The relationship between body composition and response to neoadjuvant chemotherapy in women with operable breast cancer

Egidio Del Fabbro, Henrique Parsons, Carla L. Warneke, Kalyan Pulivarthi, Jennifer K. Litton, Rony Dev, Shana L. Palla, Abenaa Brewster, Eduardo Bruera

Research output: Contribution to journalArticlepeer-review

95 Scopus citations

Abstract

Introduction. 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/m2. 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.

Original languageEnglish (US)
Pages (from-to)1240-1245
Number of pages6
JournalOncologist
Volume17
Issue number10
DOIs
StatePublished - 2012
Externally publishedYes

Keywords

  • Body composition
  • Breast cancer
  • Clinical outcome

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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