Higher environmental temperatures are associated with better outcomes among patients with stage I-III breast cancer, according to research presented in a poster at the NCCN 2022 Annual Conference.

Living in a region with an annual average temperature (AAT) greater than 60.9° F was associated with 12% greater odds of achieving a pathologic complete response (pCR).

Researchers also observed a 2% improvement in overall survival (OS) for every 5-degree increase in AAT.

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To test the hypothesis that environmental temperatures affect breast cancer outcomes, the researchers conducted a retrospective analysis of 1,209,332 patients with stage I-III breast cancer who were enrolled in the National Cancer Database between 2004 and 2018.

Most patients were older than 55 years of age (69.2%), White (83.9%), and lived in urban areas (98.6%). They had hormone receptor (HR)-positive/HER2-negative disease (52.1%), triple-negative breast cancer (TNBC; 8.6%), HR+/HER2+ disease (7.2%), and HR-/HER2+ disease (3.1%). They were treated with chemotherapy (38.3%), hormone therapy (68.5%), radiation (62.7%), and surgery (94.3%).

Compared with an AAT of 60.9° F or below at the time of surgery, an AAT greater than 60.9°F was associated with an increased likelihood of achieving pCR (odds ratio [OR], 1.12; 95% CI, 1.07-1.18; P <.001).

When patients were stratified by breast cancer subtype, a greater likelihood of achieving pCR was observed for patients living in warmer areas who had HR+/HER2- disease (OR, 1.15; 95% CI, 1.04-1.27; P =.008) or TNBC (OR, 1.14; 95% CI, 1.07-1.23; P <.001).

Compared with patients who lived in an area with an AAT of 53.7° F or below at the time of diagnosis, patients living in areas with a higher AAT had a lower risk of death (hazard ratio [HR], 0.98; 95% CI, 0.96-0.99; P =.002).

In fact, the mortality risk was reduced with every 5-degree increase in AAT (HR, 0.98; 95% CI, 0.97-0.99; P <.001). When patients were stratified by breast cancer subtype, higher temperatures had a protective effect for those with HR+/HER2- disease (HR, 0.97; 95% CI, 0.95-0.99; P =.003).

“After controlling for potential confounders, higher environmental temperatures are associated with significant improvements in pCR as well as OS in stage I-III [breast cancer patients],” the researchers wrote. “Further research focusing on underlying mechanisms and therapeutic strategies to abrogate this outcome disparity is warranted.”


Gupta A, Attwood K, Gupta K, et al. Influence of environmental temperature on pathological complete response and overall survival in breast cancer: A national cancer database population-based study. Presented at NCCN 2022 Annual Conference; March 31 – April 2, 2022. Abstract CLO22-051.

This article originally appeared on Cancer Therapy Advisor