title: Impact of weight change during neoadjuvant chemotherapy on pathologic response in triple-negative breast cancer.
abstract: Triple-negative breast cancer (TNBC) is an uncommon but aggressive subtype of breast cancer. Obesity has been associated with an increased risk of breast cancer and worse prognosis. Some studies suggest that obese patients are less likely to achieve pathologic complete response (pCR) to neoadjuvant chemotherapy (NCT) and experience worse overall survival. Ki-67 is a proliferation marker that correlates with tumor aggressiveness. The goal of this study was to examine the impact of weight change during NCT for TNBC on pathologic response and Ki-67 reduction. Retrospective review identified 173 TNBC patients treated between 2004 and 2011. Data were collected on patient demographics, pre- and post-NCT body mass index (BMI), Ki-67, and pCR. Data analysis was performed using the two-tailed Student's t-test, analysis of variance (ANOVA), and Fisher's exact test. Sixty-six patients met final study criteria. Forty-three patients lost weight during chemotherapy and 23 gained weight. Patients in the weight gain group were significantly younger (P = 0.0013). There was no significant difference between the two groups in terms of Ki-67 reduction (P = 0.98) or pCR (P = 0.58). When patients were separated into normal weight (BMI<25 kg/m(2) ), overweight (BMI ≥ 25 and <30 kg/m(2) ), and obese (BMI ≥ 30 kg/m(2) ), there was no significant difference in Ki-67 among those groups either before or after NCT. The degree of obesity did not have a significant impact on Ki-67 reduction. Weight change during NCT does not appear to correlate with Ki-67 change or achieving pCR in TNBC. This may reflect the nature of this subtype of breast cancer that is less responsive to the hormonal effects that adipose tissue exerts on cancer cell proliferation.
authors: Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas, 75390-9155.
authors: Jean
authors: J
authors: Bao
authors: Nicholas
authors: N
authors: Borja
authors: Madhu
authors: M
authors: Rao
authors: James
authors: J
authors: Huth
authors: A Marilyn
authors: AM
authors: Leitch
authors: Aeisha
authors: A
authors: Rivers
authors: Rachel
authors: R
authors: Wooldridge
authors: Roshni
authors: R
authors: Rao
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000188:drug therapy*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009765:Obesity / Q000150:complications / Q000628:therapy; D010865:Pilot Projects; D012189:Retrospective Studies; D064726:Triple Negative Breast Neoplasms / Q000150:complications / Q000188:drug therapy*; D015430:Weight Gain / Q000502:physiology; D015431:Weight Loss / Q000502:physiology
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen
keywords: Ki-67; neoadjuvant chemotherapy; triple-negative breast cancer; weight change
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