Association of body composition with clinical outcome in Chinese women diagnosed with breast cancer

Abstract

ObjectiveThis study aims to explore the association of body composition with clinical outcomes in Chinese women diagnosed with breast cancer.MethodA total of 2,948 Chinese female patients with breast cancer have been included in this retrospective study. Body composition mainly includes the measurements of adiposity and muscle mass. Visceral fat area (VFA) is used to measure visceral obesity, while appendicular skeletal muscle mass index (ASMI) is utilized to evaluate sarcopenia. The endpoints of this study are disease-free survival (DFS) and overall survival (OS). The association of the body composition parameters with DFS and OS was statistically analyzed.ResultThe median follow-up time for survivors was 42 months (range, 3 to 70 months). In total, 194 patients (6.9%) had breast cancer recurrence, and 32 patients passed away (1.1%). Among the 2,948 patients included, 1,226 (41.6%) patients were viscerally obese, and 511 (17.3%) patients were sarcopenic. We found that visceral obesity had a significant prognostic impact on DFS (HR, 1.46; 95% CI, 1.10–1.95; p = 0.010) but not on OS (P = 0.173). Multivariate analysis revealed sarcopenia as an independent prognostic factor for DFS (HR, 1.44; 95% CI, 1.02–2.03; p = 0.038) and OS (HR, 2.13; 95% CI, 1.00–4.51; p = 0.049). Body mass index was not significantly associated with both DFS (P = 0.224) and OS (P = 0.544).ConclusionVisceral obesity is associated with a higher risk of disease recurrence, and sarcopenia is significantly associated with increased recurrence and overall mortality among Chinese women with breast cancer. Body composition assessment could be a simple and useful approach in breast cancer management. Further studies can focus on decreasing visceral fat and increasing skeletal muscle mass to improve prognosis in breast cancer survivors.

Machine learning predicts the risk of osteoporosis in patients with breast cancer and healthy women

“…This study showed that an endocrine therapy-induced decrease in estrogen levels may cause changes in body composition. This observation is consistent with the results of a genetic-level study by Napoli et al (Napoli et al 2013 ), where the effect of the rs700518 polymorphism in the CYP19A1 gene was identified on changes in body composition in postmenopausal patients with ER-positive breast cancer undergoing AI therapy, and with those of a clinical-level study by Liu et al (Liu et al 2022 ), who examined the association of the body composition regarding clinical prognosis in Chinese female patients with breast cancer; visceral obesity was associated with higher disease recurrence rates, and sarcopenia was significantly associated with increased recurrence rates and increased overall mortality. It is believed that physical activity and dietary changes during chemotherapy cause a decrease in nonadipose tissue in patients, which can be related to the fact that the patients enrolled in this study had already undergone stages of surgery, radiotherapy, and chemotherapy.…”

“…Determination of body composition, which is of great importance in evaluating the nutritional status of the human body, the efficacy of disease treatment, obesity management, and health maintenance. Some studies (Napoli et al 2013 ; Liu et al 2022 ; Hamood et al 2018 ) have shown that changes in body composition have a certain correlation with breast cancer treatment and prognosis of the patients, and that weight gain, obesity, and edema are detrimental to the prognosis of patients with breast cancer.…”

Sarcopenia in Breast Cancer Patients: A Systematic Review and Meta-Analysis

“…More recently, body composition was evaluated in several studies on breast cancer, and an artificial intelligence (AI) model that can predict five-year survival in patients with stage IV metastatic breast cancer included sarcopenia among the selected prognostic factors [12]. Most of the published results showed that there is a significant association between sarcopenia and a higher risk of mortality [13][14][15][16][17][18][19] and toxicity during chemotherapy in breast cancer patients. These studies demonstrated also that sarcopenia was associated with worse global and physical functioning of health-related quality of life scores and may reflect a multifactorial and bidirectional relationship between skeletal muscle status and wellbeing [20,21].…”