Tumor aggressiveness is associated with cell integrity changes in breast cancer-surviving women: a follow-up study.

INTRODUCTION: Introduction: cell integrity and fat mass had been studied as a prognostic marker for cancer survival. Objective: our aim was to evaluate the association between tumor aggressiveness and cell integrity changes and adiposity in breast cancer (BC) survivors. Methods: women with BC (n = 114) were evaluated at diagnosis and 5 years later. Percentage of lean mass, fat mass, phase angle (PA), resistance (R) and reactance (Xc) were obtained by bioimpedance (450-50 kHz). Plasma leptin was assessed by immunoassay. Changes in body composition were assessed by the paired t-test or Wilcoxon's test. The disease effect associated with the time of diagnosis was assessed by a generalized linear model. Regression models were structured to assess the prevalence ratio between tumor aggressiveness and body composition changes adjusted for age, income, and level of schooling. Results: patients with N+ (p = 0.02) and % Ki67 > 14 (p = 0.00) show a reduction in Xc. Patients with advanced clinical staging (CS) (p = 0.02), tumors > 2 cm (p = 0.01), N+ (p = 0.01), non-luminal tumors (p = 0.02), ER- (p = 0, 00) and PR- (p = 0.02) show a PA reduction, and N+ patients (p = 0.01) show a reduction in leptin during follow-up. Tumors  2 cm (CI: 0.33-0.95; p = 0.03), initial CS (CI: 0.20-0.93; p = .0.03), and luminal tumors (CI: 0.01-0.95; p = 0.04) are related to a lower reduction in PA. Initial CS (CI: 0.00-0.00; p = 0.00) are related to increased leptin. Conclusion: tumor aggressiveness is associated with cell integrity changes in women who are BC survivors.

INTRODUCCIÓN: Introducción: se han estudiado la integridad celular y la masa grasa como marcadores pronósticos de supervivencia al cáncer. Objetivo: nuestro objetivo fue evaluar la asociación entre la agresividad del tumor y los cambios en la integridad celular y la adiposidad en supervivientes de cáncer de mama (CM). Métodos: las mujeres con CM (n = 114) se evaluaron al diagnóstico y 5 años después. El porcentaje de masa magra, masa grasa, ángulo de fase (PA), resistencia (R) y reactancia (Xc) se obtuvo mediante bioimpedancia (450-50 kHz). La leptina plasmática se evaluó mediante inmunoensayo. Los cambios en la composición corporal se evaluaron mediante la prueba de la t pareada o la prueba de Wilcoxon. El efecto de la enfermedad asociado con el momento del diagnóstico se evaluó mediante un modelo lineal generalizado. Los modelos de regresión se estructuraron para evaluar la razón de prevalencia entre la agresividad del tumor y los cambios en la composición corporal ajustados por edad, ingresos y nivel de escolaridad. Resultados: las pacientes con N+ (p = 0,02) y % Ki67 > 14 (p = 0,00) muestran una reducción de Xc. Las pacientes con estadificación clínica (EC) avanzada (p = 0,02), tumores > 2 cm (p = 0,01), N+ (p = 0,01), tumores no luminales (p = 0,02), ER- (p = 0, 00) y PR- (p = 0,02) muestran una reducción de la AP, y los pacientes N+ (p = 0,01) muestran una reducción de la leptina durante el seguimiento. Los tumores  2 cm (IC: 0,33-0,95; p = 0,03), el EC inicial (IC: 0,20-0,93; p = 0,03) y los tumores luminales (IC: 0,01-0,95; p = 0,04) se relacionan con un menor reducción de la PA. Los EC iniciales (IC: 0,00-0,00; p = 0,00) están relacionados con un aumento de leptina. Conclusión: la agresividad del tumor se asocia con cambios en la integridad celular en las mujeres que sobreviven al CM.

