Format

Send to

Choose Destination
Cancer Biol Ther. 2016 May 3;17(5):470-6. doi: 10.1080/15384047.2016.1156265. Epub 2016 Mar 2.

Body mass index and treatment outcomes following neoadjuvant therapy in women aged 45 y or younger: Evidence from a historic cohort.

Author information

1
a Breast Department , National Cancer Institute of Naples IRCCS "G. Pascale" , Naples , Italy.
2
b Sbarro Institute for Cancer Research and Molecular Medicine e del Center for Biotechnology, College of Science and Technology, Temple University , Philadelphia , PA , USA.
3
c Department of Psychology of Developmental and Socialization Processes , La Sapienza University , Rome , Italy.
4
d Pathology Department , National Cancer Institute of Naples IRCCS "G.Pascale" , Naples , Italy.
5
e Division of Medical Oncology 2, Regina Elena National Cancer Institute , Rome , Italy.
6
f Scientific Direction, Regina Elena National Cancer Institute , Rome , Italy.

Abstract

PURPOSE:

Large and consistent evidence supports the role of body mass index (BMI) as a prognostic and predictive indicator in breast cancer. However, there is paucity of data specifically referred to women diagnosed at a young age across the different disease settings. We investigated the impact of BMI on treatment outcomes in 86 breast cancer patients aged 45 y or less treated with neoadjuvant chemotherapy (CT) followed by surgery.

METHODS:

Pathologic complete response (pCR) was defined as the eradication of cancer from both breast and lymph nodes. Overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan-Meier product-limit method. Curves were compared by long rank test for significance. Potential predictors of survival were tested in Cox models.

RESULTS:

We observed a pCR in 19 patients (22%). Lower values of BMI were more commonly associated with pCR (p = 0.05). Results from univariate, but not multivariate, models were somewhat supportive of higher pCR rates in leaner women (p = 0.06). None of the variables impacted DFS. OS was longer in leaner patients (medians and 95%CI: 74.6 months, 66.2-82.9 and 58.5 months, 49.6-67.4, p = 0.009). Longer OS was also related to lower T-stage, adjuvant radiotherapy (RT), and non triple negative (TN) subtype (p = 0.046, p = 0.024, and p = 0.015, respectively). Cox models confirmed the protective role of lower BMI (Hazard Ratios: 0.30, 95%CI: 0.12-0.71, p = 0.007), non TN subtype and adjuvant RT (p = 0.008 and p = 0.024).

CONCLUSIONS:

In young breast cancer patients treated with neoadjuvant CT followed by surgery, lower values of BMI are associated with longer OS. Our data also showed longer OS in association with a non TN molecular subtype and adjuvant RT. The modifiable nature of BMI and aggressive biologic behavior of the disease diagnosed at a young age encourage further studies to corroborate our findings.

KEYWORDS:

Body mass index; breast cancer; neoadjuvant setting; young age

PMID:
26934127
PMCID:
PMC4910911
[Available on 2017-03-02]
DOI:
10.1080/15384047.2016.1156265
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Taylor & Francis Icon for PubMed Central
Loading ...
Support Center