Impact of body composition on outcome in patients with early breast cancer

Deluche, Élise; Léobon, Sophie; Desport, J.C.; Vénat-Bouvet, Laurence; Usseglio, Julie; Tubiana-Mathieu, Nicole

doi:10.1007/s00520-017-3902-6

Cited by 136 publications

(110 citation statements)

References 34 publications

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“…These results show that ultra-processed food consumption and overweight were associated with breast cancer in this sample of Brazilian women, which is partially consistent with published studies [5,7,21,22]. Additionally, poor environmental sanitation and family history of cancer were identified as risk factors for breast cancer in these women.…”

Section: Discussionsupporting

confidence: 91%

Nutritional and environmental risk factors for breast cancer: a case-control study

Queiroz¹,

Sousa²,

Silva³

et al. 2018

Sci Med

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Section: Discussionsupporting

confidence: 91%

Nutritional and environmental risk factors for breast cancer: a case-control study

Queiroz¹,

Sousa²,

Silva³

et al. 2018

Sci Med

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“…The cutoff points used for classifying BCPs were based on data in the literature. 6,8 Radiologists, who performed the BCPs measures, were blinded for clinical data. We evaluated subcutaneous fat area (SFA, cm 2 ), visceral fat area (VFA, cm 2 ), lumbar muscle crosssectional area (LMCA, m 2 ) and liver steatosis (L/S ratio).…”

Section: Body Composition Parameters (Bcps)mentioning

confidence: 99%

<p>Predictive Role Of Body Composition Parameters In Operable Breast Cancer Patients Treated With Neoadjuvant Chemotherapy</p>

Omarini¹,

Palumbo

Pecchi³

et al. 2019

CMAR

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Background: Fat tissue is strongly involved in BC tumorigenesis inducing insulin resistance, chronic inflammation and hormonal changes. Computed tomography (CT) imaging instead of body mass index (BMI) gives a reliable measure of skeletal muscle mass and body fat distribution. The impact of body composition parameters (BCPs) on chemosensitivity is still debated. We examined the associations between BCPs and tumor response to neoadjuvant chemotherapy (NC) in patients treated for operable breast cancer (BC). Methods: A retrospective review of BC patients treated with NC in Modena Cancer Center between 2005 and 2017 was performed. BCPs, such as subcutaneous fat area (SFA), visceral fat area (VFA), lumbar skeletal muscle index (LSMI) and liver-to-spleen (L/S) ratio were calculated by Advance workstation (General Electric), software ADW server 3.2 or 4.7. BMI and BCPs were correlated with pathological complete response (pCR) and survival outcomes. Results: 407 patients were included in the study: 55% with BMI < 25 and 45% with BMI ≥ 25. 137 of them had pre-treatment CT scan imagines. Overweight was significantly associated with postmenopausal status and older age. Hormonal receptor positive BC was more frequent in overweight patients (p<0.05). Postmenopausal women had higher VFA, fatty liver disease and obesity compared to premenopausal patients. No association between BMI classes and tumor response was detected. High VFA and liver steatosis were negative predictive factors for pCR (pCR rate: 36% normal VFA vs 20% high VFA, p= 0.048; no steatosis 32% vs steatosis 13%, p=0.056). Neither BMI classes nor BCPs significantly influenced overall survival and relapse-free survival. Conclusion: Visceral adiposity as well as steatosis were closely involved in chemosensitivity in BC patients treated with NC. Their measures from clinically acquired CT scans provide significant predictive information that outperform BMI value. More research is required to evaluate the relationship among adiposity site and survival outcomes.

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“…38 The smallest study (n=119) found similar results with sarcopenia (defined as skeletal muscle index < 41 cm2/m2 measured on CT) significantly associated with worse disease free (p=0.02) and overall (p=0.05) survival, whereas there was no significant association between BMI and survival. 39 …”

Section: Association With Cancer Recurrence and Survivalmentioning

confidence: 99%

Clinical implications of low skeletal muscle mass in early-stage breast and colorectal cancer

Feliciano

Chen

2018

Proc. Nutr. Soc.

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Although obesity has now been widely accepted to be an important risk factor for cancer survival, the associations between body mass index and cancer mortality have not been consistently linear. Although morbid obesity has clearly been associated with worse survival, some studies have suggested a U-shaped association with no adverse association with overweight or lower levels of obesity. This “obesity paradox” may be due to the fact that body mass index likely incompletely captures key measures of body composition, including distribution of skeletal muscle and adipose tissue. Fat and lean body mass can be measured using clinically acquired CT scans. Many of the earlier studies focused on patients with metastatic cancer. However, skeletal muscle loss in the metastatic setting may reflect end stage disease processes. Therefore, this article focuses on the clinical implication of low skeletal muscle mass in early stage non-metastatic breast and colorectal cancer where measures of body composition have been shown to be strong predictors of disease-free survival and overall survival and also chemotherapy toxicity and operative risk.

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Impact of body composition on outcome in patients with early breast cancer

Cited by 136 publications

References 34 publications

Nutritional and environmental risk factors for breast cancer: a case-control study

Nutritional and environmental risk factors for breast cancer: a case-control study

<p>Predictive Role Of Body Composition Parameters In Operable Breast Cancer Patients Treated With Neoadjuvant Chemotherapy</p>

Clinical implications of low skeletal muscle mass in early-stage breast and colorectal cancer

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