48P - The relationship among bowel FDG-PET uptake, pathological complete response, and the influence of eating and exercise habits in breast cancer patients undergoing neoadjuvant chemotherapy

Background

In the last decades, the impact of patients’ eating and exercise habits on breast cancer (BC) management on one side, and inflammation on the other, have been deeply explored and proven. Here, we investigated whether unhealthy habits could correlate with bowel FDG uptake and the latter, in turn, with pathological Complete Response (pCR) to standard neoadjuvant chemotherapy (NAC).

Methods

The study included stage I-III BC patients undergoing NAC at IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Rozzano, Italy. At baseline, patients fulfilled a survey concerning eating and lifestyle habits. In the absence of data on the effects of individual foods, the frequency of consumption of specific food items was aggregated for their inflammatory properties: alcohol and spirits as “pro-inflammatory drinks”, red and cured meats as “pro-inflammatory foods”, fruits and vegetables as “anti-inflammatory foods”. Before NAC, women performed a whole-body staging [18]F-FDG PET/CT scan. On PET/CT images, two regions of interest were designed on the area of highest uptake in the rectum-sigmoid district and in the colon, respectively, and radiotracer mean standardized uptake values (SUV_mean) were extracted.

Results

Data were recorded for 82 women (median age: 48 years), of whom 29 were diagnosed with triple-negative BC, 45 with a HER2-positive BC, 7 presented a Luminal B tumor, and 1 had a Luminal A BC. We found a positive correlation between colon SUV_mean and pro-inflammatory drinks (r = +0.33, p = 0.006) and foods (r = +0.25, p = 0.033) and a negative association with exercise frequency (r = -0.24, p = 0.04). A negative correlation was also observed between rectum SUV_mean and anti-inflammatory foods (r = -0.24, p = 0.027). Finally, colon SUV_mean was significantly lower in patients with pCR compared to those without pCR (p = 0.025).

Conclusions

Our study showed, for the first time, that bowel FDG uptake was affected by patients’ anti- and pro-inflammatory habits and that colon SUV_mean correlated with pCR. Moreover, our results suggest that PET scan may be an easy instrument for identifying patients with unhealthy lifestyle habits.

Legal entity responsible for the study

The authors.

Funding

IRCCS Humanitas Research Hospital (5X1000 funding).

Disclosure

All authors have declared no conflicts of interest.