Postgraduate Program in Health Sciences, Health Sciences Centre, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil.
Postgraduate Program in Nutrition, Department of Nutrition, Federal University of Pernambuco, Recife 50670-901, Brazil.
Nutrients. 2024 Sep 19;16(18):3175. doi: 10.3390/nu16183175.
/ Increasing evidence indicates that body composition can significantly influence prognosis in women with breast cancer. However, alterations in body composition, particularly among young women (<40 years), remain largely unknown and underexplored. This study aimed to investigate the relationship of computed tomography (CT)-derived body composition with mortality rates among young women recently diagnosed with breast cancer, identifying the best-correlated cutoff value. This is a bi-set cohort study with retrospective data collection. Women newly diagnosed with ductal invasive breast cancer, aged 20 to 40 years, treated in reference oncology units were included. Body composition was assessed using CT scans at the third lumbar vertebra (L3) level, including muscle and adipose compartments. The outcome of interest was the incidence of overall mortality. A maximally selected log-rank Cox-derived analysis was employed to assess the cutoffs associated with mortality. A total of 192 women were included before any form of treatment (median age of 35 years, IQ range: 31-37). Overall mortality occurred in 12% of the females. Stages III-IV were the most frequent (69.5%). Patients who died had a significantly lower muscle area index. CT-derived muscle area was inversely associated with mortality. Each 1 cm/m decrease in skeletal muscle index increased the mortality hazard by 9%. Higher values of adiposity compartments were independently associated with higher mortality. Our study highlights the predictive significance of skeletal muscle area and adipose tissue in predicting survival among young women recently diagnosed with breast cancer.
越来越多的证据表明，身体成分可以显著影响乳腺癌女性的预后。然而，身体成分的改变，尤其是在年轻女性（<40 岁）中，仍然很大程度上未知和未被充分探索。本研究旨在调查 CT 衍生的身体成分与近期被诊断为乳腺癌的年轻女性死亡率之间的关系，确定最佳相关的截断值。
这是一项具有回顾性数据收集的双队列研究。纳入在参考肿瘤学单位接受治疗的年龄在 20 至 40 岁之间、被诊断为导管浸润性乳腺癌的女性。使用第 3 腰椎（L3）水平的 CT 扫描评估身体成分，包括肌肉和脂肪成分。主要终点是全因死亡率的发生率。采用最大选择对数秩 Cox 衍生分析来评估与死亡率相关的截断值。
在任何治疗形式之前，共纳入 192 名女性（中位年龄为 35 岁，IQR 范围：31-37）。12%的女性发生了全因死亡。III-IV 期是最常见的（69.5%）。死亡患者的肌肉面积指数显著较低。CT 衍生的肌肉面积与死亡率呈负相关。骨骼肌指数每减少 1 cm/m，死亡风险增加 9%。脂肪组织体积的较高值与较高的死亡率独立相关。
我们的研究强调了骨骼肌面积和脂肪组织在预测近期被诊断为乳腺癌的年轻女性生存方面的预测意义。
