380 - Impact of body mass index (BMI) on disease free survival and likelihood of pathologic complete response in patients with locally advanced breast can...
|Date||28 September 2012|
|Event||ESMO Congress 2012|
|Topics|| Breast Cancer, Locally Advanced
Cancer Aetiology, Epidemiology, Prevention
A. Armengol-Alonso1, A. Arance1, M. Campayo1, X. González-Farré1, A. García-Herrera2, P.L. Fernández2, X. Caparros3, I. Alonso3, B. Farrus4, M. Munoz1
The BMI is a clinical parameter that although not perfect is often used to measure adiposity. In breast cancer there are multiple studies indicating that overweight/obesity (O/O) is related with lower survival and increased risk of relapse. It has been also reported less likely to achieve a pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in O/O patients.Methods
We retrospectively reviewed the records of 108 patients diagnosed with invasive locally advanced breast cancer (ILABC) who had been treated with NAC (anthracycline + taxane ± trastuzumab). The aim of our study was to review the impact of BMI on the pCR and the possibility of recurrence. pCR was defined as the criterion of strict pCR breast+nodes.Results
From 2004 to 2011, 108 patients received NAC. Based on their weight and height at baseline we divided into two groups; group 1: underweight/normal (BMI <25 kg/m2) and group 2: O/O (BMI ≥25 kg/m2). Fifty one (47.2%) patients were in group 1 and 57 (52.8%) were in group 2. Median age was 46 years in group 1 and 52 in group 2 (p = 0.012). There were no differences at cTNM stage in both groups (p = 0.269). The NAC dose intensity was not different between groups (p = 0.399) Hormonal receptor negative tumors were more frequent in group 2 [27 (71.1%)] than in group 1 [11 (28.9%)] (p = 0.005). Likewise the triple negative receptor status was more frequent in group 2 [20 (83.3%)] than in group 1 [4 (16.7%)] (p = 0.001). Thirty-four patients had HER2 overexpression but was not different in both groups. (p = 0.695). There was a pCR in 18 patients (35.3%) from group 1 vs 11 patients (19.3%) from group 2 (p = 0.061). O/O patients were less likely to have pCR (OR 0.43 CI 95% 0.18-1.0). Median follow-up was 26 months (7-84). Twelve patients relapsed (3 local, 8 systemic or both 1). There were more relapses in group 2 (10 patients vs 2) (log rank 0.014). In an adjusted Cox regression analysis the BMI ≥25 kg/m2 was an independent factor for disease recurrence (HR 5.3 CI 95% 1.1-26.1).Conclusions
Despite the retrospective nature of this study we can conclude that the patients with ILABC and O/O have a high risk for relapse and decreased response to NAC. It requires well-designed prospective studies to control confounding factors (dose intensity, chemotherapy regimens, changes in BMI) to get clear answers of these associations.Disclosure
All authors have declared no conflicts of interest.