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
Session Publication Only
Topics Breast Cancer, Locally Advanced
Cancer Aetiology, Epidemiology, Prevention
Presenter Alejandra Armengol-Alonso
Authors A. Armengol-Alonso1, A. Arance1, M. Campayo1, X. González-Farré1, A. García-Herrera2, P.L. Fernández2, X. Caparros3, I. Alonso3, B. Farrus4, M. Munoz1
  • 1Oncologia Medica, Hospital Clinic y Provincial de Barcelona, 08036 - Barcelona/ES
  • 2Pathology, Hospital Clinic y Pronvincial Barcelona, barcelona/ES
  • 3Gynecology And Obstetrics Department, hospital clinic Barcelona, barcelona/ES
  • 4Department Of Radiation Oncology, hospital clinic Barcelona, barcelona/ES

Abstract

Background

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.