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Association between thoracic adiposity and survival in non-metastatic breast cancer.

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Titel: Association between thoracic adiposity and survival in non-metastatic breast cancer.
Autoren: Cao A; Kaiser Permanente Division of Research, Kaiser Permanente Northern California, 4480 Hacienda Dr., Pleasanton, CA, 94588, USA., Fumagalli IA; Kaiser Permanente Division of Research, Kaiser Permanente Northern California, 4480 Hacienda Dr., Pleasanton, CA, 94588, USA., Chen WY; Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA., Llanos AAM; Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA.; Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA., Quesenberry CP; Kaiser Permanente Division of Research, Kaiser Permanente Northern California, 4480 Hacienda Dr., Pleasanton, CA, 94588, USA., Caan BJ; Kaiser Permanente Division of Research, Kaiser Permanente Northern California, 4480 Hacienda Dr., Pleasanton, CA, 94588, USA., Cespedes Feliciano EM; Kaiser Permanente Division of Research, Kaiser Permanente Northern California, 4480 Hacienda Dr., Pleasanton, CA, 94588, USA. elizabeth.m.cespedes@kp.org.
Quelle: Breast cancer research : BCR [Breast Cancer Res] 2025 Oct 14; Vol. 27 (1), pp. 176. Date of Electronic Publication: 2025 Oct 14.
Publikationsart: Journal Article
Sprache: English
Info zur Zeitschrift: Publisher: BioMed Central Ltd Country of Publication: England NLM ID: 100927353 Publication Model: Electronic Cited Medium: Internet ISSN: 1465-542X (Electronic) Linking ISSN: 14655411 NLM ISO Abbreviation: Breast Cancer Res Subsets: MEDLINE
Imprint Name(s): Publication: London, UK : BioMed Central Ltd
Original Publication: London, UK : Current Science, c1999-
MeSH-Schlagworte: Breast Neoplasms*/mortality , Breast Neoplasms*/pathology , Adiposity* , Thoracic Vertebrae*/diagnostic imaging , Thoracic Vertebrae*/pathology, Humans ; Female ; Middle Aged ; Adult ; Aged ; Aged, 80 and over ; Tomography, X-Ray Computed ; Young Adult ; Body Mass Index ; Adolescent ; Lumbar Vertebrae/diagnostic imaging ; Prognosis ; Follow-Up Studies
Abstract: Competing Interests: Declarations. Competing interests: All authors declare no financial or non-financial competing interests.
Background: Total adiposity measured by abdominal computed tomography (CT) at the third lumbar vertebrae (L3) has been associated with breast cancer survival, but most patients undergo chest CT. If adipose tissues at the thoracic level, including those surrounding the thoracic organs, are associated with survival, they could be used to inform care for significantly more breast cancer patients.
Methods: We included 2127 individuals aged 18-< 90, diagnosed with stage II-III breast cancer at Kaiser Permanente Northern California (2005-2019). Cross-sectional areas of adiposity were quantified at the fourth thoracic vertebrae (T4) and L3. Using multivariable Cox models, we estimated hazard ratios (HRs) and 95% confidence intervals to compare the strength of association of T4-level versus L3-level adiposity with all-cause and cause-specific mortality.
Results: Participants were on average 56.2 years old at diagnosis. During an average follow-up of 8.2 years, 593 deaths occurred, with 100 from heart disease and 429 from breast cancer. Positive, moderate-to-strong correlations were observed between adiposity at T4 and L3. After adjusting for covariates including body mass index and muscle, higher intrathoracic and intermuscular adiposity at T4 were associated with increased all-cause (intrathoracic: HR = 1.35[1.06-1.72]; intermuscular: HR = 1.26[1.01-1.59]) and heart disease-specific mortality (intrathoracic: HR = 2.23[1.31-3.78]; intermuscular: HR = 2.25[1.37-3.68]). Greater subcutaneous adiposity at T4 showed a non-significant trend toward increased mortality (overall: HR = 1.24[0.95-1.61]; breast cancer-specific: 1.27[0.93-1.73]). These associations were not observed at L3.
Conclusions: Despite strong correlations with L3, adiposity at T4 was significantly associated with overall and heart disease-specific mortality, while measurements at L3 were not, possibly due to the proximity of T4 to the breast tumor and heart.
(© 2025. The Author(s).)
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Grant Information: PF-24-1192552-01-CTPS American Cancer Society; R01 CA277862 United States CA NCI NIH HHS; R01CA251589 United States CA NCI NIH HHS; R01CA277862 United States CA NCI NIH HHS; R01 CA251589 United States CA NCI NIH HHS
Contributed Indexing: Keywords: Body composition; Breast cancer; Cancer survival; Chest CT
Entry Date(s): Date Created: 20251015 Date Completed: 20251015 Latest Revision: 20251018
Update Code: 20251018
PubMed Central ID: PMC12523217
DOI: 10.1186/s13058-025-02127-1
PMID: 41088394
Datenbank: MEDLINE
Beschreibung
Abstract:Competing Interests: Declarations. Competing interests: All authors declare no financial or non-financial competing interests.<br />Background: Total adiposity measured by abdominal computed tomography (CT) at the third lumbar vertebrae (L3) has been associated with breast cancer survival, but most patients undergo chest CT. If adipose tissues at the thoracic level, including those surrounding the thoracic organs, are associated with survival, they could be used to inform care for significantly more breast cancer patients.<br />Methods: We included 2127 individuals aged 18-&lt; 90, diagnosed with stage II-III breast cancer at Kaiser Permanente Northern California (2005-2019). Cross-sectional areas of adiposity were quantified at the fourth thoracic vertebrae (T4) and L3. Using multivariable Cox models, we estimated hazard ratios (HRs) and 95% confidence intervals to compare the strength of association of T4-level versus L3-level adiposity with all-cause and cause-specific mortality.<br />Results: Participants were on average 56.2 years old at diagnosis. During an average follow-up of 8.2 years, 593 deaths occurred, with 100 from heart disease and 429 from breast cancer. Positive, moderate-to-strong correlations were observed between adiposity at T4 and L3. After adjusting for covariates including body mass index and muscle, higher intrathoracic and intermuscular adiposity at T4 were associated with increased all-cause (intrathoracic: HR = 1.35[1.06-1.72]; intermuscular: HR = 1.26[1.01-1.59]) and heart disease-specific mortality (intrathoracic: HR = 2.23[1.31-3.78]; intermuscular: HR = 2.25[1.37-3.68]). Greater subcutaneous adiposity at T4 showed a non-significant trend toward increased mortality (overall: HR = 1.24[0.95-1.61]; breast cancer-specific: 1.27[0.93-1.73]). These associations were not observed at L3.<br />Conclusions: Despite strong correlations with L3, adiposity at T4 was significantly associated with overall and heart disease-specific mortality, while measurements at L3 were not, possibly due to the proximity of T4 to the breast tumor and heart.<br /> (© 2025. The Author(s).)
ISSN:1465-542X
DOI:10.1186/s13058-025-02127-1