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Breast Cancer Res Treat. 2018 Nov;172(2):425-436. doi: 10.1007/s10549-018-4915-7. Epub 2018 Aug 21.

Prognostic impact of skeletal muscle volume derived from cross-sectional computed tomography images in breast cancer.

Author information

1
Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea.
2
Department of Surgery, Seonam Hospital, Seoul, Republic of Korea.
3
Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea. cwlee@ncc.re.kr.
4
Department of Surgery, Keimyung University School of Medicine, Daegu, Republic of Korea.
5
Biometric Research Branch, Research Institute, National Cancer Center, Goyang, Republic of Korea.
6
Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea. eslee@ncc.re.kr.

Abstract

PURPOSE:

This study aimed to determine whether the prognosis of breast cancer is affected by muscle or fat volume as measured from computed tomography (CT) images.

METHODS:

We identified 1460 patients with chest CT who were diagnosed as having breast cancer at the National Cancer Center, Korea, between January 2001 and December 2009. Using CT images of 10-mm slices, we measured the cross-sectional areas of skeletal muscle and adipose tissue at the 3rd lumbar vertebrae, and derived their volumes. The skeletal muscle volume, fat volume, and muscle-to-fat ratio were evaluated for association with overall survival (OS) and recurrence-free survival (RFS).

RESULTS:

The median skeletal muscle and fat volumes among the patients were 93.3 cc (range 39.6-236.9) and 420.1 cc (range 19.5-1392.3), respectively. Patients with higher muscle volume had better prognosis than those with lower muscle volume [hazard ratio (HR) 0.56, 95% confidence interval (CI) 0.34-0.92, P = 0.022 for OS; HR 0.72, 95% CI 0.52-0.99, P = 0.046 for RFS]. However, body mass index (BMI) and fat volume were not associated with prognosis. In addition, muscle volume was a significant prognosticator for OS, regardless of BMI (HR 0.55, 95% CI 0.32-0.93, P = 0.034 in BMI < 25.0; HR 0.44, 95% CI 0.21-0.91, P = 0.026 in BMI ≥ 25.0). Among older patients (≥ 50), those with higher muscle volume showed better OS and RFS (HR 0.44, 95% CI 0.23-0.85, P = 0.015; HR 0.55, 95% CI 0.34-0.90, P = 0.017, respectively).

CONCLUSION:

This study demonstrated that breast cancer patients with higher skeletal muscle volume showed more favorable prognosis.

KEYWORDS:

Breast cancer; Obesity; Prognosis; Skeletal muscle volume

PMID:
30132218
DOI:
10.1007/s10549-018-4915-7
[Indexed for MEDLINE]

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