Breast Cancer Research and Treatment

, Volume 167, Issue 3, pp 821–821 | Cite as

Dose adjustment in obese breast cancer patients receiving neoadjuvant chemotherapy might have an impact on survival

  • Kadri Altundag
Letter to the Editor

To the Editor,

I wish to congratulate Liu and colleagues for their article [1] in which they tried to find out an association between obesity and survival in the neoadjuvant breast cancer receiving adriamycin/taxane-based chemotherapy. They reported that obesity may negatively impact survival, with differences among tumor subtypes. However, the authors did not report about the adjustment of the chemotherapy dose to the patients’ exact body surface area (BSA) values. Karatas et al. recently reported that obesity had an adverse effect on pathological complete response (pCR) among women with neoadjuvant chemotherapy (NAC) [2]. However, study by Karatas et al. did not uniformly adjust the dose to the patients’ exact BSA values, limiting them at a lower level of 2 m2 to prevent side effects. Contrary to Karatas et al. study, Farr et al. found that obese women receiving full uncapped doses of anthracycline-taxane-based NAC have increased pCR and favorable progression-free survival. They concluded that this could result from increased dose intensity with increased efficacy and toxicity [3]. Taken all together, dose adjustment in obese breast cancer patients receiving NAC might have an impact on survival.


Compliance with ethical standards

Conflict of interest

I have no conflict of interest to declare.

Ethical approval

My manuscript complies with the Ethical Rules applicable for this journal. This article does not contain any studies with human participants or animals performed by any of the authors.


  1. 1.
    Liu YL, Saraf A, Catanese B, Lee SM, Zhang Y, Connolly EP, Kalinsky K (2017) Obesity and survival in the neoadjuvant breast cancer setting: role of tumor subtype in an ethnically diverse population. Breast Cancer Res Treat. doi: 10.1007/s10549-017-4507-y Google Scholar
  2. 2.
    Karatas F, Erdem GU, Sahin S, Aytekin A, Yuce D, Sever AR, Babacan T, Ates O, Ozisik Y, Altundag K (2017) Obesity is an independent prognostic factor of decreased pathological complete response to neoadjuvant chemotherapy in breast cancer patients. Breast 32:237–244. doi: 10.1016/j.breast.2016.05.013 Epub 2016 Jun 16 CrossRefPubMedGoogle Scholar
  3. 3.
    Farr A, Stolz M, Baumann L, Bago-Horvath Z, Oppolzer E, Pfeiler G, Seifert M, Singer CF (2017) The effect of obesity on pathological complete response and survival in breast cancer patients receiving uncapped doses of neoadjuvant anthracycline-taxane-based chemotherapy. Breast 33:153–158. doi: 10.1016/j.breast.2017.04.001 Epub 2017 Apr 7 CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.MKA Breast Cancer ClinicTepe PrimeCankayaTurkey

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