title: BMI and Pathologic Complete Response to Neoadjuvant Chemotherapy in Breast Cancer: A Study and Meta-Analysis.
abstract: There is only limited data from clinical practice on the relevance of body mass index (BMI) on pathologic complete response (pCR) following neoadjuvant chemotherapy (NAC) in patients with breast cancer (BC).
  
  
  
  The impact of BMI on pCR and survival outcome was examined in 324 patients with primary non-metastatic BC. An additional meta-analysis was performed on the current data and relevant previously published studies in clinical practice.
  
  
  
  Multivariable regression analysis identified lymph vascular invasion (odds ratio [OR], 0.05; 95% confidence interval [CI], 0.01-0.18; P = .0000), grading 3 (OR, 3.12; 95% CI, 1.59-6.12; P = .0009), and HER2/neu status (OR, 4.76; 95% CI, 1.86-12.18; P = .011) as independent factors for pCR after NAC. There was no association between pCR and continuous or categorical BMI. Various additional subgroup analyses of molecular BC subtypes (triple-negative, luminal-like, HER2-luminal, HER2-like) and BMI also showed no association. These findings were confirmed by the meta-analysis. Except for one subgroup analysis in which overweight and obese patients were combined as one group, no association between BMI and pCR as well as survival outcome was found.
  
  
  
  BMI was not established as a relevant clinical factor. Only lymph vascular invasion, grading 3, luminal-like, and HER2/like BC subtype showed predictive and prognostic impact in patients with BC receiving NAC.
authors.affiliation: Department of Obstetrics and Gynecology, Medical Center - University of Freiburg, Freiburg, Germany. Electronic address: thalia.erbes@uniklinik-freiburg.de.
authors.forename: Thalia
authors.initials: T
authors.lastname: Erbes
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Center - Rheinisch-Westfälische Technische Hochschule, Aachen, Germany.
authors.forename: Elmar
authors.initials: E
authors.lastname: Stickeler
authors.affiliation: Institute for Medical Biometry and Statistics, Medical Center - University of Freiburg, Freiburg, Germany.
authors.forename: Gerta
authors.initials: G
authors.lastname: Rücker
authors.affiliation: Department of Surgery, Medical Center - University of Freiburg, Freiburg, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Buroh
authors.affiliation: Department of Obstetrics and Gynecology, Medical Center - University of Freiburg, Freiburg, Germany.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Asberger
authors.affiliation: Department of Obstetrics and Gynecology, Medical Center - University of Freiburg, Freiburg, Germany.
authors.forename: Nora
authors.initials: N
authors.lastname: Dany
authors.affiliation: Department of Obstetrics and Gynecology, Medical Center - University of Freiburg, Freiburg, Germany.
authors.forename: Sophia
authors.initials: S
authors.lastname: Thornton
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Center - Rheinisch-Westfälische Technische Hochschule, Aachen, Germany.
authors.forename: Severine
authors.initials: S
authors.lastname: Iborra
authors.affiliation: Department of Obstetrics and Gynecology, Medical Center - University of Freiburg, Freiburg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Hirschfeld
authors.affiliation: Department of Obstetrics and Gynecology, Medical Center - University of Freiburg, Freiburg, Germany.
authors.forename: Gerald
authors.initials: G
authors.lastname: Gitsch
authors.affiliation: Department of Obstetrics and Gynecology, Medical Center - University of Freiburg, Freiburg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Mayer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor; D015992:Body Mass Index; D001940:Breast; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: Body weight; Chemotherapy response; Lifestyle parameter; Predictive value; Risk factor