{
    "abstract": "Obesity is associated with a greater risk of developing distant recurrences in patients with estrogen receptor-positive (ER+) breast cancer. This association is however poorly investigated in patients treated with extended endocrine treatment (ET). We therefore evaluated the prognostic role of BMI in the SOLE trial, where postmenopausal patients, after having completed 4-6 years of adjuvant ET, were treated with 5 additional years of continuous or intermittent letrozole.\nWe considered the 3606 patients with ER+\u202f/HER2- lymph node-positive BC with available BMI from the SOLE trial (NCT00553410). Distant-recurrence free interval (DRFI) was the main endpoint, and breast cancer-free interval (BCFI), disease-free survival (DFS) and overall survival (OS) secondary endpoints. Adjusted risk ratios (RR) for distant metastases were estimated with crude cumulative incidence models.\n38.6\u202f% of the patients were underweight or normal weight, 36.5\u202f% overweight and 24.9\u202f% obese. BMI was associated with age, tumor size, number of positive lymph nodes, menopausal status and type of prior ET. In the adjusted analyses, the prognostic value of BMI was dependent on prior ET and extended ET arm (second-order interaction p-value<0.001 for DRFI, BCFI and DFS, but not for OS). For instance, in patients treated with both a selective estrogen receptor modulator and an aromatase inhibitor in the first five years, obesity, as compared to normal-weight, was associated with better (RR\nWe observed that the prognostic relation of BMI changes according to the type of adjuvant ET and mode of administration of extended AI. This warrants further investigation.",
    "authors": [
        {
            "affiliation": "Unit of Medical Statistics, Biometry and Epidemiology, Department of Biomedical and Clinical Sciences (DIBIC) \"L. Sacco\" & DSRC, LITA Vialba campus, University of Milan, Milan, Italy.",
            "firstname": "Giacomo",
            "initials": "G",
            "lastname": "Biganzoli"
        },
        {
            "affiliation": "KU Leuven, Department of Oncology, Laboratory for Translational Breast Cancer Research, Leuven, Belgium.",
            "firstname": "Edoardo",
            "initials": "E",
            "lastname": "Isnaldi"
        },
        {
            "affiliation": "KU Leuven, Department of Oncology, Laboratory for Translational Breast Cancer Research, Leuven, Belgium.",
            "firstname": "Fran\u00e7ois",
            "initials": "F",
            "lastname": "Richard"
        },
        {
            "affiliation": "Unit of Medical Statistics, Biometry and Epidemiology, Department of Biomedical and Clinical Sciences (DIBIC) \"L. Sacco\" & DSRC, LITA Vialba campus, University of Milan, Milan, Italy.",
            "firstname": "Giuseppe",
            "initials": "G",
            "lastname": "Marano"
        },
        {
            "affiliation": "Unit of Medical Statistics, Biometry and Epidemiology, Department of Biomedical and Clinical Sciences (DIBIC) \"L. Sacco\" & DSRC, LITA Vialba campus, University of Milan, Milan, Italy.",
            "firstname": "Patrizia",
            "initials": "P",
            "lastname": "Boracchi"
        },
        {
            "affiliation": "KU Leuven, Department of Oncology, Laboratory for Translational Breast Cancer Research, Leuven, Belgium.",
            "firstname": "Marion",
            "initials": "M",
            "lastname": "Maetens"
        },
        {
            "affiliation": "KU Leuven, Translational Cell and Tissue Research Unit, Department of Imaging and Pathology, Leuven, Belgium; University Hospitals Leuven, Department of Pathology, Leuven, Belgium.",
            "firstname": "Giuseppe",
            "initials": "G",
            "lastname": "Floris"
        },
        {
            "affiliation": "Gynecologic Oncology and Multidisciplinary Breast Center, University Hospitals UZ-Leuven, KU Leuven, Leuven, Belgium.",
            "firstname": "Patrick",
            "initials": "P",
            "lastname": "Neven"
        },
        {
            "affiliation": "Medical Oncology Department, CHU Li\u00e8ge, Li\u00e8ge University, Li\u00e8ge, Belgium.",
            "firstname": "Guy",
            "initials": "G",
            "lastname": "Jerusalem"
        },
        {
            "affiliation": "Division of Medical Senology, IEO European Institute of Oncology IRCCS, Milan, Italy.",
            "firstname": "Elisabetta",
            "initials": "E",
            "lastname": "Munzone"
        },
