Abstract
The purpose of this study was to evaluate the prognostic significance of computed tomography (CT)-attenuation of tumor-adjacent breast adipose tissue for predicting recurrence-free survival (RFS) in patients with breast cancer. We retrospectively enrolled 287 breast cancer patients who underwent pretreatment 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT. From non-contrast-enhanced CT images of PET/CT, CT-attenuation values of tumor-adjacent breast adipose tissue (TAT HU) and contralateral breast adipose tissue (CAT HU) were measured. Difference (HU difference) and percent difference (HU difference %) in CT-attenuation values between TAT HU and CAT HU were calculated. The relationships of these breast adipose tissue parameters with tumor factors and RFS were assessed. TAT HU was significantly higher than CAT HU (p < 0.001). TAT HU, HU difference, and HU difference % showed significant correlations with T stage and estrogen receptor and progesterone receptor status (p < 0.05), whereas CAT HU had no significant relationships with tumor factors (p > 0.05). Patients with high TAT HU, HU difference, and HU difference % had significantly worse RFS than those with low values (p < 0.001). In multivariate analysis, TAT HU and HU difference % were significantly associated with RFS after adjusting for clinico-pathologic factors (p < 0.05). CT-attenuation of tumor-adjacent breast adipose tissue was significantly associated with RFS in patients with breast cancer. The findings seem to support the close contact between breast cancer cells and tumor-adjacent adipocytes observed with imaging studies.
Highlights
Adipose tissue is one of the major components of the human body, found all around the body [1].In non-lactating human breast tissue, up to 56% of the total breast volume consists of adipose tissue [2]. adipose tissue is mainly composed of adipocytes, it is comprised of various other kinds of cell types including immune cells, endothelial cells, pre-adipocytes, and fibroblasts [1,3]
Adipose tissue is mainly composed of adipocytes, it is comprised of various other kinds of cell types including immune cells, endothelial cells, pre-adipocytes, and fibroblasts [1,3]
Adipose tissue was considered to function as a simple storage organ of excessive energy; evidence showed that adipose tissue function as an endocrine organ secreting hundreds of cell signaling proteins, called adipokines [4]
Summary
Adipose tissue is one of the major components of the human body, found all around the body [1].In non-lactating human breast tissue, up to 56% of the total breast volume consists of adipose tissue [2]. adipose tissue is mainly composed of adipocytes, it is comprised of various other kinds of cell types including immune cells, endothelial cells, pre-adipocytes, and fibroblasts [1,3]. Adipose tissue was considered to function as a simple storage organ of excessive energy; evidence showed that adipose tissue function as an endocrine organ secreting hundreds of cell signaling proteins, called adipokines [4]. Cancers 2019, 11, 1135 continuously demonstrated that adipose tissue could play a role in cancer growth, progression, and metastasis by secreting multiple kinds of adipokines, inducing inflammatory micro-environment, remodeling the extracellular matrix, and providing energy to tumor cells [1,3,5]. In previous cell-culture and histopathological studies of breast cancer, it has already been proven that breast cancer cells have active interaction with peritumoral adipose tissue, which further enhances aggressiveness and invasiveness of breast cancer cells [1,3,7,8,9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
