Page 26 - Deleware Medical Journal - September/October 2019

Is Metabolic Syndrome Associated
with Decreased Survival in African American
Breast Cancer Patients?
Jennifer Bayron, MD; Jennifer Sims Mourtada, PhD; Diana Dickson-Witmer, MD, FACS
BACKGROUND/OBJECTIVE: African American (AA) patients living in Delaware have a decreased survival rate across all breast cancer types. The objective of this study was to assess whether the presence of metabolic syndrome or specific medical comorbidities was associated with decreased survival in AA breast cancer patients in Delaware.
METHODS: A retrospective database review from the Helen F. Graham Cancer Center & Research Institute (HFGCCRI) cancer registry was performed from 2006-2010. There were 1,672 breast cancer patients identified, including 281 AA patients. All patient comorbidity data, such as hypertension, diabetes, and obesity defined as BMI >30, were analyzed using chi square analysis (P<.05) and log-rank Mantel Cox for survival. Metabolic syndrome was defined as having hypertension, diabetes, and obesity.
RESULTS: Breast cancer survival is twice as high in Caucasian patients as AA (p=0.0001, HR 2.63 95% CI 1.968-6.609). Patients with hypertension or diabetes had worse breast cancer-specific survival (p=0.037). There was a higher incidence of hypertension, diabetes, and obesity in AA patients. Patients with metabolic syndrome have worse survival (p=0.02, log-rank Mantel Cox). Although there was a higher incidence of metabolic syndrome in AA patients, AAs with metabolic syndrome fared worse than Caucasians with metabolic syndrome.
CONCLUSIONS: All patients with hypertension, diabetes, and/or metabolic syndrome have worse breast cancer-specific survival. Although AA patients were more likely to have metabolic syndrome, there was no difference in breast cancer- specific survival for patients with metabolic syndrome based on race. Continued investigation of modifiable risk factors for AA patients to improve breast cancer-specific survival is ongoing. Increased risk of developing breast cancer in patients with metabolic syndrome has been established in the literature. Our study now demonstrates worse breast cancer-specific survival, further supporting the need to focus on management and prevention of obesity and associated comorbidities to improve breast cancer-specific survival.
218 Del Med J | September/October 2019 | Vol. 91 | No. 5
Abstract