ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
Factors associated with clinical outcomes of breast cancer based on glucose metabolic activity of subcutaneous adipose tissue
Provisionally accepted
Jinci Mai1
Huanhua Wu2
Wanwan Wu1Jinjun Zhou1Yuee Wu1Xiaobei Duan1Rizhao Wu1
Youzhu Hu2Zuowu Zhen1*
Binhao Huang1*- 1Jiangmen Central Hospital, Jiangmen, China
- 2The Affiliated Shunde Hospital of Jinan University, Foshan, China
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Background: Obesity increases the risk of breast cancer, with dysfunctional metabolic activity in subcutaneous adipose tissue (SAT) implicated as a key underlying mechanism. Our study sought to explore the correlation between SAT metabolic activities and clinical prognosis among breast cancer patients. Methods: The body composition parameters and clinicopathological data of the third lumbar vertebra of 74 patients with breast cancer were collected. Two COX models are established using the least absolute shrinkage and selection operator (LASSO) for variable selection. Then, compared the two models via time-dependent area under the receiver operating characteristic curve (AUC) and the net reclassification index (NRI). Furthermore, we assessed the confounding effect for the association between the mean of standard uptake value of subcutaneous adipose tissue (SUVmean_SAT), AJCC stage and progression status of patients with breast cancer. Results: Twenty-five out of 74 patients experienced a recurrence during the median 18-month follow-up. 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) was higher than that of the individual AJCC stage Cox model. Finally, the changes in effect estimate showed the 12.2% decreasing in the hazard ratios when SUVmean_SAT was added to the individual AJCC stage model. High SUVmean_SAT demonstrated a significant correlation with a heightened risk of progression-free survival in patients with breast cancer. Conclusions: A comprehensive assessment incorporating both SUVmean_SAT and AJCC stage could enhance insights into the impact of adiposity on breast cancer prognosis.
Keywords: breast cancer, positron emission tomography (PET), prognosis, subcutaneous adipose tissue, visceral adipose tissue
Received: 10 Oct 2025; Accepted: 06 Feb 2026.
Copyright: © 2026 Mai, Wu, Wu, Zhou, Wu, Duan, Wu, Hu, Zhen and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zuowu Zhen
Binhao Huang
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