Health-Related quality of life by 31-item Cervantes scale in breast cancer survivors undergoing adjuvant endocrine therapy

ABSTRACT Introduction Instruments to manage adverse effects of endocrine therapy with Aromatase inhibitors (AI) may improve adherence and persistence to treatment and Health-Related Quality of Life (HRQL). The 31-item Cervantes Scale (CS-31) is an HRQL questionnaire with particularities of the perimenopausal and postmenopausal period that could be an appropriate instrument to assess HRQL in Breast Cancer (BC) survivors. Objective This study aimed to perform additional validation of the CS-31 for BC survivors undergoing adjuvant endocrine therapy. Methods This prospective study was performed at three time points named T0, T1, and T2: initial, intermediate, and final follow-up period, respectively, totaling 24 months of follow-up. At each time point, the participants completed the CS-31, Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F), and Hospital Anxiety and Depression Scale (HADS). The internal consistency, construct validity, responsiveness analyses, and known-group validity of CS-31 were evaluated. Results This study included 89 postmenopausal women diagnosed with hormone receptor-positive early BC in adjuvant endocrine therapy with AI. The internal consistency was good (Cronbach's alpha = 0.89). Construct validity received a positive rating, with 100% of results consistent with prior hypotheses. A prospective improvement in HRQL was identified for the CS-31 Global Score and FACIT-F Total Score and for most of their domains. Furthermore, women with anxiety and depression by HADS presented worse HRQL by CS-31. Conclusion The authors identified that the CS-31 seems to be appropriate for use in oncology medical routine and may help to monitor adverse effects and HRQL of BC survivors during adjuvant endocrine therapy.

Relationship between food perceptions and health-related quality of life in a prospective study with breast cancer patients undergoing chemotherapy

OBJECTIVE: To correlate the perceptions related to dietary intake with the domains and subscales of health-related quality of life (HRQL) in women with breast neoplasms receiving chemotherapy. METHODS: In this prospective study, 55 women with breast cancer were followed up during chemotherapy at three different times (T0, T1, T2). Before chemotherapy, perceptions related to food consumption were evaluated. HRQL was analyzed with the EORTC QLQ-C30 and Br23 instruments 21 days after each investigated cycle. The differences (T2-T0) in the subscales and HRQL domains were correlated with the differences (T2-T0) in the appetite scores. Spearman's correlation was used to verify a possible correlation between differences in functional and overall HRQL domains (T2-T0) and differences in appetite scores for certain foods and between the differences in some subscales of EORTC QLQ-C30 and Br23 (T2-T0) and differences in appetite scores for certain food groups (T2-T0). RESULTS: Correlations between pain and appetite for bitter taste and between an increased appetite for juices and pain intensification or fatigue were identified, and pain was correlated with an appetite for starchy foods. An appetite for vegetables, legumes and meat/eggs was correlated with physical function. The only significant correlation with social functions occurred between the appetite for sweet foods and these functions. We found a correlation between overall health, emotional function, social function and physical function and the appetite for juices. CONCLUSION: Chemotherapy alters the individual's relationship with food and, consequently, the individual's HRQL.

Consumo alimentar e estado nutricional de mulheres em quimioterapia / Food intake and the nutritional status of women undergoing chemotherapy

Resumo O objetivo deste estudo foi analisar o consumo alimentar e o estado nutricional de mulheres com câncer de mama (CM) em quimioterapia (QT). A avaliação dietética quantitativa foi realizada de acordo com as Dietary Reference Intakes (DRI) e a avaliação qualitativa pelo Índice de Qualidade da Dieta Revisado (IQD-R). Dentre o total de pacientes (n = 20), 60% (n = 12) apresentaram circunferência da cintura igual ou superior a 88 cm. Foi verificado 75% (n = 15) de indivíduos com excesso de peso. A média da ingestão de cálcio, cobre, ferro, fibra alimentar, magnésio, potássio, vitamina A, niacina, vitamina B6 e zinco encontrava-se abaixo da recomendação de ingestão adequada e o consumo de vitamina C, fósforo, manganês, sódio e tiamina encontrava-se acima. Quanto à análise do IQD-R, 80% (n = 16) das pacientes apresentaram uma “dieta que requer modificações”, enquanto que 20% (n = 4) apresentaram uma “dieta saudável”. Observou-se elevado excesso de peso, desequilíbrio na ingestão de micronutrientes e dieta que necessita melhorias. Dessa forma, a criação e a utilização de um protocolo de intervenção nutricional são de grande relevância para melhorar a dieta de pacientes com CM que realizam QT.

