Obesity Is an Independent Prognostic Factor That Reduced Pathological Complete Response in Operable Breast Cancer Patients

<i>Background and Objectives</i>: Obesity is a significant risk factor for the development of breast cancer (BC) and associated poorer outcomes. A pathological complete response (pCR) with neoadjuvant chemotherapy (NACT) correlates with improved long-term prognosis in BC patients. In thi...

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Main Authors: Murad Guliyev, Özkan Alan, Murat Günaltılı, Shamkhal Safarov, Mehmet Cem Fidan, Gülin Alkan Şen, Ezgi Değerli, Berrin Papila, Nebi Serkan Demirci, Çiğdem Papila
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Language:English
Published: MDPI AG 2024-11-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/60/12/1953
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author Murad Guliyev
Özkan Alan
Murat Günaltılı
Shamkhal Safarov
Mehmet Cem Fidan
Gülin Alkan Şen
Ezgi Değerli
Berrin Papila
Nebi Serkan Demirci
Çiğdem Papila
author_facet Murad Guliyev
Özkan Alan
Murat Günaltılı
Shamkhal Safarov
Mehmet Cem Fidan
Gülin Alkan Şen
Ezgi Değerli
Berrin Papila
Nebi Serkan Demirci
Çiğdem Papila
author_sort Murad Guliyev
collection DOAJ
description <i>Background and Objectives</i>: Obesity is a significant risk factor for the development of breast cancer (BC) and associated poorer outcomes. A pathological complete response (pCR) with neoadjuvant chemotherapy (NACT) correlates with improved long-term prognosis in BC patients. In this study, we aimed to investigate the predictive effect of obesity on achieving pCR following NACT. <i>Methods</i>: This single-center retrospective study included patients with operable BC who were treated with NACT. Patients were categorized based on their pre-chemotherapy body mass index (BMI), including non-obese (<30 kg/m<sup>2</sup>) and obese (≥30 kg/m<sup>2</sup>) groups, and pathological responses to NACT were compared. <i>Results</i>: A total of 191 female patients were included in this study; of these, 83 (43.4%) were obese and 108 (56.6%) were in the non-obese group. Obesity was more common in postmenopausal patients, and the median age of obese patients was significantly higher compared to non-obese patients. Patients in the obese group demonstrated significantly lower pCR rates compared to the non-obese group (30% vs. 45%, <i>p</i> = 0.03). The histological subtype assessment indicated that only in the HR-positive/HER2-negative patients was the pCR rate significantly lower in the obese group compared to the non-obese group (11% vs. 27%, <i>p</i> = 0.05). According to menopausal assessment, a significant difference in pCR rates was observed only among postmenopausal patients, with rates of 29% in the obese group compared to 52% in the non-obese group (<i>p</i> = 0.03). In logistic regression analysis, obesity (OR: 0.52, 95% CI: 0.28–0.97; <i>p</i> = 0.04) and a low Ki-67 score (HR: 2.7, 95% CI: 1.37–5.53; <i>p</i> = 0.003) were independently associated with a decreased rate of pCR. <i>Conclusions</i>: The impact of obesity on achieving pCR in BC patients undergoing NACT remains controversial. Our study revealed that obesity was an independently significant negative predictive factor for achieving pCR.
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spelling doaj-art-37d948f69f6d4bfca01459ffbe5cf6ea2024-12-27T14:38:38ZengMDPI AGMedicina1010-660X1648-91442024-11-016012195310.3390/medicina60121953Obesity Is an Independent Prognostic Factor That Reduced Pathological Complete Response in Operable Breast Cancer PatientsMurad Guliyev0Özkan Alan1Murat Günaltılı2Shamkhal Safarov3Mehmet Cem Fidan4Gülin Alkan Şen5Ezgi Değerli6Berrin Papila7Nebi Serkan Demirci8Çiğdem Papila9Division of Medical Oncology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul 34098, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul 34098, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul 34098, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul 34098, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul 34098, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul 34098, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul 34098, TurkeyDepartment of General Surgery, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul 34098, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul 34098, TurkeyDivision of Medical Oncology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University-Cerrahpaşa, İstanbul 34098, Turkey<i>Background and Objectives</i>: Obesity is a significant risk factor for the development of breast cancer (BC) and associated poorer outcomes. A pathological complete response (pCR) with neoadjuvant chemotherapy (NACT) correlates with improved long-term prognosis in BC patients. In this study, we aimed to investigate the predictive effect of obesity on achieving pCR following NACT. <i>Methods</i>: This single-center retrospective study included patients with operable BC who were treated with NACT. Patients were categorized based on their pre-chemotherapy body mass index (BMI), including non-obese (<30 kg/m<sup>2</sup>) and obese (≥30 kg/m<sup>2</sup>) groups, and pathological responses to NACT were compared. <i>Results</i>: A total of 191 female patients were included in this study; of these, 83 (43.4%) were obese and 108 (56.6%) were in the non-obese group. Obesity was more common in postmenopausal patients, and the median age of obese patients was significantly higher compared to non-obese patients. Patients in the obese group demonstrated significantly lower pCR rates compared to the non-obese group (30% vs. 45%, <i>p</i> = 0.03). The histological subtype assessment indicated that only in the HR-positive/HER2-negative patients was the pCR rate significantly lower in the obese group compared to the non-obese group (11% vs. 27%, <i>p</i> = 0.05). According to menopausal assessment, a significant difference in pCR rates was observed only among postmenopausal patients, with rates of 29% in the obese group compared to 52% in the non-obese group (<i>p</i> = 0.03). In logistic regression analysis, obesity (OR: 0.52, 95% CI: 0.28–0.97; <i>p</i> = 0.04) and a low Ki-67 score (HR: 2.7, 95% CI: 1.37–5.53; <i>p</i> = 0.003) were independently associated with a decreased rate of pCR. <i>Conclusions</i>: The impact of obesity on achieving pCR in BC patients undergoing NACT remains controversial. Our study revealed that obesity was an independently significant negative predictive factor for achieving pCR.https://www.mdpi.com/1648-9144/60/12/1953breast cancerobesitybody mass indexpathological complete responseneoadjuvant treatment
spellingShingle Murad Guliyev
Özkan Alan
Murat Günaltılı
Shamkhal Safarov
Mehmet Cem Fidan
Gülin Alkan Şen
Ezgi Değerli
Berrin Papila
Nebi Serkan Demirci
Çiğdem Papila
Obesity Is an Independent Prognostic Factor That Reduced Pathological Complete Response in Operable Breast Cancer Patients
Medicina
breast cancer
obesity
body mass index
pathological complete response
neoadjuvant treatment
title Obesity Is an Independent Prognostic Factor That Reduced Pathological Complete Response in Operable Breast Cancer Patients
title_full Obesity Is an Independent Prognostic Factor That Reduced Pathological Complete Response in Operable Breast Cancer Patients
title_fullStr Obesity Is an Independent Prognostic Factor That Reduced Pathological Complete Response in Operable Breast Cancer Patients
title_full_unstemmed Obesity Is an Independent Prognostic Factor That Reduced Pathological Complete Response in Operable Breast Cancer Patients
title_short Obesity Is an Independent Prognostic Factor That Reduced Pathological Complete Response in Operable Breast Cancer Patients
title_sort obesity is an independent prognostic factor that reduced pathological complete response in operable breast cancer patients
topic breast cancer
obesity
body mass index
pathological complete response
neoadjuvant treatment
url https://www.mdpi.com/1648-9144/60/12/1953
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AT shamkhalsafarov obesityisanindependentprognosticfactorthatreducedpathologicalcompleteresponseinoperablebreastcancerpatients
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