Serum Lipids and Outcome of Early-stage Breast Cancer: Results of a Prospective Cohort Study
Abstract
Purpose The prognosis of women with early-stage breast cancer is influenced by insulin and body mass index (BMI). High levels of serum insulin and obesity often coexist with dyslipidemia in the insulin resistance syndrome (IRS), but the contribution of lipids to breast cancer outcome is unclear. Here, we examine whether serum levels of total cholesterol (TC) and triglycerides (TG) influence breast cancer outcome. Patients and methods A cohort of 520 women without known hyperlipidemia or diabetes, with stage T1-T3, N0-N1, M0 breast cancer, was assembled from July 1989 to June 1996. Fasting blood was collected at baseline. Subjects were followed prospectively, for recurrence (local, regional, distant) and death. Cox models were used to calculate the prognostic effect of TC and TG levels. Two-sided significance levels were set at 0.025. Results TC was correlated with age (Spearman's r = 0.44) and low tumor grade (p = 0.01), while TG was correlated with insulin (r = 0.43) and BMI (r = 0.45). At a median follow-up of 8.7 years, TC and TG were not associated with breast cancer recurrence or death before of after adjustment for age, tumor-related variables, BMI or fasting insulin levels. In multivariate analysis adjusting for age, tumor-related variables and BMI, a trend towards an adverse effect of TC on disease recurrence was seen (HR recurrence = 1.62 for the 4th versus. 1st quartile, 2-sided p = 0.03). Conclusions Fasting TG was not associated with outcome. A trend towards risk…
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Elevated circulating cholesterol is associated with breast cancer recurrence.
“Elevated circulating cholesterol has been associated with breast cancer recurrence (6).”
From Cholesterol efflux protein, ABCA1, supports anticancer functions of myeloid immune cells (2026) · cites this paper as [6]
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Vidana Gamage, H. E., Shahoei, S. H., Wang, Y., Jacquin, E., Weisser, E., Bautista, R. O., Henn, M. A., Schane, C. P., Nelczyk, A. T., Ma, L., et al. (2024) · Cancer Letters · doi:10.1016/j.canlet.2024.217042 · Cited by 9 · see citing works
“Clinical observations have identified an association between hypercholesterolemia and breast cancer recurrence [8].”
Cholesterol efflux protein, ABCA1, supports anticancer functions of myeloid immune cells
Bendre, S. V., Wang, Y., Hajyousif, B., K C, R., Bhogale, S. G., Pradeep, D., Krawczynska, N., Schane, C. P., Weisser, E., Singh, A., et al. (2026) · Science Advances · doi:10.1126/sciadv.adx5490 · Cited by 8 · see citing works
“Elevated circulating cholesterol has been associated with breast cancer recurrence ( 8 ).”
- Authors
- Bahl, M., Ennis, M., Tannock, I. F., Hux, J. E., Pritchard, K. I., Koo, J., & Goodwin, P. J.
- Affiliations
- Mount Sinai Hospital (CA)
- University of Toronto (CA)
- Sunnybrook Health Science Centre (CA)
- St. Michael's Hospital (CA)
- Corresponding author
- Bahl, Mala
- Venue
- Breast Cancer Research and Treatment
- Published
- 2005-11
- Volume
- 94
- Issue
- 2
- Pages
- 135-144
- ISSN
- 0167-6806 (ISSN-L)
- 1573-7217
- OpenAlex
- W2082075144
- Cited by
- 80
- References
- 0
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 9 · 2022: 10 · 2021: 8 · 2020: 7 · 2019: 2 · 2018: 5 · 2017: 5 · 2016: 6 · 2015: 2 · 2014: 5 · 2013: 5 · 2012: 3
- FWCI
- 0.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Breast Cancer Research and Treatment (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
- Keywords
- early breast cancer, serum cholesterol, triglycerides, serum lipids, breast cancer recurrence, breast cancer mortality, prognosis, fasting insulin, body mass index, metabolic syndrome, dyslipidemia
- MeSH terms
- Adult, Aged, Breast Neoplasms, Cholesterol, Female, Humans, Insulin, Lipids, Cholesterol, HDL, Cholesterol, LDL, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, Ontario, Prognosis, Prospective Studies, Risk Factors, Triglycerides, Cohort Studies, Body Mass Index, Proportional Hazards Models, Disease-Free Survival
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