Massimiliano D'Aiuto1, Andrea Chirico2,3, Michele Antonio De Riggi1, Giuseppe Frasci1, Michelino De Laurentiis1, Maurizio Di Bonito4, Patrizia Vici5, Laura Pizzuti5, Domenico Sergi5, Marcello Maugeri-Saccà5,6, Maddalena Barba5,6, Antonio Giordano2. 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.
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 cancerpatients 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 cancerpatients 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.
Entities:
Keywords:
Body mass index; breast cancer; neoadjuvant setting; young age
Authors: Cheryl L Rock; Colleen Doyle; Wendy Demark-Wahnefried; Jeffrey Meyerhardt; Kerry S Courneya; Anna L Schwartz; Elisa V Bandera; Kathryn K Hamilton; Barbara Grant; Marji McCullough; Tim Byers; Ted Gansler Journal: CA Cancer J Clin Date: 2012-04-26 Impact factor: 508.702
Authors: P De Miguel-Etayo; M I Mesana; G Cardon; I De Bourdeaudhuij; M Góźdź; P Socha; M Lateva; V Iotova; B V Koletzko; K Duvinage; O Androutsos; Y Manios; L A Moreno Journal: Obes Rev Date: 2014-08 Impact factor: 9.213
Authors: Carey K Anders; David S Hsu; Gloria Broadwater; Chaitanya R Acharya; John A Foekens; Yi Zhang; Yixin Wang; P Kelly Marcom; Jeffrey R Marks; Phillip G Febbo; Joseph R Nevins; Anil Potti; Kimberly L Blackwell Journal: J Clin Oncol Date: 2008-07-10 Impact factor: 44.544
Authors: Pamela J Goodwin; Marguerite Ennis; Mala Bahl; I George Fantus; Kathleen I Pritchard; Maureen E Trudeau; Jarley Koo; Nicky Hood Journal: Breast Cancer Res Treat Date: 2008-04-25 Impact factor: 4.872
Authors: Peter Widschwendter; Thomas Wp Friedl; Lukas Schwentner; Nikolaus DeGregorio; Bernadette Jaeger; Amelie Schramm; Inga Bekes; Miriam Deniz; Krisztian Lato; Tobias Weissenbacher; Bernd Kost; Ulrich Andergassen; Julia Jueckstock; Julia Neugebauer; Elisabeth Trapp; Peter A Fasching; Matthias W Beckmann; Andreas Schneeweiss; Ines Schrader; Brigitte Rack; Wolfgang Janni; Christoph Scholz Journal: Breast Cancer Res Date: 2015-09-18 Impact factor: 6.466
Authors: Laura Pizzuti; Domenico Sergi; Isabella Sperduti; Luigi Di Lauro; Marco Mazzotta; Claudio Botti; Fiorentino Izzo; Luca Marchetti; Silverio Tomao; Paolo Marchetti; Clara Natoli; Antonino Grassadonia; Teresa Gamucci; Lucia Mentuccia; Emanuela Magnolfi; Angela Vaccaro; Alessandra Cassano; Ernesto Rossi; Andrea Botticelli; Valentina Sini; Maria G Sarobba; Maria Agnese Fabbri; Luca Moscetti; Antonio Astone; Andrea Michelotti; Claudia De Angelis; Ilaria Bertolini; Francesco Angelini; Gennaro Ciliberto; Marcello Maugeri-Saccà; Antonio Giordano; Maddalena Barba; Patrizia Vici Journal: Cancer Biol Ther Date: 2018-02-16 Impact factor: 4.742
Authors: Laura Pizzuti; Maddalena Barba; Diana Giannarelli; Domenico Sergi; Claudio Botti; Paolo Marchetti; Michele Anzà; Marcello Maugeri-Saccà; Clara Natoli; Simona Di Filippo; Teresa Catenaro; Federica Tomao; Antonella Amodio; Silvia Carpano; Letizia Perracchio; Marcella Mottolese; Luigi Di Lauro; Giuseppe Sanguineti; Anna Di Benedetto; Antonio Giordano; Patrizia Vici Journal: J Cell Physiol Date: 2016-06-02 Impact factor: 6.384