Table S2. Multivariable adjusted Cox proportional hazard ratios (HRs) for overall mortality and breast cancer-free interval by pre-diagnostic triglycerides among HER2+ patients (DOCX 16 kb

Andreas Stensvold (3528713)

Anne Eggen (4100746)

Anne McTiernan (3542132)

Elin Mortensen (5396498)

Erik Wist (3542126)

Hanne Frydenberg (3542120)

Hawa Nalwoga (845585)

Inger Thune (315574)

Jon Reitan (5396495)

Lars Akslen (4406518)

Sura Aziz (655431)

Terje Risberg (25586)

Tom Wilsgaard (321883)

Trygve LofterĂ¸d (5396534)

BMC Cancer

Background High triglycerides and low levels of high density lipoprotein (HDL)-cholesterol are observed to promote tumor growth. However, whether breast cancer heterogeneity may explain the contradictory influence of triglycerides and cholesterol observed on breast cancer prognosis remains unclear. Methods A population-based survival study among 464 breast cancer cases identified within the Tromsø study was conducted. Pre-diagnostic triglycerides, total-cholesterol and HDL-cholesterol were measured, and detailed clinical and histopathological data were obtained. Using tissue microarray, all breast cancer cases were reclassified into the following subtypes: Luminal A, Luminal B, HER2-enriched, and triple negative breast cancer (TNBC). Multivariable Cox proportional hazards regression models were used to study the associations between pre-diagnostic lipids and breast cancer recurrence, mortality, and survival. Results A total of 464 breast cancer patients, with mean age at diagnosis of 57.9 years, were followed for a mean 8.4 years. TNBC patients in the highest tertile of triglycerides (≥ 1.23 mmol/l) had 3 times higher overall mortality compared to TNBC patients in the lowest tertile (≤ 0.82 mmol/l) (HR 2.99, 95% CI 1.17–7.63), and the 5-year overall survival was 19% lower for TNBC patients in the highest vs. lowest tertile of triglycerides (65% vs. 84%). TNBC patients in the highest tertile of the HDL-cholesterol/total-cholesterol ratio (≥0.35), compared to those in the lowest tertile (≤0.27), had a 67% reduced overall mortality risk (HR 0.33, 95% CI 0.12–0.89). No associations were observed between lipids and prognostic outcome among breast cancer patients overall, or among patients with luminal A and luminal B subtypes. Among HER2-enriched patients, pre-diagnostic triglyceride level was inversely associated with overall mortality. Conclusion Our study suggests that pre-diagnostic triglycerides and the HDL-cholesterol/total-cholesterol ratio may independently provide unique information regarding prognostic outcome among triple negative breast cancer patients. However, a small sample size underlines the need for additional studies

Lofterød, Trygve

Mortensen, Elin Synnøve

Nalwoga, Hawa

Wilsgaard, Tom

Frydenberg, Hanne

Risberg, Terje

Eggen, Anne Elise

McTiernan, Anne

Aziz, Sura Mohammed

Wist, Erik

Stensvold, Andreas

Reitan, Jon Brinchmann

Akslen, Lars A.

Thune, Inger

NORA - Norwegian Open Research Archives

Impact of pre-diagnostic triglycerides and HDL-cholesterol on breast cancer recurrence and survival by breast cancer subtypes

Figure S2. Age-adjusted breast cancer-free interval by breast cancer molecular subtypesa. a Luminal A - ER positive, PR positive, HER2 negative, and Ki-67 < 20%; Luminal B - ER positive and/or PR positive, HER2 positive (or HER2 negative and Ki-67 ≥ 20% or PR negative); HER2-enriched - ER negative, PR negative, and HER2 positive; and TNBC - ER negative, PR negative and HER2 negative. Abbreviations: ER, estrogen receptor; HER2, human epidermal growth factor receptor-2; PR, progesterone receptor; TNBC, triple negative breast cancer (PDF 215 kb

Trygve Lofterød (5396501)

FigShare

Additional file 3: of Impact of pre-diagnostic triglycerides and HDL-cholesterol on breast cancer recurrence and survival by breast cancer subtypes

Trygve Lofterød

Elin S. Mortensen

Hawa Nalwoga

Tom Wilsgaard

Hanne Frydenberg

Terje Risberg

Anne Elise Eggen

Anne McTiernan

Sura Aziz

Erik A. Wist

Andreas Stensvold

Jon B. Reitan

Lars A. Akslen

Inger Thune

Crossref

Figure S1. Age-adjusted overall survival by breast cancer molecular subtypesa. a Luminal A - ER positive, PR positive, HER2 negative, and Ki-67 < 20%; Luminal B - ER positive and/or PR positive, HER2 positive (or HER2 negative and Ki-67 ≥ 20% or PR negative); HER2-enriched - ER negative, PR negative, and HER2 positive; and TNBC - ER negative, PR negative and HER2 negative. Abbreviations: ER, estrogen receptor; HER2, human epidermal growth factor receptor-2; PR, progesterone receptor; TNBC, triple negative breast cancer (PDF 215 kb

