Min SK, et al. J Breast Cancer. 2020 Sep;24:e4. https://doi.org/10.4048/jbc.2021.24.e4

The association between serum lipid level and prognosis of breast cancer is controversial. The purpose of this study was to evaluate the impact of serum lipid level in breast cancer recurrence. We analyzed a total of 4190 patients with operable breast cancer who had baseline serum lipid profiles; total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), apolipoprotein A-1, and apolipoprotein B. Recurrence-free survival is defined as the elapsed time from the date of curative surgery to the detection of any recurrence, and recurrence includes locoregional recurrence, distant metastasis, or both local and distant metastasis. Cox-proportional hazard analysis was used to estimate hazard ratios with 95% confidence intervals (CI) for study outcomes comparing the three lowest quartiles of each lipid parameter to the highest quartile adjusting for age, body mass index (BMI), and pathologic stage, estrogen receptor (ER), progesterone receptor (PR), comorbidities (hypertension, diabetes, or vascular event) at time of breast cancer diagnosis. Patients with dyslipidemia (high bad cholesterol and low good cholesterol level) had worse prognostic factors (i.e., negative hormone receptor status, positive human epidermal growth factor receptor 2 (HER2) expression, higher nuclear grade). After adjusting for these poor prognostic factors, the patients with dyslipidemia showed good prognosis for breast cancer recurrence. Our study showed that baseline high lipid level could be a good prognostic factor of breast cancer. This study indicates that desirable changes in lipid profile for cardiovascular disease risk are not always beneficial for patients with breast cancer. However, as proper control of lipid level has advantages for cardiovascular disease, these findings require careful interpretation.

Jung SM, et al. J Breast Cancer. 2019 Nov;23:e61. https://doi.org/10.4048/jbc.2020.23.e61

Jung SM, et al. Ann Surg Treat Res. 2020 Nov;99(5):251-258. https://doi.org/10.4174/astr.2020.99.5.251

Alyami H, et al. J Breast Cancer. 2020 Sep;24:e16. https://doi.org/10.4048/jbc.2021.24.e16

Purpose The purpose of this study was to investigate risk factors for post-metastasis overall survival (PMOS), and to analyze the effect of early detection of distant metastases before symptoms occur on survival in breast cancer patients under intensive surveillance.Methods A total of 7,840 patients underwent surgery for breast cancer from January 2010 to December 2014 at Samsung Medical Center; of these, we retrospectively studied 316 metastatic breast cancer patients. The patients were divided into two groups based on method of metastases detection, routine surveillance without symptoms (asymptomatic group) or follow-up for new-onset symptoms (symptomatic group).Results Multivariate analysis of PMOS showed that the patients with multiple metastases had a 1.872 fold risk of PMOS (p = 0.011) compared to the patients with bone metastasis only. The hazard ratio for the symptomatic group was higher than that for the asymptomatic group (p < 0.001). When patients were stratified by tumor subtype, patients who were HR-positive and asymptomatic on diagnosis of distant metastasis had a better prognosis than those who were HR-positive and symptomatic on diagnosis. However, patients who were HER2-positive showed no significant survival difference between two groups.Conclusion Breast cancer patients who were diagnosed with distant metastasis after symptoms occurred had a poorer prognosis than patients who were diagnosed before symptoms had developed. It is important to follow up patients regularly for symptoms related to distant metastases. Our findings validate the need for intensive surveillance, suggesting reconsideration of the guidelines for metastases screening in breast cancer patients.