J Breast Cancer.  2020 Feb;23(1):80-92. 10.4048/jbc.2020.23.e8.

Prognostic Value of Skeletal Muscle Depletion Measured on Computed Tomography for Overall Survival in Patients with Non-Metastatic Breast Cancer

Affiliations
  • 1Department of Radiology, Ajou University School of Medicine, Suwon, Korea. h219435@gmail.com
  • 2Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea.
  • 3Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea.
  • 4Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
  • 5Department of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Suwon, Korea.

Abstract

PURPOSE
The purpose of this study was to evaluate the prognostic value of skeletal muscle depletion measured on computed tomography (CT) in patients with non-metastatic invasive breast cancer.
METHODS
This retrospective study included 577 consecutive women (mean age ± standard deviation: 48.9 ± 10.2 years with breast cancer who underwent a preoperative positron-emission tomography (PET)/CT scan and curative surgery between January 2012 and August 2014. The total abdominal muscle area (TAMA), subcutaneous fat area (SFA), and visceral fat area (VFA) were measured on CT images at the L3 vertebral level. Univariate and multivariate Cox proportional-hazard regression analyses were performed to evaluate whether there was an association between sarcopenia and overall survival (OS) outcome.
RESULTS
Of the 577 women, 49 (8.5%) died after a mean of 46 months. The best TAMA threshold for predicting OS was 83.7 cm². The multivariate Cox proportional-hazard analysis revealed that sarcopenia (TAMA ≤ 83.70 cm²) was a strong prognostic biomarker (hazard ratio [HR], 1.951; 95% confidence interval [CI], 1.061-3.586), along with large tumor size, axillary lymph node metastasis, high nuclear grade, estrogen receptor status, and adjuvant radiation therapy. In the subgroup analysis of patients aged ≥ 50 years, TAMA (≤ 77.14 cm²) was a significant independent factor (HR, 2.856; 95% CI, 1.218-6.695).
CONCLUSION
Skeletal muscle depletion measured on CT was associated with worse OS outcome in patients with non-metastatic breast cancer.

Keyword

Breast; Carcinoma; Sarcopenia; Survival

MeSH Terms

Abdominal Muscles
Breast Neoplasms*
Breast*
Estrogens
Female
Humans
Intra-Abdominal Fat
Lymph Nodes
Muscle, Skeletal*
Neoplasm Metastasis
Positron-Emission Tomography
Retrospective Studies
Sarcopenia
Subcutaneous Fat
Estrogens
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