Association between preoperative body composition and health-related quality of life in breast cancer patients: a prospective Eastern European study

PURPOSE: The rising proportion of patients diagnosed with early-stage breast cancer (BC) has shifted the focus of oncological care toward patient-reported outcomes (PROs) as an important component of treatment evaluation. Nevertheless, data on the association between body composition and BC-specific PROs remain scarce and mainly retrospective. This study aimed to evaluate the association between preoperative bioelectrical impedance analysis (BIA) parameters and BC-specific PROs measured using the EORTC QLQ-BR23. METHODS: This prospective study included 81 patients with histologically confirmed BC qualified for surgical treatment. Body composition was assessed preoperatively using multi-frequency BIA. BC-specific PROs was evaluated using the EORTC QLQ-BR23 questionnaires. Statistical analysis included the Mann-Whitney U test and Kruskal-Wallis ANOVA for group comparisons and Spearman's rank correlation coefficient to assess associations between variables. RESULTS: Significant associations were observed between selected BIA parameters and PROs in BC patients. Higher phase angle and reactance values were positively correlated with body image, whereas higher lower-limb fat-free mass percentage and elevated TBW/FFM ratios were associated with poorer sexual functioning and enjoyment. In addition, body composition parameters differed across molecular subtypes with HER2-positive patients demonstrating lower values of total body water, fat-free mass, skeletal muscle mass and basal metabolic rate. CONCLUSION: These findings support the clinical utility of BIA as a complementary tool for personalized assessment linking physiological status with tumor characteristics and PROs.