Breast cancer survivors have less lean mass and lower phase angle after cancer treatment / Sobreviventes do câncer de mama tem menos massa magra e menor ângulo de fase após o tratamento oncológico

Objective: To evaluate the weight status and body composition of women who survived breast cancer after cancer treatment. Methods: This is a before and after clinical study, in which 27 breast cancer survivors were evaluated before (T0) and after (T1) cancer treatment (surgical and clinical). Current weight and height were measured to determine the body mass index (BMI). Body composition was assessed by tetrapolar bioelectrical impedance. The percentage of fat and lean mass and the phase angle were calculated. We used Student's t-test to assess the difference among means of anthropometric variables and body composition between T0 and T1, and the McNemar's test to evaluate differences in the prevalence of overweight, adopting a 5% significance. Results: Patients have a mean increase of 2.6 kg in weight after treatment (p=0.00) and 1.15 km/m2 in BMI (p=0.00). The percentage of fat mass increased by 0.6% (p=0.003) in T1, while the lean mass decreased (p=0.03). Concerning the phase angle, the mean decrease is 0.6 (p=0.026) after treatment. Conclusion: Breast cancer survivors have increased adiposity, decreased lean mass, and compromised cell integrity after cancer treatment, suggesting elevated risk factors for disease recurrence.

Objetivo: Avaliar o estado do peso e a composição corporal de mulheres sobreviventes do câncer de mama após tratamento oncológico. Metodologia: Trata-se de estudo clínico do tipo antes e depois, em que 27 pacientes sobreviventes do câncer de mama foram avaliadas antes (T0) e depois (T1) do tratamento oncológico (cirúrgico e clínico). Aferiram-se peso atual e estatura para definição do índice de massa corporal (IMC). A avaliação da composição corporal deu-se por impedância bioelétrica tetrapolar, sendo aferidos percentual de massa gorda e de massa magra e ângulo de fase. Aplicou-se o teste t de Student para avaliar a diferença de médias das variáveis antropométricas e de composição corporal entre T0 e T1, bem como o teste de McNemar para avaliar diferenças na prevalência de sobrepeso, adotando significância de 5%. Resultados: As pacientes têm aumento médio de 2,6 kg após o tratamento (p=0,00) e 1,15 kg/m2 no IMC (p=0,00). O percentual de massa gorda aumenta 0,6% (p=0,003) e há redução na massa magra (p=0,03) no T1. Em relação ao ângulo de fase, há diminuição média de 0,6 (p=0,026) após o tratamento. Conclusão: Mulheres sobreviventes do câncer de mama têm aumento de adiposidade, redução da massa magra e piora da integridade celular após o tratamento oncológico, o que sugere acréscimo de fatores de risco para recidiva da doença.

Plasma and erythrocyte ω-3 and ω-6 fatty acids are associated with multiple inflammatory and oxidative stress biomarkers in breast cancer.

OBJECTIVES: The aim of this study was to assess the association of plasma and erythrocyte ω-3 and ω-6 fatty acids with multiple oxidative stress biomarkers in breast cancer patients. METHODS: Ninety-five women with recently diagnosed breast cancer and no previous treatment were selected for this study. The socioeconomic, clinical, and demographic profile of the patients was determined using a structured questionnaire and medical records. Body weight and height were measured to calculate body mass index. Blood samples were drawn after a 12-h fast for biochemical analyses. The oxidative stress biomarkers low-density lipoprotein (-) and its anti-low-density lipoprotein (-) antibodies, α-tocopherol, ß-carotene, high-density lipoprotein cholesterol, thiobarbituric acid reactive substance, and adiponectin were measured. Plasma and erythrocyte fatty acids were assessed by gas chromatography. Factor and principal component analysis was used to identify three factors called factor 1 (anti-inflammatory), factor 2 (antioxidant), and factor 3 (oxidant). Linear regression, adjusted for confounding variables, was used to estimate the association of these factors with plasma and erythrocyte ω-3 and ω-6 fatty acids and their ratios. RESULTS: ω-3 series fatty acids showed a positive association with Factor 1. A positive association of plasma and erythrocyte ω-6 fatty acids with factors 1 and 2, respectively, was found. ω-6/ω-3 ratio (plasma) was inversely associated with the anti-inflammatory factor. CONCLUSION: Polyunsaturated fatty acids of the plasma and erythrocyte ω-3 and ω-6 series were associated with multiple inflammatory and oxidative stress biomarkers in breast cancer.

