Background
Methods
Korean breast cancer registry (KBCR)
Patients and follow-up
Statistical analysis
Results
Patient characteristics
Characteristic | Overall | Underweight BMI | Normal BMI | Overweight BMI | Obese BMI | p value |
---|---|---|---|---|---|---|
<18.5 kg/m2 | 18.5-24.9 kg/m2 | 25-29.9 kg/m2 | ≥30 kg/m2 | |||
No. of subjects | 41021 | 1387 | 27519 | 10483 | 1632 | |
Age (years) | ||||||
mean(SD) | 48(10) | 42(10) | 47(10) | 52(10) | 53(11) | <0.0001 |
Median(Range) | 47(18-93) | 41(19-87) | 46(18-93) | 51(19-90) | 53(22-87) | |
≤ 35 | 3737(9.11) | 390(28.12) | 2793(10.15) | 483(4.61) | 71(4.35) | <0.0001 |
> 35 | 37284(90.89) | 997(71.88) | 24726(89.85) | 10000(95.39) | 1561(95.65) | |
Tumor size (cm) | ||||||
0 - 2 | 21931(53.46) | 827(59.63) | 15331(55.71) | 5083(48.49) | 690(42.28) | <0.0001 |
> 2 | 19090(46.54) | 560(40.37) | 12188(44.29) | 5400(51.51) | 942(57.72) | |
Axillary lymph node metastasis | ||||||
Negative | 25205(61.44) | 916(66.04) | 17205(62.52) | 6153(58.70) | 931(57.05) | <0.0001 |
Positive | 15816(38.56) | 471(33.96) | 10314(37.48) | 4330(41.30) | 701(42.95) | |
Operation method | ||||||
Mastectomy | 23362(56.95) | 759(54.72) | 15361(55.82) | 6254(59.66) | 988(60.54) | <0.0001 |
Conserving surgery | 17659(43.05) | 628(45.28) | 12158(44.18) | 4229(40.34) | 644(39.46) | |
ER/PR expression | ||||||
ER and/or PR Positive | 28166(68.66) | 970(69.94) | 19065(69.28) | 7040(67.16) | 1091(66.85) | 0.0002 |
ER and PR Negative | 12855(31.34) | 417(30.06) | 8454(30.72) | 3443(32.84) | 541(33.15) | |
HER 2 expression | ||||||
Negative | 28530(69.55) | 955(68.85) | 18995(69.03) | 7401(70.60) | 1179(72.24) | 0.0004 |
Positive | 8005(19.51) | 265(19.11) | 5541(20.14) | 1917(18.29) | 282(17.28) | |
Unknown | 4486(10.94) | 167(12.04) | 2983(10.84) | 1165(11.11) | 171(10.48) | |
Subtype | ||||||
ER and/or PR + and HER 2 - | 21094(51.42) | 706(50.90) | 14179(51.52) | 5363(51.16) | 846(51.84) | <0.0001 |
ER and/or PR + and HER 2 + | 4118(10.04) | 144(10.38) | 2909(10.57) | 929(8.86) | 136(8.33) | |
ER and PR - and HER 2 + | 3887(9.48) | 121(8.72) | 2632(9.56) | 988(9.42) | 146(8.95) | |
ER and PR - and HER 2 - - | 7436(18.13) | 249(17.95) | 4816(17.50) | 2038(19.44) | 333(20.40) | |
Unknown | 4486(10.94) | 167(12.04) | 2983(10.84) | 1165(11.11) | 171(10.48) | |
Histologic grade | ||||||
Low (grade1 - 2) | 20043(48.86) | 690(49.75) | 13495(49.04) | 5050(48.17) | 808(49.51) | 0.0032 |
High (Grade 3) | 15890(38.74) | 498(35.90) | 10560(38.37) | 4186(39.93) | 646(39.58) | |
Unknown | 5088(12.4) | 199(14.35) | 3464(12.59) | 1247(11.90) | 178(10.91) | |
Adjuvant chemotherapy | ||||||
Yes | 28812(70.24) | 891(64.24) | 19289(70.09) | 7477(71.33) | 1155(70.77) | <0.0001 |
No | 9682(23.6) | 409(29.49) | 6578(23.90) | 2320(22.13) | 375(22.98) | |
Unknown | 2527(6.16) | 87(6.27) | 1652(6.00) | 686(6.54) | 102(6.25) | |
