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The association between body mass index and pathological complete response in neoadjuvant-treated breast cancer patients

Skarping, Ida LU orcid ; Blaabjerg Pedersen, Stine ; Förnvik, Daniel LU ; Zackrisson, Sophia LU and Borgquist, Signe LU (2022) In Acta Oncologica 61(6). p.731-737
Abstract

Background: Obesity seems to be associated with a poorer response to adjuvant chemotherapy in breast cancer (BC); however, associations in the neoadjuvant chemotherapy (NACT) setting and according to menopausal status are less studied. This study aims to investigate the association between pretreatment body mass index (BMI) and pathological complete response (pCR) following NACT in BC according to menopausal and estrogen receptor (ER) status. Material and Methods: The study cohort consisted of 491 patients receiving NACT in 2005–2019. Based on pre-NACT patient and tumor characteristics, the association between BMI and achieving pCR was analyzed using logistic regression models (crude and adjusted models (age, tumor size, and node... (More)

Background: Obesity seems to be associated with a poorer response to adjuvant chemotherapy in breast cancer (BC); however, associations in the neoadjuvant chemotherapy (NACT) setting and according to menopausal status are less studied. This study aims to investigate the association between pretreatment body mass index (BMI) and pathological complete response (pCR) following NACT in BC according to menopausal and estrogen receptor (ER) status. Material and Methods: The study cohort consisted of 491 patients receiving NACT in 2005–2019. Based on pre-NACT patient and tumor characteristics, the association between BMI and achieving pCR was analyzed using logistic regression models (crude and adjusted models (age, tumor size, and node status)) with stratification by menopausal and ER status. Results: In the overall cohort, being overweight (BMI ≥25) compared by being normal-weight (BMI <25), increased the odds of accomplishing pCR by 15%. However, based on the 95% confidence interval (CI) the data were compatible with associations within the range of a decrease of 30% to an increase of 89%. Stratification according to menopausal status also showed no strong association: the odds ratio (OR) of accomplishing pCR in overweight premenopausal patients compared with normal-weight premenopausal patients was 1.76 (95% CI 0.88–3.55), whereas for postmenopausal patients the corresponding OR was 0.71 (95% CI 0.35–1.46). Discussion: In a NACT BC cohort of 491 patients, we found no evidence of high BMI as a predictive factor of accomplishing pCR, neither in the whole cohort nor stratified by menopausal status. Given the limited precision in our results, larger studies are needed before considering BMI in clinical decision-making regarding NACT or not.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
BMI, body constitution, Breast neoplasm, neoadjuvant chemotherapy, obesity
in
Acta Oncologica
volume
61
issue
6
pages
7 pages
publisher
Taylor & Francis
external identifiers
  • pmid:35363106
  • scopus:85129225993
ISSN
0284-186X
DOI
10.1080/0284186X.2022.2055976
language
English
LU publication?
yes
id
bf7831a4-60fe-48af-ada6-7e174a234b81
date added to LUP
2022-08-15 10:06:50
date last changed
2024-09-20 03:22:26
@article{bf7831a4-60fe-48af-ada6-7e174a234b81,
  abstract     = {{<p>Background: Obesity seems to be associated with a poorer response to adjuvant chemotherapy in breast cancer (BC); however, associations in the neoadjuvant chemotherapy (NACT) setting and according to menopausal status are less studied. This study aims to investigate the association between pretreatment body mass index (BMI) and pathological complete response (pCR) following NACT in BC according to menopausal and estrogen receptor (ER) status. Material and Methods: The study cohort consisted of 491 patients receiving NACT in 2005–2019. Based on pre-NACT patient and tumor characteristics, the association between BMI and achieving pCR was analyzed using logistic regression models (crude and adjusted models (age, tumor size, and node status)) with stratification by menopausal and ER status. Results: In the overall cohort, being overweight (BMI ≥25) compared by being normal-weight (BMI &lt;25), increased the odds of accomplishing pCR by 15%. However, based on the 95% confidence interval (CI) the data were compatible with associations within the range of a decrease of 30% to an increase of 89%. Stratification according to menopausal status also showed no strong association: the odds ratio (OR) of accomplishing pCR in overweight premenopausal patients compared with normal-weight premenopausal patients was 1.76 (95% CI 0.88–3.55), whereas for postmenopausal patients the corresponding OR was 0.71 (95% CI 0.35–1.46). Discussion: In a NACT BC cohort of 491 patients, we found no evidence of high BMI as a predictive factor of accomplishing pCR, neither in the whole cohort nor stratified by menopausal status. Given the limited precision in our results, larger studies are needed before considering BMI in clinical decision-making regarding NACT or not.</p>}},
  author       = {{Skarping, Ida and Blaabjerg Pedersen, Stine and Förnvik, Daniel and Zackrisson, Sophia and Borgquist, Signe}},
  issn         = {{0284-186X}},
  keywords     = {{BMI; body constitution; Breast neoplasm; neoadjuvant chemotherapy; obesity}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{731--737}},
  publisher    = {{Taylor & Francis}},
  series       = {{Acta Oncologica}},
  title        = {{The association between body mass index and pathological complete response in neoadjuvant-treated breast cancer patients}},
  url          = {{http://dx.doi.org/10.1080/0284186X.2022.2055976}},
  doi          = {{10.1080/0284186X.2022.2055976}},
  volume       = {{61}},
  year         = {{2022}},
}