Longitudinal pericardial adipose tissue changes in patients with breast cancer receiving anthracycline-based chemotherapy: a retrospective cohort study

Background: Pericardial adipose tissue (PAT) has been associated with adverse cardiac events. In this study, we evaluated changes of PAT in patients with breast cancer during and after anthracycline-based chemotherapy and explored the clinical variables associated with increases in PAT volume at the completion of chemotherapy. Methods: A total of 278 breast cancer patients who were receiving anthracycline-based chemotherapy were retrospectively enrolled. Their PAT volumes were measured using non-contrast chest computed tomography (CT) images from a dedicated workstation. We compared these volumes to their measurements at baseline, during different chemotherapy cycles, at and after chemotherapy completion. We identified the clinical variables associated with increases in PAT volume at chemotherapy completion using logistic regression analyses. Results: At the completion of chemotherapy, PAT volumes were shown to have increased compared to baseline measurements (87.67±45.09 vs. 104.25±47.74 cm3; P=0.00). After 4, 6, and 8 chemotherapy cycles, PAT volumes increased from the baseline measurement by 9.48% [95% confidence interval (CI): −2.30% to 21.27%], 14.75% (95% CI: 4.68% to 24.82%), and 20.02% (95% CI: 11.38% to 28.66%), respectively. Compared to volumes measured at chemotherapy completion (104.25±47.74 cm3), PAT volumes at 6 and 12 months after chemotherapy completion were 105.23±49.27 and 107.56±46.34 cm3, respectively. The differences between chemotherapy completion and follow-up PAT volumes were not statistically significant. A variable associated with an increase in PAT from baseline to chemotherapy completion was the number of chemotherapy cycles (8 vs. 4) [odds ratio (OR) =3.850; 95% CI: 1.751 to 8.488]. Conclusions: Patients with breast cancer who undergo anthracycline-based chemotherapy can experience unfavorable PAT volume increases, which are maintained after the completion of treatment. Patients at risk of increases in PAT volume at chemotherapy completion can be identified based on clinical risk factors and targeted for interventions.