Key result
Each 1-tertile increase in baseline triglycerides was associated with worse relapse-free survival in women with early breast cancer (HR 1.19; 95% CI 1.02-1.39).
Why the study?
The association between dyslipidaemia and breast cancer remains controversial, especially regarding dynamic changes in lipid levels.
Are serum lipid levels and their dynamic changes associated with relapse-free survival in patients with early breast cancer?
Cohort (n=3,499)
Are serum lipid levels and their dynamic changes associated with relapse-free survival in patients with early breast cancer?
Hazard Ratio: 1.19 (95% CI 1.02–1.39)
High triglyceride levels at baseline and during follow-up are associated with worse relapse-free survival in early breast cancer patients.
Observational lipid data in breast cancer leaves open causal outcome links; prospective studies needed before clinical consideration.
Background: The association between dyslipidaemia and breast cancer remains controversial, especially regarding the dynamic changes in lipid levels. Objectives: This study aimed to elucidate the role of serum lipid levels and the changes in disease outcomes in patients with breast cancer. Methods: The lipid profiles of patients with breast cancer who underwent surgery between 2013 and 2017 were retrospectively reviewed. The lipid profiles comprised triglyceride (TG), total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein. Serum lipid levels were categorized into three groups based on the tertiles. The Wilcoxon test was used to compare changes in serum lipid levels during follow-up. Hazard ratios (HRs) for survival outcomes were estimated using a multivariate Cox regression analysis. Results: A total of 3499 women diagnosed with nonmetastatic invasive breast cancer were included in this study, with a median follow-up of 60.4 months. We confirmed that each 1-tertile increased TG at baseline [HR = 1.19, 95% confidence interval (CI) 1.02-1.39] and 1-year follow-up (HR = 1.46, 95% CI 1.07-1.98) led to worse relapse-free survival (RFS). A lower risk of disease relapse was observed with each 1-tertile upregulation in HDL at 1-year follow-up (HR = 0.72, 95% CI 0.56-0.92). Receiving systemic therapies tends to induce an elevation in plasma lipid levels 1 year after surgery, especially in terms of TG. Regarding the prognostic value of dynamic changes in lipid levels, patients with sustained high levels of TG had poorer RFS (HR = 1.90, 95% CI 1.16-3.11), whereas maintaining high levels of HDL led to better survival (HR = 0.60, 95% CI 0.37-0.97). Conclusion: High TG at baseline and during follow-up was associated with worse disease outcome in early breast cancer patients. Systemic treatment would lead to an elevation of serum lipid levels. Patients with sustained high HDL level at 1-year follow-up after surgery had a superior prognosis, warranting further clinical evaluation.
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Dong et al. (2023) conducted a cohort in Nonmetastatic invasive breast cancer (n=3,499). 1-tertile increase in baseline triglycerides vs. Lower tertiles was evaluated on Relapse-free survival (RFS) (HR 1.19, 95% CI 1.02-1.39). Each 1-tertile increase in baseline triglycerides was associated with worse relapse-free survival in women with early breast cancer (HR 1.19; 95% CI 1.02-1.39).
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