Chemotherapy negatively impacts body composition, physical function and metabolic profile in patients with breast cancer.

BACKGROUND: Evidence suggests that chemotherapy (CT) leads to unfavorable outcomes on nutritional and metabolic profile; however, this is poorly understood. OBJECTIVE: To evaluate the impact of CT on body composition, bone mineral density (BMD), insulin resistance, lipid markers related to atherosclerotic cardiovascular diseases in women recently diagnosed with breast cancer according to menopausal status. METHODS: This is a prospective study that enrolled women newly diagnosed with stage II-III breast cancer (2014-18). Body composition were measured by dual-energy x-ray absorptiometry. Blood samples were collected to assess lipid profile, insulin resistance and sensitivity, visceral adiposity index and lipid accumulation product were calculated. Dietary intake, physical activity and function were also evaluated at the time of breast cancer diagnosis and after CT completion. RESULTS: Ninety-nine women (40.4% in the premenopausal stage) aged 51 ± 1 years took part in this study. CT duration was 197 ± 27 days and main regimen was anthracyclines with taxanes (88.9%). CT was associated with an increase in total and central adiposity, insulin resistance, and all lipid-related markers, and a decrease in appendicular lean mass index, BMD and HDL-c concentration. Premenopausal women experienced greater unfavorable outcomes on adiposity markers and BMD compared to postmenopausal women (p < 0.01). No changes were observed in dietary intake and physical activity after CT. CONCLUSIONS: Breast cancer CT negatively impacted body composition and metabolic profile. Premenopausal women experienced greater unfavorable impact on adiposity markers and BMD.

Sedentary Behavior and Alcohol Consumption Increase Breast Cancer Risk Regardless of Menopausal Status: A Case-Control Study.

Identification of modifiable risk factors for breast cancer is critical for primary prevention of the disease. The aim of this study was to evaluate how certain lifestyle variables modify the chances of developing breast cancer based on menopausal status. A case-control study was performed in a group of 542 women, 197 who were diagnosed with breast cancer and 344 control individuals. The groups were matched by age, body mass index, and menopausal status. Participants were evaluated for level of physical activity, alcohol consumption, smoking habit, weight, height, and waist circumference (WC). A multivariate logistic regression model was used to estimate odds ratios and 95% confidence intervals (95% CI). Regular consumption of alcoholic beverages (2.91, 95% CI 1.58-5.38 and 1.86, 95% CI 1.15-3.03) and sedentary behavior (2.08; 95% CI 1.12-3.85 and 1.81; 95% CI 1.12-2.94) were associated with breast cancer risk in pre- and postmenopausal women, respectively. High WC (3.31, 95% CI 1.45-7.55) was associated with an increased risk of developing breast cancer in premenopausal women. While in postmenopausal women, current smoking (2.43, 95% CI 1.01-5.83) or previous history of smoking (1.90; 95% CI 1.14-3.14) increased the chances of developing breast cancer. Sedentary behavior and current consumption of alcoholic beverages were more likely to increase the risk of developing breast cancer regardless of menopausal status.

High Bone Mineral Density of the Lumbar Spine Is Positively Associated with Breast Cancer.

OBJECTIVE: The objective of this study was to verify possible associations between bone mineral density (BMD) and breast cancer in recently diagnosed women in the Brazilian Mid-west region, considering the menopausal status of patients. METHODS: A case-control study was conducted with 142 cases of breast cancer and 234 controls matched by for age, body mass index (BMI), and menopausal status (pre- and postmenopause), performed in a university hospital in the Brazilian Mid-west. Lumbar spine (L1-L4), femoral neck, and total femur BMD were measured by the dual-energy X-ray absorptiometry (DXA) method. For association, a logistic regression analysis was used. RESULTS: Women in the highest lumbar spine BMD quartile presented had a higher chance of developing breast cancer (OR = 2.31; 1.02-5.25; p = 0.045), after adjusting for the confounding variables. Nonetheless, there were no statistically significant differences in the association between pre- and postmenopause in that quartile and breast cancer. CONCLUSIONS: High lumbar spine BMD was positively associated with breast cancer in the total sample. In evaluating the BMD of the femoral neck and total femur, such an association was not observed.

ALTERATION OF BONE MINERAL DENSITY IN BREAST CANCER FEMALE SURVIVORS ON CHEMOTHERAPY TREATMENT: AN INTEGRATIVE REVIEW / Alteração da densidade mineral óssea em mulheres sobreviventes de câncer de mama tratadas com quimioterapia: revisão integrativa da literatura

Introduction: Chemotherapy for treatment of patients with breast cancer has increased the survival of this population. However, it can significantly reduce bone mineral density (BMD). Objective: To verify bone mineral density modifications in women with breast cancer undergoing chemotherapy, as well as their clinical characteristics and risk factors. Methods: Integrative review of papers published from 2006 to 2016, carried out through specific terms in PubMed and SciELO databases. Results: In that period, 898 papers were identified (897 in PubMed and 1 in SciELO). Among the six papers recovered, there was a considerable reduction in lumbar spine and femoral bone mass. For women submitted to chemotherapy, the main regimens associated with the reduction were doxorubicin and cyclophosphamide (AC), cyclophosphamide, methotrexate and 5-fluorouracil (CMF) and cyclophosphamide, epirubicin and 5-fluorouracil (FEC). In addition, there was greater BMD reduction among women aged more than 50 years, Caucasian and who presented early ovarian failure induced by chemotherapy. Conclusion: The use of chemotherapy for breast cancer may lead to bone mass loss, especially when AC, CMF and FEC are used in women aged more than 50 years and among those with early menopause due to this treatment.

Introdução: O uso de quimioterápicos para o tratamento de pacientes com câncer de mama tem aumentado a sobrevida dessa população. Entretanto, pode reduzir significativamente a densidade mineral óssea (DMO). Objetivo: Verificar a alteração da densidade mineral óssea em mulheres com câncer de mama submetidas a quimioterapia, assim como as características clínicas e os fatores de risco. Métodos: Revisão integrativa da literatura de artigos publicados no período de 2006 a 2016, realizada por meio de termos específicos nos bancos de dados da PubMed e da SciELO. Resultados: No período selecionado, foram identificados 898 artigos (897 na base PubMed e 1 na SciELO). Entre os seis artigos recuperados para leitura na íntegra, observou-se redução considerável na massa óssea na coluna lombar e no fêmur. Os principais tipos associados à redução foram os regimes doxorrubicina e ciclofosfamida (AC), ciclofosfamida, metotrexato e 5-fluorouracil (CMF) e ciclofosfamida, epirrubicina e 5-fluorouracil (FEC). Além disso, houve maior redução da DMO entre as mulheres com idade acima de 50 anos, caucasianas e que apresentaram falência ovariana precoce induzida pela quimioterapia. Conclusão: O uso de quimioterápicos para tratamento do câncer de mama pode acarretar perda de massa óssea, principalmente quando se utilizam os regimes AC, CMF e FEC em mulheres com idade acima de 50 anos e entre aquelas que apresentam menopausa precoce decorrente desse tratamento.