Abstract The objective behind this study was the analysis of food intake and the nutritional status of women with breast cancer (BC) undergoing chemotherapy (CT). The quantitative dietary evaluation was performed in accordance with Dietary Reference Intakes (DRI), whereas the qualitative evaluation was performed through the Brazilian Healthy Eating Index – Revised (BHEI-R).From among the total number of patients (n = 20), 60% (n = 12) presented waist circumference, equal to or higher than 88cm. It was noted that 75% (n = 15) individuals were overweight. The average intake for calcium, copper, iron, dietary fiber, magnesium, potassium, vitamin A, niacin, vitamin B6 and zinc, were found to be below adequate intake levels, while the intake of vitamin C, phosphorus, manganese, sodium and thiamine were all found to be above DRIs recommendations. As for the analysis of the BHEI-R, 80% (n = 16) of the patients presented a “diet that needs modifications”, while 20% (n = 4) presented a “healthy diet”. Noted from these observations was the presence of a high overweight rate, a discrepancy in the intake of micronutrients and a diet that needed improvements. In this manner, the establishment and use of a nutritional intervention protocol are very important when it comes to the improvement of the diet in patients with BC and who are undergoing CT.

Caracterização sociodemográfica, nutricional e dietética de mulheres com câncer de mama atendidas em hospital público de Minas Gerais / Sociodemographic, nutritional and dietary characteristics of women with breast cancer treated at a public hospital in Minas Gerais state, Brazil

OBJECTIVE: To analyze the sociodemographic, dietary and nutritional profile of women with breast cancer. Data Source: A case-control study was conducted in a public hospital in Minas Gerais state involving 43 women with breast cancer and a control group of 78 women. Sociodemographic, anthropometric and dietary analyses were carried out. Diet quality was measured by the Healthy Eating Index adapted for the Brazilian population. Data between groups were compared using the Chi-square and Fisher tests. Student ́s ttest and Mann-Whitney U test were used to compare the diet quality between the women with breast cancer and those of the control group. DATA SYNTHESIS: Most of the women with breast cancer had low educational level, lower socioeconomic status, higher frequency of overweight, and diet quality classified as needing improvement. In relation to food intake, the women with breast cancer consumed a higher amount of dairy products compared with those of the control group. CONCLUSIONS: The women with breast cancer were classified as of lower socioeconomic level, overweight, and with diet requiring improvements. Studies on breast cancer should investigate such characteristics because this is a disease of multifactorial origin which presents several risk factors

OBJETIVO: Caracterizar o perfil sociodemográfico, nutricional e dietético de mulheres com câncer de mama. MÉTODOS: Trata-se de um estudo caso-controle realizado em hospital público de Minas Gerais com 43 mulheres com câncer de mama e 78 mulheres do grupo controle. Foram realizadas as análises sociodemográficas, antropométricas e dietéticas. A qualidade da dieta foi medida pelo Índice de Alimentação Saudável adaptado para a população brasileira. Realizaram-se os testes Qui-quadrado e Exato de Fisher para comparar as variáveis entre os grupos e os testes t-Student e U-Mann-Whitney na comparação da qualidade da dieta entre o grupo de mulheres com câncer de mama e grupo controle. Resultados: A maior parte das mulheres com câncer de mama apresentou baixa escolaridade, pior condição socioeconômica, maior frequência de excesso de peso e qualidade da dieta classificada como necessitando de melhorias. Em relação ao consumo alimentar, esse grupo apresentou maior consumo de produtos lácteos quando comparado ao grupo controle. CONCLUSÕES: Mulheres com câncer de mama foram classificadas com pior nível socioeconômico, excesso de peso e dieta pontualmente inadequada. Estudos sobre neoplasia mamária devem investigar tais características, já que essa é uma doença de origem multifatorial e, portanto, apresenta vários fatores de risco