Influence of Body Composition Assessed by Computed Tomography on Mortality Risk in Young Women with Breast Cancer

Nutrients. 2024 Sep 19;16(18):3175. doi: 10.3390/nu16183175.

Abstract

Background/Objectives: Increasing evidence indicates that body composition can significantly influence prognosis in women with breast cancer. However, alterations in body composition, particularly among young women (<40 years), remain largely unknown and underexplored. This study aimed to investigate the relationship of computed tomography (CT)-derived body composition with mortality rates among young women recently diagnosed with breast cancer, identifying the best-correlated cutoff value. Methods: This is a bi-set cohort study with retrospective data collection. Women newly diagnosed with ductal invasive breast cancer, aged 20 to 40 years, treated in reference oncology units were included. Body composition was assessed using CT scans at the third lumbar vertebra (L3) level, including muscle and adipose compartments. The outcome of interest was the incidence of overall mortality. A maximally selected log-rank Cox-derived analysis was employed to assess the cutoffs associated with mortality. Results: A total of 192 women were included before any form of treatment (median age of 35 years, IQ range: 31-37). Overall mortality occurred in 12% of the females. Stages III-IV were the most frequent (69.5%). Patients who died had a significantly lower muscle area index. CT-derived muscle area was inversely associated with mortality. Each 1 cm2/m2 decrease in skeletal muscle index increased the mortality hazard by 9%. Higher values of adiposity compartments were independently associated with higher mortality. Conclusions: Our study highlights the predictive significance of skeletal muscle area and adipose tissue in predicting survival among young women recently diagnosed with breast cancer.

Keywords: body composition; breast cancer; fat mass; mortality; muscle mass; prognosis.

MeSH terms

  • Adiposity
  • Adult
  • Body Composition*
  • Breast Neoplasms* / diagnostic imaging
  • Breast Neoplasms* / mortality
  • Cohort Studies
  • Female
  • Humans
  • Muscle, Skeletal / diagnostic imaging
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Tomography, X-Ray Computed* / methods
  • Young Adult

Grants and funding

This study was partially funded by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil (Finance Code 001) and the Brazilian National Council for Scientific and Technological Development (CNPq). APTF received a productivity scholarship from CNPq. The supporting sources have no involvement or restrictions regarding this publication.