Metabolic syndrome-breast cancer link varies by intrinsic molecular subtype

Immacolata Capasso, Emanuela Esposito, Michelino De Laurentiis, Nicola Maurea, Ernesta Cavalcanti, Gerardo Botti, Antonella Petrillo, Maurizio Montella, Massimiliano D'Aiuto, Carmela Coppola, Anna Crispo, Maria Grimaldi, Giuseppe Frasci, Alfredo Fucito, Gennaro Ciliberto, Giuseppe D'Aiuto

Research output: Contribution to journalArticlepeer-review


Background: Metabolic syndrome (MS) has been shown to increase the risk of breast cancer. Existing data suggest that the strength of metabolic syndrome-breast cancer link varies by intrinsic molecular subtype, but results from worldwide literature are controversial. Primary endpoint of the study was to assess whether MS is a predictor of specific breast cancer (BC) subtype. Secondary endpoint was to determine whether components of MS can individually increase the risk of specific breast cancer subtype. Methods: Anthropometric and metabolic variables were correlated to breast cancer specific subgroups, retrospectively. Statistical significance was considered when p ≤ 0.05 and 95% CI. Results: Data analysis suggests that MS per se represents a modifiable risk factor for BC in postmenopausal [OR 6.28 (95% CI 2.79-14.11) p <0.00001]. MS per se prevalence is higher among Luminal breast cancers in postmenopausal [OR 1.37 (95% CI 1.07-2.80) p = 0.03]. Body Mass Index (BMI) alone is associated to Luminal A subtype breast cancer risk [OR 1.12 (95% CI 0.96-2.196 p = 0.2]. Waist Circumference > 88 cm has been shown to be specifically and statistically significant associated to HER-2+ breast cancer subtypes in postmenopausal [OR 2.72 (95% CI 1.69-10.72) p = 0.01], whilst in Luminal B it was only marginally statistical associated [OR 2.21 (95% CI 0.77-2.60) p = 0.1]. Insulin resistance showed statistical significant association to HER-2+ and Luminal B tumors [OR 2.11 (95% CI 1.66-6.69) p = 0.05] and [OR 2.33 (95% CI 1.2-4.2) p = 0.006], respectively. Hence, it has emerged that BMI is weakly associated to Luminal A breast cancers in this case series, whereas visceral obesity and insulin resistance are likely to be linked to more aggressive breast cancer subtypes. Conclusions: New molecular biomarkers unveiling metabolic syndrome related breast carcinogenesis need to be detected to further stratify breast cancer risk by subtypes.

Original languageEnglish
Article number105
JournalDiabetology and Metabolic Syndrome
Issue number1
Publication statusPublished - Sept 26 2014


  • BMI
  • Breast cancer
  • Insulin-resistance
  • Metabolic syndrome
  • Molecular subtype
  • Waist circumference

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine


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