of individual variables on survival outcomes were estimated using Kaplan-Meier curves with the two-sided Log-Rank test. Results show that obesity negatively affected disease-free survival (p = 0.035), but not overall survival, in the whole cohort. In postmenopausal women, obesity's negative impact persisted, resulting in both worse disease-free (p = 0.003) and overall survival (p = 0.048). These findings align with recent studies (CRISPO et al. Sci Rep 2023;13: 21208.). No significant effects on survival outcomes were obtained either regarding hypertension or diabetes. Further analyses will assess the extent of obesity's influence and other comorbidities on recurrence, metastasis, and death, including other tumor and individual variables.