The impact of body mass index on pathological complete response following neoadjuvant chemotherapy in operable breast cancer

Published Date: 01st May 2024

Publication Authors: Jaiswal. R, Blower. E, Innes. H, Sripadam. R, Yiannoullou. P, Chagla. L

Introduction
Breast cancer being a global health concern, with an incidence and mortality rate of 11.7% and 6.9% respectively. Pathological complete response (PCR) post-neoadjuvant chemotherapy (NACT) is associated with improved survival outcomes. 63.5% of adults in the United Kingdom have an elevated body mass index (BMI).

Objective(s)
We aimed to compare pathological complete response rates post neoadjuvant chemotherapy in breast cancer patients with a normal BMI (18-24.9) and those with an elevated BMI (>=25).

Material(s) and Method(s)
Study included females with biopsy-confirmed operable breast carcinoma and underwent surgery after NACT between January 2018 and December 2022. Patients categorized into two BMI groups, normal (18-24.9), and elevated (>=25). PCR was defined as ypT0/Tis ypN0 or ypT0/Tis. Descriptive analyses and univariate and multivariate logistic regressions were performed using R software.

Result(s)
A total of 230 patients were included, 68 (30%) had a normal BMI, 162 (70%) had an elevated BMI (>=25). Normal BMI patients had the highest PCR rates (59%), while those with an elevated BMI had a lower PCR rate (34%) (p<0.001). A normal body mass index remained an independent predictor of pathological complete response after controlling various parameters at diagnosis. (Odds Ratio=1, 0.34; for normal and elevated BMI respectively).

Conclusion(s)
In our cohort, patients with an elevated BMI had a lower rate of PCR after NACT than patients with a normal BMI. Further studies are required to establish underlying mechanisms like the impact of insulin resistance on tumour cell pathways. This study highlights obesity as an important public health issue.

 

Jaiswal, R; Blower, E; Innes, H; Sripadam, R; Yiannoullou, P; Chagla, L. (2004). The impact of body mass index on pathological complete response following neoadjuvant chemotherapy in operable breast cancer. European Journal of Surgical Oncology. 50(Supple 1), Article Number: 108110. [Online]. Available at: https://doi.org/10.1016/j.ejso.2024.108110 [Accessed 17 May 2024]

 

 

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