Myosteatosis at diagnosis is adversely associated with 2-year survival in women with estrogen receptor-negative metastatic breast cancer

Patricia Sheean*, Sandra Gomez-Perez, Cara Joyce, Paula O’Connor, Monica Bojko, Amber Smith, Vasilios Vasilopoulos, Ruta Rao, Joy Sclamberg, Patricia Robinson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Purpose: To examine the relationship between skeletal muscle (SM) and cancer-specific outcomes for women with estrogen receptor-negative (ER−) metastatic breast cancer (MBC). Methods: For this retrospective cohort, females (≥ 18 years) with histologically confirmed ER− MBC and computerized tomography (CT) imaging were screened. Demographic, anthropometric, and clinical data were collected uniformly from the electronic medical record. CT images inclusive of the third lumbar region (L3) at diagnosis, 6 and 12 months, were used to classify sarcopenia (≤ 41 cm2/m2) and myosteatosis (< 41 or 33 Hounsfield Units, adjusted for body mass index (BMI)) and to evaluate changes in SM and total adipose tissue (TAT) over time. Kaplan–Meier curves, Cox Proportional Hazards (PH), and restricted mean survival time (RMST) estimates were generated to examine the relationship between sarcopenia and myosteatosis and time to tumor progression (TTP), treatment toxicity and 2-year survival, adjusting for covariates. Results: Participants were 58.0 (15.0) years of age, ethnically diverse (55% non-Hispanic white, 31% Black, 11% Hispanic), post-menopausal (73%, n = 111), and classified as overweight (BMI 29.4 (7.6)). At diagnosis, 40% (n = 61) were sarcopenic, 49% had myosteatosis, and 28% (n = 42) had both. While Cox PH modeling and RMST analysis reveal no significant relationship between sarcopenia at diagnosis and 2-year survival (RMST difference − 1.6 (1.4) months, HR 1.35 (0.88–2.08)), these analyses support a significant, adverse association between myosteatosis at diagnosis and 2-year survival (RMST difference − 2.4 (1.5) months, HR 1.72 (1.09–2.72)). Incident sarcopenia was 11% (n = 5/45) and 2.5% (n = 1/40), respectively, while incident myosteatosis was 19% (n = 8/42) and 15% (n = 5/34) at 6 and 12 months, respectively. TTP and treatment toxicities did not appear to be related to diagnostic SM or body composition changes over time. Conclusion: Targeted interventions initiated within the first year of diagnosis to preserve or improve SM quality seem warranted for women with ER−MBC.

Original languageEnglish (US)
Pages (from-to)121-132
Number of pages12
JournalBreast Cancer Research and Treatment
Volume190
Issue number1
DOIs
StatePublished - Nov 2021

Keywords

  • Epidemiology
  • Metastatic breast cancer
  • Myosteatosis
  • Sarcopenia
  • Skeletal muscle

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Fingerprint

Dive into the research topics of 'Myosteatosis at diagnosis is adversely associated with 2-year survival in women with estrogen receptor-negative metastatic breast cancer'. Together they form a unique fingerprint.

Cite this