Open AccessThe Relationship Between Body Composition and Response to Neoadjuvant Chemotherapy in Women with Operable Breast Cancer
Author(s) -
Del Fabbro Egidio,
Parsons Henrique,
Warneke Carla L.,
Pulivarthi Kalyan,
Litton Jennifer K.,
Dev Rony,
Palla Shana L.,
Brewster Abenaa,
Bruera Eduardo
Publication year - 2012
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2012-0169
Subject(s) - medicine , breast cancer , sarcopenia , overweight , hazard ratio , sarcopenic obesity , oncology , body mass index , cancer , neoadjuvant therapy , confidence interval
. Overweight women diagnosed with breast cancer have greater recurrence and mortality risks. Recent studies in advanced cancer showed that the combination of sarcopenia and an overweight or obese body mass index (BMI) is associated with poor clinical outcomes. Objectives. To compare pathological complete response (pCR) cases with controls and evaluate associations among a pCR, survival outcome, and sarcopenia as well as the combination of both sarcopenia and a BMI ≥25 kg/m 2 . Methods. Sixty‐seven breast cancer patients with a pCR to neoadjuvant chemotherapy (NC) were matched with controls who did not have a pCR to NC. Patients were matched by age, Black's nuclear grading system, clinical cancer stage, and estrogen receptor and progesterone receptor status. Body composition was analyzed using computed tomography images taken prior to NC. Results. BMI was associated with pCR. Among normal weight patients, the pCR rate was higher in sarcopenic patients and the progression‐free survival (PFS) interval was significantly longer than in overweight or obese BMI patients. The death hazard was 2% higher for each unit higher skeletal muscle index and 0.6% higher for each unit higher visceral adipose tissue. Conclusions. Overweight patients treated with NC had a lower pCR rate and shorter PFS time. Among patients with a normal BMI, the pCR rate was better in sarcopenic patients. More research is required to evaluate the negative impact of sarcopenic obesity on prognosis and the contributors to better response rates in operable, normal weight breast cancer patients with sarcopenia.