Key result
Full-course dyslipidemia during neoadjuvant chemotherapy was significantly associated with worse disease-free survival in breast cancer patients (HR 1.896).
Why the study?
Lipid metabolism disorders may be involved in breast cancer occurrence and development, motivating an investigation into serum lipid changes during neoadjuvant chemotherapy and their impact on prognosis.
Does dyslipidemia and its deterioration during neoadjuvant chemotherapy affect disease-free survival in patients with breast cancer?
Cohort (n=312)
No
Does dyslipidemia and its deterioration during neoadjuvant chemotherapy affect disease-free survival in patients with breast cancer?
Hazard Ratio: 1.896 (95% CI 1.069–3.36)
Absolute Event Rate: 34.7% vs 12.6%
p-value: p=0.029
Dyslipidemia deteriorates after neoadjuvant chemotherapy in breast cancer patients, and full-course dyslipidemia is an independent risk factor for poor disease-free survival.
Dyslipidemia during neoadjuvant chemotherapy was associated with worse DFS; hypothesis-generating and should not yet change practice.
Background Lipid metabolism disorders may be involved in the occurrence and development of breast cancer. This study aimed to investigate the serum lipid changes during neoadjuvant chemotherapy for breast cancer and the effect of dyslipidemia on the prognosis of breast cancer patients. Methods We collected the data from 312 breast cancer patients who underwent surgery after receiving standard neoadjuvant therapy. χ 2 test and T-test were employed to analyze the effect of chemotherapy on the serum lipid metabolism of patients. The effects of dyslipidemia on the disease-free survival (DFS) of patients with breast cancer were analyzed by χ 2 test and COX regression analysis. Results A total of 56 out of 312 patients (17.9%) suffered from relapse. The baseline serum lipid level of the patients was significantly correlated with their age and body mass index (BMI) ( p < 0.05). Chemotherapy increased the levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol, but decreased the level of high-density lipoprotein cholesterol ( p < 0.001). Preoperative dyslipidemia was significantly associated with the axillary pCR rate ( p < 0.05). COX regression analysis revealed that the full-course serum lipid level (HR = 1.896 [95%CI 1.069–3.360]; p = 0.029), N stage (HR = 4.416 [95%CI 2.348–8.308]; p < 0.001) and the total pCR rate (HR = 4.319 [95%CI 1.029–18.135]; p = 0.046) acted as prognostic factors affecting DFS in breast cancer. The relapse rate in patients with a high level of total cholesterol was higher than that in patients with a high level of triglycerides (61.9% vs 30.0%; p < 0.05). Conclusions Dyslipidemia deteriorated after chemotherapy. The full-course serum lipid level may thus serve as a blood marker for predicting breast cancer prognosis. Serum lipids should therefore be closely monitored in breast cancer patients throughout the treatment course, and patients with dyslipidemia should be treated in a timely manner.
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Ma et al. (2023) conducted a cohort in Primary breast cancer (n=312). Full-course dyslipidemia vs. Normal serum lipids was evaluated on Disease-free survival (DFS) (HR 1.896, 95% CI 1.069-3.360, p=0.029). Full-course dyslipidemia during neoadjuvant chemotherapy was significantly associated with worse disease-free survival in breast cancer patients (HR 1.896).
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