I. Woelfel1, L. Fernandez4, M. Idowu2, K. Takabe3 1Virginia Commonwealth University,School Of Medicine,Richmond, VA, USA 2Virginia Commonwealth University,Department Of Pathology,Richmond, VA, USA 3Roswell Park Cancer Institute,Buffalo, NY, USA 4Virginia Commonwealth University,Department Of Surgical Oncology,Richmond, VA, USA
Introduction: Breast cancer is the most prevalent cancer among females and one out of eight US women will be diagnosed during their life time. Despite advances in the diagnosis and treatment of this disease, we still lose close to 40,000 women to breast cancer every year. Given the fact that the risk of developing breast cancer increases with age and that life expectancy is increasing overall, we often see older patients with multiple medical comorbidities with breast cancer in the clinic. Recently it has been proposed that generalized chronic inflammation, such as obesity, biologically worsens breast cancer. Therefore, we hypothesized that the patients with multiple medical comorbidities will have biologically worse cancer, which will be reflected as shorter disease free survival.
Methods: A database including study participants from the year 2007 to 2012 was created to include significant health co-morbidities including individual behavioral and biological determinants of health gathered from the electronic medical record. This included smoking history, depression, hypertension, hyperlipidemia, diabetes, coronary artery disease, obesity, endocrine dysfunction and history of drug use. Disease free survival for each patient was determined by calculating the time elapsed between the date of diagnosis and either the patient’s date of relapse or the most recent follow-up without evidence of disease. The determinants of health data points were then used to classify patients into groups according to the number of comorbidities. A one-way analysis of variance was then performed to determine if there was a difference in the means between the groups.
Results: 177 subjects were included in the analysis with dates of diagnosis ranging from 2007 to 2012. The average age at diagnosis was 56 years. The most prevalent comorbidities were hypertension and obesity (BMI over 30) with 43% of our sample carrying those diagnoses. Others included smoking (21%), diabetes (15%), hyperlipidemia (19%), coronary artery disease (6%), thyroid dysfunction (7%), depression (9%) and history of drug use (4%). Upon analysis of the additive effect of these chronic conditions we found no significant difference in the disease free survival between people with zero comorbidities and those with up to 5 of these comorbidities. (F = 1.40, P = 0.22) The average disease free survival was 1,412 days.
Conclusion: Our results show that the population of women who face breast cancer is heterogeneous with a wide variety of comorbidities. In contrast to our expectation, our data shows that these comorbidities have little impact on the disease free survival.
