• Ilaria Trestini, Alberto Caldart, Marco Cintoni, Isabella Sperduti, Alessandro Drudi, Gregorio Aluffi, Elena Fiorio, Veronica Parolin, Valentina Zambonin, Sara Zanelli, Daniela Tregnago, Alice Avancini, Sara Pilotto, Irene Aprili, Emanuela Zandonà, Mirko D'Onofrio, Maria Cristina Mele, Antonio Gasbarrini, Giovanni Scambia, Giampaolo Tortora, Michele Milella, Emilio Bria, and Luisa Carbognin.
• Dietetic Service, Medical Direction, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy. Electronic address: ilaria.trestini@aovr.veneto.it.
• Nutrition. 2023 Jan 1; 105: 111858111858.

ObjectivesExcess adiposity is associated with several factors involved in carcinogenesis and breast cancer progression. Evidence supporting the role of body composition in breast cancer treatment is promising, but still scanty and mainly focused on adjuvant treatment. The aim of this study was to evaluate the changes in body composition during neoadjuvant chemotherapy and its association with pathologic complete response and survival outcome in patients treated for operable/locally advanced breast cancer.MethodsA retrospective review of patients with breast cancer treated with neoadjuvant chemotherapy was performed in the Oncology Section of the Department of Medicine, University of Verona between 2014 and 2019. Body composition was evaluated from clinically acquired computed tomography scans at diagnosis and after neoadjuvant chemotherapy. Descriptive statistic was adopted. The associations of body composition measures with pathologic complete response and disease-free survival were analyzed. Kaplan-Meier curves were compared with log-rank analysis.ResultsData from 93 patients were collected. After neoadjuvant chemotherapy, the adipose compound changed significantly across all body mass index categories. Body composition parameters had no significant effect on pathologic complete response. Survival analysis showed that a high gain of visceral adipose tissue during neoadjuvant chemotherapy was associated with shorter disease-free survival (hazard ratio, 10.2; P = 0.026). In particular, disease-free survival was significantly worse in patients who gained ≥10% of visceral adipose tissue compared with patients who gained <10% of visceral adipose tissue (5-y disease-free survival 71.4 versus 96.3, P = 0.009, respectively).ConclusionsOur results indicated that neoadjuvant chemotherapy significantly affects body composition, which seems to have an effect on survival outcome of breast cancer, highlighting the relevance of the body composition assessment when estimating treatment outcomes.Copyright © 2022 Elsevier Inc. All rights reserved.

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