# Factors associated with clinical outcomes of breast cancer based on glucose metabolic activity of subcutaneous adipose tissue

## TL;DR

This study shows that glucose metabolic activity in subcutaneous fat is linked to worse outcomes in breast cancer patients.

## Contribution

The study introduces SUVmean_SAT as a novel independent prognostic factor for breast cancer progression.

## Key findings

- SUVmean_SAT and AJCC stage are significant independent prognostic factors for breast cancer.
- Combining SUVmean_SAT with AJCC stage improves predictive accuracy for progression-free survival.
- High SUVmean_SAT is associated with increased risk of cancer progression.

## Abstract

Obesity increases the risk of breast cancer, with dysfunctional metabolic activity in subcutaneous adipose tissue (SAT) implicated as a key underlying mechanism. This study sought to explore the correlation between SAT metabolic activity and clinical prognosis among patients with breast cancer.

Body composition parameters at the level of the third lumbar vertebra and clinicopathological data from 74 patients with breast cancer were collected. Two Cox models were established using the least absolute shrinkage and selection operator (LASSO) for variable selection. The two models were compared using the time-dependent area under the receiver operating characteristic curve (AUC) and the net reclassification index (NRI). Furthermore, the confounding effects on the association among the mean standard uptake value of subcutaneous adipose tissue (SUVmean_SAT), American Joint Committee on Cancer (AJCC) stage, and progression status in patients with breast cancer were assessed.

Twenty-five out of 74 patients experienced recurrence during a median follow-up of 18 months. AJCC stage (p < 0.001) and SUVmean_SAT (p = 0.001) were significant independent prognostic factors. The AUC value and NRI of the combined Cox model (SUVmean_SAT plus AJCC stage) were higher than those of the Cox model based on AJCC stage alone. In addition, changes in the effect estimates showed a 12.2% decrease in hazard ratios when SUVmean_SAT was added to the AJCC stage model. High SUVmean_SAT was significantly associated with an increased risk of progression-free survival in patients with breast cancer.

A comprehensive assessment incorporating both SUVmean_SAT and AJCC stage may enhance understanding of the impact of adiposity on breast cancer prognosis.