Frontiers in global women's health · 2026
Distribution characteristics and associated factors of dyslipidemia across clinical stages of breast cancer: a retrospective observational study.
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Xin Zechang, Qu Hui, Li Pisong, Han Zhongbin, Qu Ningxin, Yu Weiting, Zhu Xiaoyu, Chen Hongshen
Аннотация
BACKGROUND: Dyslipidemia is a prevalent metabolic disorder in breast cancer patients and an important comorbidity that impacts cardiovascular outcomes, treatment tolerance, and long-term prognosis. It may also be linked to tumor progression, yet the distribution characteristics of lipid abnormalities, especially their heterogeneity across different clinical stages and molecular subtypes of breast cancer, remain insufficiently characterized in existing research.
METHODS: This retrospective observational study was conducted at the Affiliated Zhongshan Hospital of Dalian University, enrolling 5,246 patients with pathologically confirmed primary breast cancer diagnosed from 2014 to 2024 with complete clinical staging and fasting lipid profile data. Dyslipidemia was defined as at least one abnormal lipid parameter (LDL-C ≥ 3.4 mmol/L, HDL-C < 1.0 mmol/L, TC ≥ 5.2 mmol/L, TG ≥ 1.7 mmol/L). Stage-stratified multivariable logistic regression analyses were used to identify independent associated factors, with subtype-based subgroup analyses and sensitivity analyses excluding CHD patients performed to verify result robustness.
RESULTS: Dyslipidemia affected 54.8%-71.9% of patients across all clinical stages, with TC and TG abnormalities being the most common, followed by reduced HDL-C and elevated LDL-C. Cumulative proportions of individual lipid abnormalities exceeded 100% per stage, indicating frequent coexistence of multiple abnormalities. Obvious subtype heterogeneity was observed: Luminal B (HER-) had low early-stage HDL-C reduction, while triple-negative patients had a markedly high LDL-C elevation rate (up to 50%) in stage IV. Tumor burden-related factors and selected molecular pathology indicators were independently associated with dyslipidemia in a stage-specific manner, and CHD exclusion did not alter the results.
CONCLUSIONS: Dyslipidemia is a pervasive and heterogeneous metabolic comorbidity in breast cancer, with distinct stage- and subtype-specific patterns closely linked to tumor burden and molecular biological characteristics. Routine lipid assessment and subtype-tailored metabolic management should be integrated as an essential component into the comprehensive clinical care of breast cancer patients.
METHODS: This retrospective observational study was conducted at the Affiliated Zhongshan Hospital of Dalian University, enrolling 5,246 patients with pathologically confirmed primary breast cancer diagnosed from 2014 to 2024 with complete clinical staging and fasting lipid profile data. Dyslipidemia was defined as at least one abnormal lipid parameter (LDL-C ≥ 3.4 mmol/L, HDL-C < 1.0 mmol/L, TC ≥ 5.2 mmol/L, TG ≥ 1.7 mmol/L). Stage-stratified multivariable logistic regression analyses were used to identify independent associated factors, with subtype-based subgroup analyses and sensitivity analyses excluding CHD patients performed to verify result robustness.
RESULTS: Dyslipidemia affected 54.8%-71.9% of patients across all clinical stages, with TC and TG abnormalities being the most common, followed by reduced HDL-C and elevated LDL-C. Cumulative proportions of individual lipid abnormalities exceeded 100% per stage, indicating frequent coexistence of multiple abnormalities. Obvious subtype heterogeneity was observed: Luminal B (HER-) had low early-stage HDL-C reduction, while triple-negative patients had a markedly high LDL-C elevation rate (up to 50%) in stage IV. Tumor burden-related factors and selected molecular pathology indicators were independently associated with dyslipidemia in a stage-specific manner, and CHD exclusion did not alter the results.
CONCLUSIONS: Dyslipidemia is a pervasive and heterogeneous metabolic comorbidity in breast cancer, with distinct stage- and subtype-specific patterns closely linked to tumor burden and molecular biological characteristics. Routine lipid assessment and subtype-tailored metabolic management should be integrated as an essential component into the comprehensive clinical care of breast cancer patients.