Dr Caterina Fontanella talks to ecancertv at the 9th European Breast Cancer Conference (EBCC) about the adverse effects that obesity and diabetes have  on outcomes in breast cancer patients who receive chemotherapy as primary treatment before surgery.

Fontanella's anaylsis, which draws upon the study of nearly 11,000 patients with early breast cancer treated with neoadjuvant chemotherapy, showed that a high BMI adversely affects the chances of surviving without the breast cancer recurring or spreading to other parts of the body. Furthermore, obese patients receive a lower dose of chemotherapy relative to a person of average BMI, a fact that needs to be given more consideration in the future for more effective dosing, says Fontanella.

In addition, Fontanella and her colleagues investigated the incidence of Type 2 diabetes in patients with early breast cancer at the time of diagnosis. Patients with diabetes are more likely to have their cancer diagnosed at a more advanced stage, suggesting that diabetes may affect the size of the tumour. Fontanella also states that "a tumour growing in an atmosphere rich in glucose is more likely to be a bigger tumour" and that because of this, "diabetic patients have shorter overall survival and disease-free survival".

Most importantly, Fontanella argues that a greater understanding of the links between both obesity and breast cancer and diabetes and breast cancer will aid in developing a more effective strategy for the prevention of relapses in this higher risk subset of patients.