Association between dyslipidemia and breast cancer risk: a retrospective case-control study stratified by menopausal status

血脂异常与乳腺癌风险的关联:一项按绝经状态分层的回顾性病例对照研究

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Abstract

OBJECTIVE: To investigate the association between dyslipidemia and breast cancer risk in women, aiming to provide insights for prevention and clinical practice. METHODS: A retrospective case-control study was conducted on 840 women who underwent breast cancer evaluation from December 2019 to April 2024. Baseline characteristics, lipid profiles (total cholesterol [TC], triglycerides [TG], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C]), and tumor markers were compared between patients with confirmed breast cancer and non-cancer controls. Multivariate logistic regression was used to identify independent risk factors, and receiver operating characteristic (ROC) analysis assessed the diagnostic performance of lipid indicators. RESULTS: Patients with breast cancer exhibited significantly higher TC and LDL-C levels than the controls (P<0.05). Elevated TC, TG, and LDL-C showed positive correlation with carcinoembryonic antigen (CEA), carbohydrate antigen 153 (CA153), and carbohydrate antigen 125 (CA125) (P<0.05). HDL-C was negatively correlated with these tumor markers (P<0.05). Independent predictors of breast cancer included age ≥55, nulliparity, premenopausal status, and elevated TC, TG, and LDL-C (P<0.05). ROC curves yielded area under the curve (AUC) values of 0.621 for TC and 0.600 for LDL-C. Subgroup analysis revealed that, in premenopausal women, only elevated TC was associated with breast cancer risk, whereas in postmenopausal women, elevated TC, TG, and LDL-C were significantly associated with the risk. CONCLUSION: Elevated blood lipid levels, particularly increased TC and LDL-C, are associated with the occurrence of breast cancer and may serve as auxiliary markers for assessing the risk in high-risk subgroups such as nulliparous and premenopausal women.

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