Adjuvant hormonal | ||||||
Yes | 26265(64.03) | 856(61.72) | 17723(64.40) | 6651(63.45) | 1035(63.42) | 0.2424 |
No | 12782(31.16) | 463(33.38) | 8501(30.89) | 3300(31.48) | 518(31.74) | |
Unknown | 1974(4.81) | 68(4.90) | 1295(4.71) | 532(5.07) | 79(4.84) |
Overall survival and breast cancer-specific survival
Characteristic | Overall survival | Breast cancer specific survival | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Alive | Death | HR (95 % CI) | p value | Adjust HR (95 % CI) | p value | Alive | Death | HR (95 % CI) | p value | Adjust HR (95 % CI) | p value | |
No. of participants | 36553 | 4468 | 98197 | 2824 | ||||||||
Age (years) | ||||||||||||
≤ 35 | 3330(9.11) | 407(9.11) | 1.00 | 3479(9.11) | 258(9.14) | 1.00 | ||||||
> 35 | 33223(90.89) | 4061(90.89) | 1.04(0.94-1.15) | 0.4945 | 34718(90.89) | 2566(90.86) | 1.03(0.91-1.17) | 0.6453 | ||||
Tumor size (cm) | ||||||||||||
0 - 2 | 20608(56.38) | 1323(29.61) | 1.00 | 1.00 | 21185(55.46) | 746(26.42) | 1.00 | 1.00 | ||||
> 2 | 15945(43.62) | 3145(70.39) | 2.74(2.57-2.92) | <0.0001 | 1.70(1.58-1.82) | <0.0001 | 17012(44.54) | 2078(73.58) | 3.16(2.91-3.44) | <0.0001 | 1.77(1.61-1.93) | <0.0001 |
Axillary lymph node metastasis | ||||||||||||
Negative | 23731(64.92) | 1474(32.99) | 1.00 | 1.00 | 24439(63.98) | 766(27.12) | 1.00 | 1.00 | ||||
Positive | 12822(35.08) | 2994(67.01) | 3.43(3.22-3.65) | <0.0001 | 2.95(2.75-3.16) | <0.0001 | 13758(36.02) | 2058(72.88) | 4.42(4.07-4.80) | <0.0001 | 3.50(3.20-3.84) | <0.0001 |
Operation method | ||||||||||||
Mastectomy | 19830(54.25) | 3532(79.05) | 1.00 | 1.00 | 21094(55.22) | 2268(80.31) | 1.00 | 1.00 | ||||
Conserving surgery | 16723(45.75) | 936(20.95) | 0.37(0.34-0.39) | <0.0001 | 0.55(0.51-0.59) | <0.0001 | 17103(44.78) | 556(19.69) | 0.34(0.31-0.37) | <0.0001 | 0.55(0.50-0.61) | <0.0001 |
ER/PR expression | ||||||||||||
ER and/or PR Positive | 25647(70.16) | 2519(56.38) | 1.00 | 1.00 | 26629(69.71) | 1537(54.43) | 1.00 | 1.00 | ||||
ER and PR Negative | 10906(29.84) | 1949(43.62) | 1.75(1.65-1.86) | <0.0001 | 1.55(1.42-1.70) | <0.0001 | 11568(30.29) | 1287(45.57) | 1.87(1.73-2.01) | <0.0001 | 1.56(1.40-1.74) | <0.0001 |
HER 2 expression | ||||||||||||
Negative | 26098(71.40) | 2432(54.43) | 1.00 | 1.00 | 27018(70.73) | 1512(53.54) | 1.00 | 1.00 | ||||
Positive | 7040(19.26) | 965(21.59) | 1.42(1.32-1.53) | <0.0001 | 1.11(1.03-1.20) | 0.0061 | 7402(19.38) | 603(21.35) | 1.41(1.29-1.55) | <0.0001 | 1.08(0.98-1.19) | 0.1128 |
Unknown | 3415(9.34) | 1071(23.97) | 2.23(2.07-2.41) | <0.0001 | 1.70(1.58-1.84) | <0.0001 | 3777(9.89) | 709(25.10) | 2.45(2.23-2.68) | <0.0001 | 1.91(1.74-2.11) | <0.0001 |
BMI calssification | ||||||||||||
Underweight BMI | 1229(3.36) | 158(3.54) | 1.16(0.98-1.36) | 0.0784 | 1.23(1.05-1.44) | 0.0118 | 1284(3.36) | 103(3.65) | 1.18(0.97-1.44) | 0.0974 | 1.26(1.03-1.54) | 0.0219 |
