Body mass index mediates the prognostic significance of circulating tumor cells in inflammatory breast cancer

Oluwadamilola M Fayanju; Carolyn S Hall; Jessica Bowman Bauldry; Mandar Karhade; Lily M Valad; Henry M Kuerer; Sarah M DeSnyder; Carlos H Barcenas; Anthony Lucci

doi:10.1016/j.amjsurg.2017.06.005

Body mass index mediates the prognostic significance of circulating tumor cells in inflammatory breast cancer

Am J Surg. 2017 Oct;214(4):666-671. doi: 10.1016/j.amjsurg.2017.06.005. Epub 2017 Jun 23.

Authors

Oluwadamilola M Fayanju¹, Carolyn S Hall², Jessica Bowman Bauldry³, Mandar Karhade⁴, Lily M Valad⁵, Henry M Kuerer⁶, Sarah M DeSnyder⁷, Carlos H Barcenas⁸, Anthony Lucci⁹

Affiliations

¹ Division of Advanced Oncologic and GI Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA. Electronic address: lola.fayanju@duke.edu.
² Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: cshall@mdanderson.org.
³ Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: jbbauldry@mdanderson.org.
⁴ Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: mkarhade@mdanderson.org.
⁵ School of Medicine, University of Texas, Medical Branch, Galveston, TX, USA. Electronic address: lmvalad@utmb.edu.
⁶ Department of Breast Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; The Institute for Cancer Care Innovation (ICCI), The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: hkuerer@mdanderson.org.
⁷ Department of Breast Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: sgainer@mdanderson.org.
⁸ Department of Breast Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: chbarcenas@mdanderson.org.
⁹ Department of Breast Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: alucci@mdanderson.org.

Abstract

Background: Obesity (BMI≥30) may be an etiologic and prognostic factor in inflammatory breast cancer (IBC). We examined the relationship between BMI, pathologic complete response (pCR), and circulating-tumor-cell (CTC) levels in IBC.

Methods: Cohort included IBC patients diagnosed 2005-2015 who had neoadjuvant chemotherapy during a prospective trial on CTCs and pathologic review describing pCR. Chi-square, logistic regression, and Cox proportional hazards models were used to identify clinicopathologic associations with event-free survival (EFS).

Results: Of 73 patients, 61 (84%) had CTC values, 22 (30%) achieved a pCR, and 39 (53%) were obese. There was no difference between obese and non-obese patients for pCR rates (31% vs. 29%, p = 0.90) or presence of CTCs (23% vs. 26%, p = 0.80). Among non-obese patients, CTCs were associated with worse EFS (HR 11.69, p < 0.01), but among obese patients, there was no difference in EFS between those with and without CTCs.

Conclusions: BMI mediates CTCs' prognostic significance in IBC.

Keywords: Body mass index; Circulating tumor cells; Inflammatory breast cancer; Obesity; Pathologic complete response; Prognosis.

MeSH terms

Aged
Body Mass Index*
Female
Humans
Inflammatory Breast Neoplasms / pathology*
Inflammatory Breast Neoplasms / therapy
Middle Aged
Neoadjuvant Therapy
Neoplasm Staging
Neoplastic Cells, Circulating*
Obesity / complications*
Prognosis
Prospective Studies
Risk Factors

Abstract

MeSH terms

Grants and funding