Impact of serum lipids on prognosis in breast cancer patients: a systematic review and meta-analysis

Abstract Background and purpose Whether serum lipids have an impact on breast cancer(BC) prognosis remains controversial and unstudied. We conducted this systematic review (SR) and meta-analysis (MA) to explore the impact of levels of various components of the lipid profile on multiple survival outc...

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Main Authors: Wendong Gao, Yilin Yao, Qilong Gao, Tiancheng Zhao, Hegen Li
Format: Article
Language:English
Published: BMC 2025-06-01
Series:World Journal of Surgical Oncology
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Online Access:https://doi.org/10.1186/s12957-025-03875-2
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author Wendong Gao
Yilin Yao
Qilong Gao
Tiancheng Zhao
Hegen Li
author_facet Wendong Gao
Yilin Yao
Qilong Gao
Tiancheng Zhao
Hegen Li
author_sort Wendong Gao
collection DOAJ
description Abstract Background and purpose Whether serum lipids have an impact on breast cancer(BC) prognosis remains controversial and unstudied. We conducted this systematic review (SR) and meta-analysis (MA) to explore the impact of levels of various components of the lipid profile on multiple survival outcomes (OSs) of BC. Methods We searched Pubmed, Embase, Cochrane Library, and Web of Science for relevant cohort studies to assess the impact of multiple lipids on the prognosis of BC patients. Included studies were subjected to quality assessment using the Newcastle–Ottawa scale (NOS). MA of extracted data was performed using StataSE 15.1. Results 17 studies in total were included, involving a sample size of 24,026. MA showed that high levels of low-density lipoprotein cholesterol (LDL-C ) (HR (hazard ratios) = 1.96, 95% confidence interva (CI): 1.03–3.73), apolipoprotein E (ApoE) (HR = 3.68, 95% CI: 1.71–7.94), and apolipoprotein B (ApoB) (HR = 1.93, 95% CI: 1.44–2.59) were associated with poorer OS, while high levels of low-density lipoprotein (LDL) (HR = 0.81, 95% CI. 0.74–0.88) and apolipoprotein D (ApoD) (HR = 0.44, 95% CI: 0.24–0.81) were associated with better OS. Both a high level of total cholesterol (TC) (HR = 1.60, 95% CI:1.08–2.37) and dyslipidemia (HR = 1.71, 95% CI:1.12–2.62) had a negative impact on disease-free survival (DFS) in BC patients. Conclusion This MA showed that the levels of LDL-C, ApoE, and ApoB in serum were associated with OS, and the TC level in serum and dyslipidemia were associated with DFS. However, the levels of blood lipids were less associated with other prognostic outcomes. Other high-quality studies are needed to further elucidate this issue. Registration PROSPERO CRD42024541755.
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spelling doaj-art-aeb8bcd8ba0f4647ad94860f8646c2b32025-08-20T02:06:23ZengBMCWorld Journal of Surgical Oncology1477-78192025-06-0123111110.1186/s12957-025-03875-2Impact of serum lipids on prognosis in breast cancer patients: a systematic review and meta-analysisWendong Gao0Yilin Yao1Qilong Gao2Tiancheng Zhao3Hegen Li4Department of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese MedicineDepartment of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese MedicineDepartment of Integrated Traditional Chinese and Western Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer HospitalDepartment of Thoracic Surgery, Sixth People’s Hospital, Shanghai Jiaotong UniversityDepartment of Oncology, Longhua Hospital, Shanghai University of Traditional Chinese MedicineAbstract Background and purpose Whether serum lipids have an impact on breast cancer(BC) prognosis remains controversial and unstudied. We conducted this systematic review (SR) and meta-analysis (MA) to explore the impact of levels of various components of the lipid profile on multiple survival outcomes (OSs) of BC. Methods We searched Pubmed, Embase, Cochrane Library, and Web of Science for relevant cohort studies to assess the impact of multiple lipids on the prognosis of BC patients. Included studies were subjected to quality assessment using the Newcastle–Ottawa scale (NOS). MA of extracted data was performed using StataSE 15.1. Results 17 studies in total were included, involving a sample size of 24,026. MA showed that high levels of low-density lipoprotein cholesterol (LDL-C ) (HR (hazard ratios) = 1.96, 95% confidence interva (CI): 1.03–3.73), apolipoprotein E (ApoE) (HR = 3.68, 95% CI: 1.71–7.94), and apolipoprotein B (ApoB) (HR = 1.93, 95% CI: 1.44–2.59) were associated with poorer OS, while high levels of low-density lipoprotein (LDL) (HR = 0.81, 95% CI. 0.74–0.88) and apolipoprotein D (ApoD) (HR = 0.44, 95% CI: 0.24–0.81) were associated with better OS. Both a high level of total cholesterol (TC) (HR = 1.60, 95% CI:1.08–2.37) and dyslipidemia (HR = 1.71, 95% CI:1.12–2.62) had a negative impact on disease-free survival (DFS) in BC patients. Conclusion This MA showed that the levels of LDL-C, ApoE, and ApoB in serum were associated with OS, and the TC level in serum and dyslipidemia were associated with DFS. However, the levels of blood lipids were less associated with other prognostic outcomes. Other high-quality studies are needed to further elucidate this issue. Registration PROSPERO CRD42024541755.https://doi.org/10.1186/s12957-025-03875-2Breast cancerBlood lipidPrognosisMeta-analysis
spellingShingle Wendong Gao
Yilin Yao
Qilong Gao
Tiancheng Zhao
Hegen Li
Impact of serum lipids on prognosis in breast cancer patients: a systematic review and meta-analysis
World Journal of Surgical Oncology
Breast cancer
Blood lipid
Prognosis
Meta-analysis
title Impact of serum lipids on prognosis in breast cancer patients: a systematic review and meta-analysis
title_full Impact of serum lipids on prognosis in breast cancer patients: a systematic review and meta-analysis
title_fullStr Impact of serum lipids on prognosis in breast cancer patients: a systematic review and meta-analysis
title_full_unstemmed Impact of serum lipids on prognosis in breast cancer patients: a systematic review and meta-analysis
title_short Impact of serum lipids on prognosis in breast cancer patients: a systematic review and meta-analysis
title_sort impact of serum lipids on prognosis in breast cancer patients a systematic review and meta analysis
topic Breast cancer
Blood lipid
Prognosis
Meta-analysis
url https://doi.org/10.1186/s12957-025-03875-2
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AT qilonggao impactofserumlipidsonprognosisinbreastcancerpatientsasystematicreviewandmetaanalysis
AT tianchengzhao impactofserumlipidsonprognosisinbreastcancerpatientsasystematicreviewandmetaanalysis
AT hegenli impactofserumlipidsonprognosisinbreastcancerpatientsasystematicreviewandmetaanalysis