Normal BMI | 24766(67.75) | 2753(61.62) | 1.00 | 1.00 | 25774(67.48) | 1745(61.79) | 1.00 | 1.00 | ||||
Overweight BMI | 9164(25.07) | 1319(29.52) | 1.26(1.18-1.35) | <0.0001 | 1.15(1.07-1.23) | <0.0001 | 9651(25.27) | 832(29.46) | 1.25(1.15-1.36) | <0.0001 | 1.13(1.04-1.22) | 0.0052 |
Obese BMI | 1394(3.81) | 238(5.33) | 1.51(1.32-1.72) | <0.0001 | 1.29(1.13-1.48) | 0.0002 | 1488(3.90) | 144(5.10) | 1.42(1.19-1.68) | <0.0001 | 1.21(1.02-1.43) | 0.0321 |
Histologic grade | ||||||||||||
Low (grade1 - 2) | 18316(50.11) | 1727(38.65) | 1.00 | 1.00 | 19002(49.75) | 1041(36.86) | 1.00 | 1.00 | ||||
High (Grade 3) | 13631(37.29) | 2259(50.56) | 1.73(1.62-1.84) | <0.0001 | 1.32(1.23-1.41) | <0.0001 | 14401(37.70) | 1489(52.73) | 1.86(1.72-2.02) | <0.0001 | 1.36(1.25-1.48) | <0.0001 |
Unknown | 4606(12.60) | 482(10.79) | 1.02(0.92-1.13) | 0.6849 | 1.04(0.94-1.15) | 0.494 | 4794(12.55) | 294(10.41) | 1.04(0.92-1.19) | 0.5269 | 1.08(0.95-1.23) | 0.2561 |
Adjuvant chemotherapy | ||||||||||||
Yes | 25339(69.32) | 3473(77.73) | 1.00 | 1.00 | 26475(69.31) | 2337(82.75) | 1.00 | 1.00 | ||||
No | 9002(24.63) | 680(15.22) | 0.58(0.53-0.63) | <0.0001 | 1.41(1.29-1.55) | <0.0001 | 9354(24.49) | 328(11.61) | 0.42(0.37-0.47) | <0.0001 | 1.12(0.99-1.28) | 0.0753 |
Unknown | 2212(6.05) | 315(7.05) | 1.02(0.91-1.14) | 0.7874 | 1.09(0.97-1.24) | 0.1448 | 2368(6.20) | 159(5.63) | 0.75(0.64-0.88) | 0.0005 | 0.79(0.67-0.94) | 0.0062 |
Adjuvant hormonal | ||||||||||||
Yes | 23785(65.07) | 2480(55.51) | 1.00 | 1.00 | 24743(64.78) | 1522(53.90) | 1.00 | 1.00 | ||||
No | 11000(30.09) | 1782(39.88) | 1.53(1.44-1.63) | <0.0001 | 1.07(0.98-1.17) | 0.1399 | 11604(30.38) | 1178(41.71) | 1.63(1.51-1.76) | <0.0001 | 1.12(1.01-1.25) | 0.0414 |
Unknown | 1768(4.84) | 206(4.61) | 1.13(0.98-1.30) | 0.0920 | 1.02(0.88-1.19) | 0.7627 | 1850(4.84) | 124(4.39) | 1.10(0.92-1.32) | 0.3058 | 1.04(0.86-1.25) | 0.6977 |
Subtype | Overall survival | Breast cancer specific survival | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Alive | Death | HR (95 % CI) | p value | Adjust HR (95 % CI) | p value | Alive | Death | HR (95 % CI) | p value | Adjust HR (95 % CI) | p value | |
ER and/or PR + and HER 2 - | ||||||||||||
No. of participants | 19674 | 1420 | 20248 | 846 | ||||||||
Underweight BMI | 659(3.35) | 47(3.31) | 1.17(0.87-1.57) | 0.2902 | 1.26(0.94-1.69) | 0.1269 | 678(3.35) | 28(3.31) | 1.17(0.80-1.71) | 0.4239 | 1.24(0.85-1.82) | 0.2684 |
Normal BMI | 13352(67.87) | 827(58.24) | 1.00 | 1.00 | 13686(67.59) | 493(58.27) | 1.00 | 1.00 | ||||
Overweight BMI | 4901(24.91) | 462(32.54) | 1.48(1.32-1.66) | <0.0001 | 1.32(1.18-1.48) | <0.0001 | 5084(25.11) | 279(32.98) | 1.49(1.29-1.73) | 0.0035 | 1.30(0.96-1.76) | 0.0874 |
Obese BMI | 762(3.87) | 84(5.92) | 1.74(1.39-2.18) | <0.0001 | 1.48(1.18-1.85) | 0.0006 | 800(3.95) | 46(5.44) | 1.57(1.16-2.12) | <0.0001 | 1.31(1.13-1.52) | 0.0003 |
