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. 2021 Apr 9;13(8):1806.
doi: 10.3390/cancers13081806.

Association between Skeletal Muscle Loss and the Response to Neoadjuvant Chemotherapy for Breast Cancer

Byung Min Lee  1 , Yeona Cho  1 , Jun Won Kim  1 , Sung Gwe Ahn  2 , Jee Hung Kim  3 , Hei Cheul Jeung  3 , Joon Jeong  2 , Ik Jae Lee  1
Affiliations

Association between Skeletal Muscle Loss and the Response to Neoadjuvant Chemotherapy for Breast Cancer

Byung Min Lee et al. Cancers (Basel). .

Abstract

There are no means to predict patient response to neoadjuvant chemotherapy (NAC); the impact of skeletal muscle loss on the response to NAC remains undefined. We investigated the association between response to chemotherapy and skeletal muscle loss in breast cancer patients. Patients diagnosed with invasive breast cancer who were treated with NAC, surgery, and radiotherapy were analyzed. We quantified skeletal muscle loss using pre-NAC and post-NAC computed tomography scans. The response to treatment was determined using the Response Evaluation Criteria in Solid Tumors. We included 246 patients in this study (median follow-up, 28.85 months). The median age was 48 years old (interquartile range 42-54) and 115 patients were less than 48 years old (46.7%). Patients showing a complete or partial response were categorized into the responder group (208 patients); the rest were categorized into the non-responder group (38 patients). The skeletal muscle mass cut-off value was determined using a receiver operating characteristic curve; it showed areas under the curve of 0.732 and 0.885 for the pre-NAC and post-NAC skeletal muscle index (p < 0.001 for both), respectively. Skeletal muscle loss and cancer stage were significantly associated with poor response to NAC in locally advanced breast cancer patients. Accurately measuring muscle loss to guide treatment and delaying muscle loss through various interventions would help enhance the response to NAC and improve clinical outcomes.

Keywords: breast cancer; skeletal muscle loss; treatment-induced cachexia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Computed tomography images of patients with skeletal muscle loss (upper) and without skeletal muscle loss (lower). skeletal muscle index of upper image: 4.88, skeletal muscle index of lower image: 9.83.
Figure 2
Figure 2
Receiver operating characteristic curve of the skeletal muscle index at the T4 level prior to the initiation of neoadjuvant chemotherapy.
Figure 3
Figure 3
Receiver operating characteristic curve of the skeletal muscle index at the T4 level after the completion of neoadjuvant chemotherapy.
See this image and copyright information in PMC

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