Additional file 2: of Impact of pre-diagnostic triglycerides and HDL-cholesterol on breast cancer recurrence and survival by breast cancer subtypes

Background High triglycerides and low levels of high density lipoprotein (HDL)-cholesterol are observed to promote tumor growth. However, whether breast cancer heterogeneity may explain the contradictory influence of triglycerides and cholesterol observed on breast cancer prognosis remains unclear. Methods A population-based survival study among 464 breast cancer cases identified within the Tromsø study was conducted. Pre-diagnostic triglycerides, total-cholesterol and HDL-cholesterol were measured, and detailed clinical and histopathological data were obtained. Using tissue microarray, all breast cancer cases were reclassified into the following subtypes: Luminal A, Luminal B, HER2-enriched, and triple negative breast cancer (TNBC). Multivariable Cox proportional hazards regression models were used to study the associations between pre-diagnostic lipids and breast cancer recurrence, mortality, and survival. Results A total of 464 breast cancer patients, with mean age at diagnosis of 57.9 years, were followed for a mean 8.4 years. TNBC patients in the highest tertile of triglycerides (≥ 1.23 mmol/l) had 3 times higher overall mortality compared to TNBC patients in the lowest tertile (≤ 0.82 mmol/l) (HR 2.99, 95% CI 1.17–7.63), and the 5-year overall survival was 19% lower for TNBC patients in the highest vs. lowest tertile of triglycerides (65% vs. 84%). TNBC patients in the highest tertile of the HDL-cholesterol/total-cholesterol ratio (≥0.35), compared to those in the lowest tertile (≤0.27), had a 67% reduced overall mortality risk (HR 0.33, 95% CI 0.12–0.89). No associations were observed between lipids and prognostic outcome among breast cancer patients overall, or among patients with luminal A and luminal B subtypes. Among HER2-enriched patients, pre-diagnostic triglyceride level was inversely associated with overall mortality. Conclusion Our study suggests that pre-diagnostic triglycerides and the HDL-cholesterol/total-cholesterol ratio may independently provide unique information regarding prognostic outcome among triple negative breast cancer patients. However, a small sample size underlines the need for additional studies.publishedVersio

University of Bergen

English

Additional file 4: of Impact of pre-diagnostic triglycerides and HDL-cholesterol on breast cancer recurrence and survival by breast cancer subtypes

Abstract Background High triglycerides and low levels of high density lipoprotein (HDL)-cholesterol are observed to promote tumor growth. However, whether breast cancer heterogeneity may explain the contradictory influence of triglycerides and cholesterol observed on breast cancer prognosis remains unclear. Methods A population-based survival study among 464 breast cancer cases identified within the Tromsø study was conducted. Pre-diagnostic triglycerides, total-cholesterol and HDL-cholesterol were measured, and detailed clinical and histopathological data were obtained. Using tissue microarray, all breast cancer cases were reclassified into the following subtypes: Luminal A, Luminal B, HER2-enriched, and triple negative breast cancer (TNBC). Multivariable Cox proportional hazards regression models were used to study the associations between pre-diagnostic lipids and breast cancer recurrence, mortality, and survival. Results A total of 464 breast cancer patients, with mean age at diagnosis of 57.9 years, were followed for a mean 8.4 years. TNBC patients in the highest tertile of triglycerides (≥ 1.23 mmol/l) had 3 times higher overall mortality compared to TNBC patients in the lowest tertile (≤ 0.82 mmol/l) (HR 2.99, 95% CI 1.17–7.63), and the 5-year overall survival was 19% lower for TNBC patients in the highest vs. lowest tertile of triglycerides (65% vs. 84%). TNBC patients in the highest tertile of the HDL-cholesterol/total-cholesterol ratio (≥0.35), compared to those in the lowest tertile (≤0.27), had a 67% reduced overall mortality risk (HR 0.33, 95% CI 0.12–0.89). No associations were observed between lipids and prognostic outcome among breast cancer patients overall, or among patients with luminal A and luminal B subtypes. Among HER2-enriched patients, pre-diagnostic triglyceride level was inversely associated with overall mortality. Conclusion Our study suggests that pre-diagnostic triglycerides and the HDL-cholesterol/total-cholesterol ratio may independently provide unique information regarding prognostic outcome among triple negative breast cancer patients. However, a small sample size underlines the need for additional studies

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Table S3. Multivariable adjusted Cox proportional hazard ratios (HRs) for overall mortality and breast cancer-free interval by pre-diagnostic triglycerides/HDL-cholesterol ratio among triple negative breast cancer (TNBC) patients (DOCX 16 kb

Additional file 5: of Impact of pre-diagnostic triglycerides and HDL-cholesterol on breast cancer recurrence and survival by breast cancer subtypes

Background: High triglycerides and low levels of high density lipoprotein (HDL)-cholesterol are observed to
promote tumor growth. However, whether breast cancer heterogeneity may explain the contradictory influence of
triglycerides and cholesterol observed on breast cancer prognosis remains unclear.