ER and/or PR + and HER 2 + | ||||||||||||
No. of participants | 3691 | 427 | 3851 | 267 | ||||||||
Underweight BMI | 130(3.52) | 14(3.28) | 0.95(0.56-1.62) | 0.8463 | 1.07(0.63-1.83) | 0.802 | 139(3.61) | 5(1.87) | 0.54(0.22-1.31) | 0.1737 | 0.61(0.25-1.48) | 0.2705 |
Normal BMI | 2612(70.77) | 297(69.56) | 1.00 | 1.00 | 2726(70.79) | 183(68.54) | 1.00 | 1.00 | ||||
Overweight BMI | 827(22.41) | 102(23.89) | 1.06(0.85-1.33) | 0.5960 | 1.02(0.81-1.28) | 0.875 | 856(22.23) | 73(27.34) | 1.24(0.95-1.63) | 0.1177 | 1.18(0.90-1.55) | 0.2251 |
Obese BMI | 122(3.31) | 14(3.28) | 1.05(0.61-1.79) | 0.8608 | 0.94(0.55-1.61) | 0.8193 | 130(3.38) | 6(2.25) | 0.72(0.32-1.62) | 0.4277 | 0.62(0.27-1.39) | 0.2449 |
ER and PR - and HER 2 + | ||||||||||||
No. of participants | 3349 | 538 | 3551 | 336 | ||||||||
Underweight BMI | 94(2.81) | 27(5.02) | 1.79(1.21-2.65) | 0.0034 | 1.67(1.12-2.47) | 0.0113 | 103(2.90) | 18(5.36) | 1.88(1.16-3.05) | 0.0099 | 1.79(1.11-2.90) | 0.0179 |
Normal BMI | 2288(68.32) | 344(63.94) | 1.00 | 1.00 | 2418(68.09) | 214(63.69) | 1.00 | 1.00 | ||||
Overweight BMI | 847(25.29) | 141(26.21) | 1.09(0.90-1.33) | 0.3926 | 0.94(0.77-1.14) | 0.5093 | 900(25.34) | 88(26.19) | 1.09(0.85-1.40) | 0.4921 | 0.93(0.73-1.19) | 0.5715 |
Obese BMI | 120(3.58) | 26(4.83) | 1.38(0.93-2.06) | 0.1132 | 1.18(0.79-1.76) | 0.4247 | 130(3.66) | 16(4.76) | 1.35(0.81-2.24) | 0.2496 | 1.16(0.70-1.93) | 0.5683 |
ER and PR - and HER 2 - | ||||||||||||
No. of participants | 6424 | 1012 | 6770 | 666 | ||||||||
Underweight BMI | 215(3.35) | 34(3.36) | 1.09(0.77-1.54) | 0.6222 | 1.19(0.84-1.68) | 0.3333 | 225(3.32) | 24(3.60) | 1.14(0.76-1.72) | 0.5347 | 1.27(0.84-1.92) | 0.2606 |
Normal BMI | 4206(65.47) | 610(60.28) | 1.00 | 1.00 | 4402(65.02) | 414(62.16) | 1.00 | 1.00 | ||||
Overweight BMI | 1727(26.88) | 311(30.73) | 1.20(1.05-1.38) | 0.0080 | 1.07(0.93-1.23) | 0.3301 | 1849(27.31) | 189(28.38) | 1.07(0.90-1.27) | 0.4398 | 0.93(0.79-1.11) | 0.4320 |
Obese BMI | 276(4.30) | 57(5.63) | 1.37(1.04-1.80) | 0.0234 | 1.18(0.90-1.55) | 0.2395 | 294(4.34) | 39(5.86) | 1.38(0.99-1.91) | 0.0571 | 1.16(0.84-1.61) | 0.3749 |
Unknown | ||||||||||||
No. of participants | 3415 | 1071 | 3777 | 709 | ||||||||
Underweight BMI | 131(3.84) | 36(3.36) | 0.98(0.70-1.37) | 0.8923 | 1.11(0.79-1.55) | 0.5528 | 139(3.68) | 28(3.95) | 1.16(0.79-1.70) | 0.44 | 1.29(0.87-1.89) | 0.2010 |
Normal BMI | 2308(67.58) | 675(63.03) | 1.00 | 1.00 | 2542(67.30) | 441(62.20) | 1.00 | 1.00 | ||||
Overweight BMI | 862(25.24) | 303(28.29) | 1.18(1.03-1.35) | 0.0153 | 1.12(0.98-1.28) | 0.1042 | 962(25.47) | 203(28.63) | 1.20(1.02-1.42) | 0.0283 | 1.15(0.97-1.36) | 0.1030 |
Obese BMI | 114(3.34) | 57(5.32) | 1.61(1.23-2.11) | 0.0005 | 1.36(1.04-1.79) | 0.0261 | 134(3.55) | 37(5.22) | 1.56(1.11-2.18) | 0.0099 | 1.36(0.97-1.90) | 0.0747 |