RESUMO
Several studies have shown that hormonal, metabolic and inflammatory mechanisms may affect breast cancer progression. We tested the prognostic value of metabolic syndrome in 110 postmenopausal breast cancer patients, who participated in a 1-year dietary intervention study. The risk of adverse events after 5.5 years of follow-up was examined by Cox' proportional hazard modelling, adjusting for hormone receptor status, stage at diagnosis and serum testosterone level, which were shown to significantly affect prognosis. The adjusted hazard ratio of recurrence for the presence of metabolic syndrome at baseline was 3.0 (95% CI 1.2-7.1). Combining metabolic syndrome and serum testosterone, the adjusted hazard ratio of recurrence among women with metabolic syndrome and testosterone levels higher than 0.40 ng/ml (median value) was 6.7 (95% CI 2.3-19.8) compared with that among women without metabolic syndrome and testosterone levels < or =0.40 ng/ml. The results suggest that metabolic syndrome may be an important prognostic factor for breast cancer.
Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Síndrome Metabólica/complicações , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/etiologia , Testosterona/sangue , Idoso , Neoplasias da Mama/sangue , Feminino , Humanos , Incidência , Itália/epidemiologia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/sangue , Razão de Chances , Pós-Menopausa , Valor Preditivo dos Testes , Prognóstico , Modelos de Riscos Proporcionais , Medição de Risco , Fatores de RiscoRESUMO
Western lifestyle, characterized by reduced physical activity and a diet rich in fat, refined carbohydrates, and animal protein is associated with high prevalence of overweight, metabolic syndrome, insulin resistance, and high plasma levels of several growth factors and sex hormones. Most of these factors are associated with breast cancer risk and, in breast cancer patients, with increased risk of recurrences. Recent trials have proven that such a metabolic and endocrine imbalance can be favorably modified through comprehensive dietary modification, shifting from Western to Mediterranean and macrobiotic diet.