        {
            "affiliation": "Department of Medical Oncology and Clinical Pharmacology \"B\", National Institute of Oncology, Budapest, Hungary.",
            "firstname": "Erika",
            "initials": "E",
            "lastname": "Hitre"
        },
        {
            "affiliation": "Medical Oncology Department, Institut Jules Bordet and Universit\u00e9 Libre de Bruxelles (ULB), Brussels, Belgium.",
            "firstname": "Andrea",
            "initials": "A",
            "lastname": "Gombos"
        },
        {
            "affiliation": "Division of Surgical Oncology, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, USA.",
            "firstname": "Alastair",
            "initials": "A",
            "lastname": "Thompson"
        },
        {
            "affiliation": "Division of Medical Oncology, Cancer Center, Lucerne Cantonal, Hospital, Lucerne, Switzerland; Faculty of Medicine, University of Bern, Bern, Switzerland.",
            "firstname": "Stefan",
            "initials": "S",
            "lastname": "Aebi"
        },
        {
            "affiliation": "Translational Research Coordination, ETOP IBCSG Partners Foundation, Bern, Switzerland.",
            "firstname": "Roswitha",
            "initials": "R",
            "lastname": "Kammler"
        },
        {
            "affiliation": "IBCSG Central Pathology Office, Milan, Italy.",
            "firstname": "Patrizia",
            "initials": "P",
            "lastname": "Dell'Orto"
        },
        {
            "affiliation": "IBCSG Central Pathology Office, Milan, Italy; Department of Pathology and Laboratory Medicine, IEO European Institute of Oncology IRCCS, Milan, Italy.",
            "firstname": "Giuseppe",
            "initials": "G",
            "lastname": "Viale"
        },
        {
            "affiliation": "IBCSG Statistical Center, Division of Biostatistics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA.",
            "firstname": "Meredith M",
            "initials": "MM",
            "lastname": "Regan"
        },
        {
            "affiliation": "Division of Medical Senology, IEO European Institute of Oncology IRCCS, Milan, Italy.",
            "firstname": "Marco",
            "initials": "M",
            "lastname": "Colleoni"
        },
        {
            "affiliation": "Unit of Medical Statistics, Biometry and Epidemiology, Department of Biomedical and Clinical Sciences (DIBIC) \"L. Sacco\" & DSRC, LITA Vialba campus, University of Milan, Milan, Italy; KU Leuven, Department of Oncology, Laboratory for Translational Breast Cancer Research, Leuven, Belgium.",
            "firstname": "Elia",
            "initials": "E",
            "lastname": "Biganzoli"
        },
        {
            "affiliation": "KU Leuven, Department of Oncology, Laboratory for Translational Breast Cancer Research, Leuven, Belgium. Electronic address: christine.desmedt@kuleuven.be.",
            "firstname": "Christine",
            "initials": "C",
            "lastname": "Desmedt"
        }
    ],
    "conclusions": "We observed that the prognostic relation of BMI changes according to the type of adjuvant ET and mode of administration of extended AI. This warrants further investigation.",
    "copyrights": "Copyright \u00a9 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.",
    "doi": "10.1016/j.ejca.2025.115438",
    "journal": "European journal of cancer (Oxford, England : 1990)",
    "keywords": [
        "Body mass index",
        "Breast cancer",
        "Extended endocrine therapy",
        "Obesity"
    ],
    "methods": null,
    "publication_date": "2025-04-27",
    "pubmed_id": "40286474",
    "results": "38.6\u202f% of the patients were underweight or normal weight, 36.5\u202f% overweight and 24.9\u202f% obese. BMI was associated with age, tumor size, number of positive lymph nodes, menopausal status and type of prior ET. In the adjusted analyses, the prognostic value of BMI was dependent on prior ET and extended ET arm (second-order interaction p-value<0.001 for DRFI, BCFI and DFS, but not for OS). For instance, in patients treated with both a selective estrogen receptor modulator and an aromatase inhibitor in the first five years, obesity, as compared to normal-weight, was associated with better (RR",
    "title": "Prognostic relation of body mass index on extended aromatase inhibition treatment in postmenopausal patients with estrogen receptor positive breast cancer: A retrospective analysis of the SOLE trial.",
    "xml": "<Element 'PubmedArticle' at 0x788505e5bf10>"
}