Metabolic syndrome and early stage breast cancer outcome: results from a prospective observational study

Giuseppe Buono, Anna Crispo, Mario Giuliano, Carmine De Angelis, Francesco Schettini, Valeria Forestieri, Rossella Lauria, Michelino De Laurentiis, Pietro De Placido, Carmen Giusy Rea, Carmen Pacilio, Emanuela Esposito, Maria Grimaldi, Flavia Nocerino, Giuseppe Porciello, Aldo Giudice, Alfonso Amore, Anita Minopoli, Gerardo Botti, Sabino De PlacidoMeghana V. Trivedi, Grazia Arpino

Research output: Contribution to journalArticlepeer-review


Purpose: Obesity and insulin resistance have been associated with poor prognosis in breast cancer (BC). The present prospective study aimed to investigate the impact of metabolic syndrome (MetS) and its components on early BC (eBC) patients’ outcome. Methods: MetS was defined by the presence of 3 to 5 of the following components: waist circumference > 88 cm, blood pressure ≥ 130/≥ 85 mmHg, serum levels of triglycerides ≥ 150 mg/dL, high density lipoprotein < 50 mg/dL and fasting glucose ≥ 110 mg/dL. Seven hundred and seventeen patients with data on ≥ 4 MetS components at BC diagnosis were enrolled. Study population was divided into two groups: patients with < 3 (non-MetS) vs. ≥ 3 components (MetS). Categorical variables were analyzed by Chi-square test and survival data by log-rank test and Cox proportional hazards regression model. Results: Overall, 544 (75.9%) and 173 (24.1%) women were categorized as non-MetS and MetS, respectively. MetS patients were more likely to be older, postmenopausal, and insulin-resistant compared to non-MetS patients (p < 0.05). In multivariate analysis, MetS patients had a numerically higher risk of relapse [disease-free survival (DFS), hazard ratio (HR) 1.51, p = 0.07] and a significantly higher risk of death compared to non-MetS patients [overall survival (OS), HR 3.01, p < 0.0001; breast cancer-specific survival (BCSS), HR 3.16, p = 0.001]. Additionally, patients with 1 to 2 components of MetS had an increased risk of dying compared to patients with 0 components (OS, HR 4.90, p = 0.01; BCSS, HR 6.07, p = 0.02). Conclusions: MetS correlated with poor outcome in eBC patients. Among patients without full criteria for MetS diagnosis, the presence of 1 or 2 components of the syndrome may predict for worse survival.

Original languageEnglish
JournalBreast Cancer Research and Treatment
Publication statusPublished - 2020


  • Breast cancer
  • Breast cancer outcome
  • Metabolic syndrome
  • Metabolic syndrome components

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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