Effect of Obesity at the Pathologic Response to Neoadjuvant Chemotherapy Among Premenopausal Tunisian Women With Breast Cancer

Abstract

In this article, we evaluated BMI and response to neoadjuvant chemotherapy (NC) in premenopausal Tunisian women with operable breast cancer. From May 2006 to July 2009, 800 patients were diagnosed and received NC from CHU Farhat Hached (Sousse, Tunisia). Patients were categorized as obese (BMI >/=30 kg/m(2)), overweight (25 </= BMI < 30 kg/m(2)), or normal/underweight (BMI <25 kg/m(2)). Logistic regression was used to examine associations between BMI and pathologic complete response (pCR). Breast cancer-specific, progression-free, and overall survival times were examined using the Kaplan-Meier method and Cox proportional hazards regression analysis. Median age was 42 years; 27% of patients were obese, 25% were overweight, and 48% were normal or underweight. In the univariate model, there was a significant difference in pCR to NC for obese compared with normal/underweight patients. In multivariate analysis, there was no significant difference in pCR for obese compared to normal weight patients. Overweight and the combination of overweight and obese patients were significantly less likely to have a pCR (odds ratio (OR) = 0.59; 95% confidence interval (CI), 0.37-0.95; and OR = 0.67; 95% CI, 0.45-0.99, respectively). Higher BMI was associated with worse pCR to NC. So, its association with worse overall survival suggests that greater attention should be focused on this risk factor to optimize the care of breast cancer patients.