Non-linear association between body mass index and port-related thrombosis in breast cancer patients: a retrospective cohort study.

Authors

Yanzhen Chen, Duanduan Wang, Liangqiang Li, Tingting Lin, Xiaoju Lin, Xianqiang Du, Weibin Lian

Published in

BMC cancer. Jul 04, 2026. Epub Jul 04, 2026.

Abstract

The association between body mass index (BMI) and the risk of catheter-related thrombosis in breast cancer patients remains unclear, particularly regarding potential non-linear relationships and clinically relevant thresholds. This study aimed to investigate the impact of BMI on the risk of port-related thrombosis and to characterize its dose-response pattern.
This retrospective cohort study included 1,247 breast cancer patients who underwent totally implantable venous access port (TIVAP) implantation at a single center between January 2019 and September 2025. Restricted cubic spline (RCS) analysis was performed to explore the non-linear association between BMI and thrombosis risk and to identify a potential threshold. Based on the RCS results, patients were categorized into two groups (BMI ≤ 23 vs. > 23 kg/m²). Logistic regression analyses were conducted to identify independent risk factors, and Kaplan-Meier analysis was used to evaluate thrombosis-free survival.
RCS analysis revealed a non-linear association between BMI and the risk of port-related thrombosis, with a threshold at approximately 23 kg/m², beyond which the risk increased progressively. The incidence of thrombosis was significantly higher in patients with BMI > 23 kg/m² compared with those with BMI ≤ 23 kg/m² (9.30% vs. 5.58%, P = 0.013). In multivariate logistic regression analysis, BMI > 23 kg/m² remained an independent risk factor for thrombosis (OR = 1.58, 95% CI: 1.02-2.47, P = 0.042), while hypertension was also associated with increased risk (OR = 2.53, 95% CI: 1.37-4.66, P = 0.003), and HER2-positive status was associated with a lower risk of thrombosis (OR = 0.58, 95% CI: 0.36-0.93, P = 0.024). Kaplan-Meier analysis showed that patients with higher BMI had significantly lower thrombosis-free survival, with early curve separation and a progressively widening difference over time.
Elevated BMI is significantly associated with an increased risk of port-related thrombosis in breast cancer patients, with a non-linear dose-response relationship and a threshold effect at approximately 23 kg/m². These findings suggest that BMI may serve as a clinically useful marker for risk stratification and highlight the importance of tailored thromboprophylaxis strategies in high-risk patients.

PMID:
42401902
Bibliographic data and abstract were imported from PubMed on 05 Jul 2026.

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