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Jamal Zekri

Jamal Zekri

Al Faisal University, Saudi Arabia

Title: Obesity in post-menopausal women starting adjuvant aromatase inhibitors for breast cancer: Is there an effect of body mass index on outcome?

Biography

Biography: Jamal Zekri

Abstract

Introduction: Aromatization of androgens accounts for the peripheral formation of significant proportion of estrogen. For this reason, aromatase inhibitors (AIs) including letrzole are standard adjuvant treatments for post-menopausal (PM) women with hormone receptor positive (HR+) breast cancer (BC). Aromatase enzyme activity is predominant in adipose tissue. This has led to speculation that aromatase activity is elevated in obese women and subsequently decreased clinical activity of AIs. In Saudi Arabia, 80% of women with BC are overweight, obese or morbidly obese. Results of international studies investigating the effect of body mass index (BMI) on clinical outcome of women with BC on adjuvant AIs are not conclusive.. Certainly, there are no such studies in women from Saudi Arabia.

Patients and Methods: The electronic records of consecutive 320 PM women with HR+ BC starting adjuvant letrozole between January 2005 and December 2014 were retrospectively reviewed. Individual patients’ data were extracted including: BMI on day of starting letrozole, patients’ and tumors’ characteristics and disease outcome. The co-primary endpoints are (1) Frequency of obesity in this population (2) Comparing relapse free survival (RFS) in non-obese (Group 1: G1) and obese (Group 2: G2) patients.

Results: Obesity (BMI ≥30) and morbid obesity (BMI ≥35) are present in 220/320 (68.8%) and 115/320 (35.9%) patients respectively. RFS at 5 years (G1: 68.8% vs. G2: 80%) and at 8 years (G1: 68.8% vs. G2: 71.6%). Median RFS was not reached in both groups (Log Rank; P=0.097). Correlation between RFS and other patients’ and tumor characteristics will be presented at the congress.

Conclusion: About two thirds of PM women starting adjuvant AIs for BC are classified as obese. In this cohort, obesity did not adversely affect RFS. Larger cohort is needed to confirm this result.