Methods: A population-based survival study among 464 breast cancer cases identified within the Tromsø study was
conducted. Pre-diagnostic triglycerides, total-cholesterol and HDL-cholesterol were measured, and detailed clinical and
histopathological data were obtained. Using tissue microarray, all breast cancer cases were reclassified into the
following subtypes: Luminal A, Luminal B, HER2-enriched, and triple negative breast cancer (TNBC). Multivariable Cox
proportional hazards regression models were used to study the associations between pre-diagnostic lipids and breast
cancer recurrence, mortality, and survival.

Results: A total of 464 breast cancer patients, with mean age at diagnosis of 57.9 years, were followed for a mean
8.4 years. TNBC patients in the highest tertile of triglycerides (≥ 1.23 mmol/l) had 3 times higher overall mortality
compared to TNBC patients in the lowest tertile (≤ 0.82 mmol/l) (HR 2.99, 95% CI 1.17–7.63), and the 5-year overall
survival was 19% lower for TNBC patients in the highest vs. lowest tertile of triglycerides (65% vs. 84%). TNBC patients in
the highest tertile of the HDL-cholesterol/total-cholesterol ratio (≥0.35), compared to those in the lowest tertile (≤0.27),
had a 67% reduced overall mortality risk (HR 0.33, 95% CI 0.12–0.89). No associations were observed between lipids and
prognostic outcome among breast cancer patients overall, or among patients with luminal A and luminal B subtypes.
Among HER2-enriched patients, pre-diagnostic triglyceride level was inversely associated with overall mortality.

Conclusion: Our study suggests that pre-diagnostic triglycerides and the HDL-cholesterol/total-cholesterol ratio may
independently provide unique information regarding prognostic outcome among triple negative breast cancer
patients. However, a small sample size underlines the need for additional studies.<p

Source at https://doi.org/10.1186/s12885-018-4568-2.  ©  The Author(s). 2018Background: High triglycerides and low levels of high density lipoprotein (HDL)-cholesterol are observed to
promote tumor growth. However, whether breast cancer heterogeneity may explain the contradictory influence of
triglycerides and cholesterol observed on breast cancer prognosis remains unclear.

Methods: A population-based survival study among 464 breast cancer cases identified within the Tromsø study was
conducted. Pre-diagnostic triglycerides, total-cholesterol and HDL-cholesterol were measured, and detailed clinical and
histopathological data were obtained. Using tissue microarray, all breast cancer cases were reclassified into the
following subtypes: Luminal A, Luminal B, HER2-enriched, and triple negative breast cancer (TNBC). Multivariable Cox
proportional hazards regression models were used to study the associations between pre-diagnostic lipids and breast
cancer recurrence, mortality, and survival.

Results: A total of 464 breast cancer patients, with mean age at diagnosis of 57.9 years, were followed for a mean
8.4 years. TNBC patients in the highest tertile of triglycerides (≥ 1.23 mmol/l) had 3 times higher overall mortality
compared to TNBC patients in the lowest tertile (≤ 0.82 mmol/l) (HR 2.99, 95% CI 1.17–7.63), and the 5-year overall
survival was 19% lower for TNBC patients in the highest vs. lowest tertile of triglycerides (65% vs. 84%). TNBC patients in
the highest tertile of the HDL-cholesterol/total-cholesterol ratio (≥0.35), compared to those in the lowest tertile (≤0.27),
had a 67% reduced overall mortality risk (HR 0.33, 95% CI 0.12–0.89). No associations were observed between lipids and
prognostic outcome among breast cancer patients overall, or among patients with luminal A and luminal B subtypes.
Among HER2-enriched patients, pre-diagnostic triglyceride level was inversely associated with overall mortality.

Conclusion: Our study suggests that pre-diagnostic triglycerides and the HDL-cholesterol/total-cholesterol ratio may
independently provide unique information regarding prognostic outcome among triple negative breast cancer
patients. However, a small sample size underlines the need for additional studies.<p

Munin - Open Research Archive

https://figshare.com/articles/Additional_file_3_of_Impact_of_pre-diagnostic_triglycerides_and_HDL-cholesterol_on_breast_cancer_recurrence_and_survival_by_breast_cancer_subtypes/6540587

Additional file 4: of Impact of pre-diagnostic triglycerides and HDL-cholesterol on breast cancer recurrence and survival by breast cancer subtypes

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