Modification of abdominal fat distribution after aromatase inhibitor therapy in breast cancer patients visualized using 3-D computed tomography volumetry.
BACKGROUND
The purpose of this study was to describe modification of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) distributions in breast cancer patients after aromatase inhibitor (AI) therapy using computed tomography (CT) volumetric measurement of abdominal body fat distribution.


METHODS
Sixty-four consecutive patients who were receiving adjuvant AI therapy were included in this study. Patients were evaluated using CT before and after at least 6 months of AI therapy with imaging follow-up of 4.3 ± 2.2 years. Abdominal fat distribution was automatically calculated using a workstation that obtained total abdominal adipose tissue (TAAT) area (mm(3)). SAT was manually segmented and VAT was determined as TAAT - SAT. Percentages were calculated for change of TAAT, VAT, and SAT. VAT/SAT ratio was calculated.


RESULTS
Percentage of TAAT after AI therapy was increased by a mean of 9.1% from baseline (16,280.3 ± 6953.3 mm(3)) to (17,763.6 ± 6850.8 mm(3)). Two groups of patients were observed; those with an increase in TAAT and those with a decrease. Modification of VAT/SAT ratio was observed (from 1.38 to 1.69) in all subjects, reflecting a relative increased volume of VAT (mean, 18%) and slight mean reduction of SAT (mean 1.9%).


CONCLUSIONS
In our study, therapy with AI in breast cancer patients was accompanied with a change in fat distribution to relatively greater VAT/SAT ratio in patients, regardless of whether they gained or lost weight after therapy. Because this pattern of fat distribution is associated with metabolic disorders, attention must be paid to these clinical manifestations in patients during their follow-up management.
Department of Radiology, Campus Bio-Medico University of Rome, Rome, Italy. Electronic address: sofia.battisti@hotmail.it.
Sofia
S
Battisti
Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy.
Francesco Maria
FM
Guida
Department of Radiology, Campus Bio-Medico University of Rome, Rome, Italy.
Federica
F
Coppa
Department of Radiology, Campus Bio-Medico University of Rome, Rome, Italy.
Donata M
DM
Vaccaro
Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy.
Daniele
D
Santini
Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy.
Giuseppe
G
Tonini
Department of Radiology, Campus Bio-Medico University of Rome, Rome, Italy.
Bruno B
BB
Zobel
Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Richard C
RC
Semelka
D047072:Aromatase Inhibitors / Q000009:adverse effects*; D050218:Body Fat Distribution; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000187:drug effects*; D008875:Middle Aged; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging / Q000187:drug effects*; D014057:Tomography, X-Ray Computed
D047072:Aromatase Inhibitors
Aromatase inhibitor therapy; Breast cancer; CT; Subcutaneous fat; Visceral fat