Metabolic Syndrome Predicts Breast Cancer Recurrence

Metabolic syndrome, especially if associated with elevated testosterone, is “an important prognostic factor” in the recurrence of breast cancer, In a small study 50% of the women with metabolic syndrome developed breast cancer recurrence. The findings come from a trial conducted by Italian investigators and reported in the July 1st International Journal of Cancer.
"Previous studies suggested that several aspects of metabolic syndrome, such as low HDL-cholesterol, high blood glucose, high triglycerides, abdominal obesity, hypertension, and high levels of insulin and insulin-like growth factor I, are associated with breast cancer risk, said " Dr. Patrizia Pasanisi, from Istituto Nazionale Tumori in Milano.

"However, this is the first report addressing the issue of whether breast cancer prognosis is affected by metabolic syndrome," she said.

Dr. Pasanisi and colleagues evaluated 110 postmenopausal women who underwent surgery for breast cancer at least 12 months earlier and who volunteered to participate in a yearlong dietary intervention study. The women were not undergoing chemotherapy and had no evidence of recurrence at study entry.

The metabolic syndrome was diagnosed at baseline in 16 women. After 5.5 years of follow-up, 32 women developed breast cancer recurrences, including 8 of the 16 women with metabolic syndrome.

In women with metabolic syndrome at baseline, the adjusted hazard ratio of breast cancer recurrence was 3.0, the team reports. The adjusted hazard ratio of recurrence increased to 6.7 in women with metabolic syndrome and serum testosterone levels greater than 0.40 ng/mL (median value), compared with women without metabolic syndrome and testosterone levels of 0.40 ng/mL or lower.

"If the predictive value of metabolic syndrome is confirmed," said Dr. Pasanisi, "we think that its evaluation should become part of the standard diagnostic workup of breast cancer patients, and dietary intervention to control the syndrome should be considered."

Previous studies, she also noted, have suggested that levels of sex hormones, and anthropometric and metabolic variables related to metabolic syndrome, "can be favorably modified by a comprehensive change in diet…thus favorably influencing the prognosis for breast cancer."

However, to be effective, correction of metabolic syndrome "must be sufficient to obtain a substantial decrease in serum testosterone," the authors note in their report.

Int J Cancer 2006;119:236-238.

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