Low Levels of High-Density Lipoprotein are Associated With Poor Prognosis in Patients With Early Triple-Negative Breast Cancer.

Abstract

Background: Although dyslipidemia has been shown to be associated with breast cancer prognosis, the prognostic value of high-density lipoprotein (HDL) in triple-negative breast cancer (TNBC) remains uncertain. The purpose of this study was to evaluate the relationship between preoperative HDL levels and prognosis in TNBC patients.

Methods: Preoperative HDL levels and clinical data from 287 patients who underwent TNBC surgery were retrospectively collected. Overall survival (OS) and disease-free survival (DFS) were analyzed via the Kaplan-Meier method and the Cox proportional hazards regression model.

Results: Via the combination of receiver operating characteristics and Kaplan-Meier analysis, we found that low HDL levels were a prognostic factor for TNBC. Patients with lower HDL levels had a significantly lower T1 ratio than patients with higher HDL levels and exhibited a significantly higher neoadjuvant chemotherapy ratio than patients with higher HDL levels. In univariate analysis, the DFS and OS of patients with low HDL levels were worse than those of patients with high HDL levels in terms of DFS (HR: 0.452; 95% CI: 0.237-0.862; P = 0.016) and OS (HR: 0.438; 95% CI: 0.199-0.968; P = 0.041). However, in the multivariate analysis, there was no difference observed between patients with low HDL levels and those with high HDL levels in terms of DFS or OS. According to the subgroup analysis, lymph node-negative (N-) patients with low levels of HDL had worse DFS and OS than did patients with high HDL levels. However, in lymph node-positive (N+) patients, there was no difference observed in prognosis between the high- and low-HDL groups.

Discussion: Low HDL levels are correlated with the progression of TNBC. Moreover, low HDL levels (particularly in patients who are N-) have been identified as a significant prognostic factor impacting the prognosis of TNBC patients; however, these levels do not represent an independent prognostic factor.