Dados do Resumo

Título

Evaluation of the Presence of Metabolic Syndrome in Breast Cancer Patients Treated at a Brazilian Cancer Center

Introdução

Metabolic syndrome (MetS), also known as insulin resistance syndrome, is characterized by the presence of at least 3 of the following 5 factors characterized by the presence of at least 3 of the 5 factors: systemic arterial hypertension/SAH, hyperinsulinemia, increased abdominal circumference/AC (visceral obesity or increased body mass index) and dyslipidemia and is associated with an increased risk (RR/Relative Risk 2.01) of developing breast câncer/BC, aggressive phenotype and metastasis.

Objetivo

To assess the incidence of MetS and the prevalence of obesity in patients treated for breast cancer in a Brazilian cancer center. To analyze the components of MetS and its (potential) impact on breast cancer treatment.

Métodos

This is a retrospective cross-sectional study. Patients diagnosed with breast cancer (invasive or cancer (invasive or insitu), treated at the A.C. Camargo Cancer Center between 2016 and 2020, with evidence of diagnosis of metabolic syndrome. The sample was extracted from a previous research database for the evaluation of computed tomography/CT and adipose tissue in patients with breast cancer. Data collected was entered into a database built on the REDCap®️ system. To summarize the quantitative variables, the summary measures of position and dispersion were considered, such as mean, median, standard deviation and minimum and maximum values. Absolute and relative frequencies were used for the qualitative variables. We considered p=0.05. A total of 362 participants were included. Ethics approval Nº 3580/24.

Resultados

The median age was 50.0 years/y and the incidence of MetS was 24.3%; in this group MetS the median age was higher (58.0y). Around 40.0% were postmenopausal. More than 70.0% of the tumors were luminal and 52.1% had early disease. The median BMI was 26.2 kg/m2. Regarding the presence of comorbidities/CBs, 225 patients had at least 1 CB (60.4%): Insulin Resistance (74.9%), Systemic Arterial Hypertension (49.4%), Dyslipidemia (32.9%), Obesity (26.8%) were the most prevalent. More than 70% of the participants with MetS had early disease and the majority of locally advanced disease was among those without MetS (p<0.05). Considering the visceral fat, the largest areas were found in the group with MetS (71.3%) and in the group with 3 or more CBs (71.2%); and the smallest areas in the group without MetS (67.7%) and in the group with only 2 CBs (76.7%), p<0.05. Overall survival was 138 months and there was no statistical difference between the presence of MetS/body fat distribution.

Conclusões

MetS is very prevalent in the BC population and is more related to more advanced tumors and patients with more CBs. The assessment of visceral fat area was also correlated with the presence of MetS. In the absence of a third criterion for diagnosing MetS, CT assessment can be used in clinical routine, as it is an imaging test that is widely used during the staging of cancer patients. Thus, the assessment of the area of adipose tissue should be incorporated into oncological practice.

Palavras Chave

Breast cancer; metabolic syndrome; obesity