Padrão alimentar de mulheres com câncer de mama: um estudo a posteriori / Dietary pattern of women with breast cancer: a posteriori study / Patrón alimentario de mujeres con cáncer de mama: estúdio a Posteriori

Objetivo: Identificar o padrão alimentar a posteriori de mulheres com câncer de mama. Métodos: Estudo observacional, transversal e analítico. Foram avaliadas 100 mulheres com câncer de mama, submetidas à quimioterapia/radioterapia, atendidas em um centro de câncer, na cidade de Fortaleza-CE, de julho a dezembro de 2012. Coletaram-se dados clínicos (subtipo, estadiamento clínico ? EC, tratamento), socioeconômicos (escolaridade e renda mensal), antropométricos (peso, estatura, índice de massa corporal ? IMC) e de consumo alimentar. Para avaliação do consumo, foi utilizado um questionário quantitativo de frequência alimentar (QQFA) validado para mulheres do Nordeste, e o consumo diário de cada alimento foi definido em gramas/ml, sendo agrupados, de acordo com sua composição nutricional, em 10 grupos, seguindo a pirâmide alimentar adaptada à população brasileira. Definiu-se o padrão alimentar por componentes alimentares a partir da análise fatorial explanatória dos dez grupos de alimentos, utilizando-se o SPSS, versão 20.0. Resultados: Idade média de 50,9±10,2 anos, com prevalência de carcinoma ductal (n=83; 83%) em EC III (n=60; 60%). A média do IMC indicou excesso de peso (28,3±4,4 kg/m2) e a circunferência da cintura estava acima do recomendado (98,6±10,9 cm). Identificaram-se quatro componentes alimentares e 21% da variância da dieta foi explicada pelo componente alimentar 1 (Risk), com a matriz composta por carne vermelha e processada, óleos, gorduras e cereais. Conclusão: O padrão alimentar das pacientes foi caracterizado por uma dieta de risco, que pode contribuir positivamente para a recidiva da doença.

Objective: To identify a posteriori dietary pattern of women with breast cancer. Methods: Observational, cross-sectional and analytical study. It evaluated 100 women with breast cancer, undergoing chemotherapy/radiotherapy, treated at a cancer center in the city of Fortaleza, from July to December 2012. The study collected clinical data (subtype, clinical stage - CS, treatment), socioeconomic (educational level and monthly income) and anthropometric data (weight, height, body mass index - BMI), and food consumption. To evaluate the consumption, a quantitative food frequency questionnaire (FFQ), validated for women of the Brazilian Northeast, was applied, and the daily consumption of each food was set in grams/ml, being grouped according to their nutritional composition, into 10 groups, following the food pyramid adapted to the Brazilian population. The dietary pattern was defined by food components from the exploratory factor analysis of those ten food groups, using the SPSS, version 20.0. Results: Mean age of 50.9±10.2 years, with prevalence of ductal carcinoma (n=83; 83%) in CS III (n=60; 60%). The mean BMI indicated overweight (28.3±4.4 kg/m2) and waist circumference was above the recommended (98.6±10.9 cm). Four food components were identified, and 21% of the diet variance was explained by food component 1 (Risk), with the matrix composed of red and processed meat, oils, fats and cereals. Conclusion: The patients? dietary pattern was characterized by a risk diet, which can positively contribute to the disease recurrence.

Objetivo: Identificar el patrón alimentario a posteriori de mujeres con cáncer de mama. Métodos: Estudio observacional, transversal y analítico. Fueron evaluadas 100 mujeres con câncer de mama sometidas a quimioterapia/radioterapia asistidas en um centro de cáncer de Fortaleza-CE, de julio a diciembre de 2012. Se recogieron datos clínicos (subtipo, clasificación clínica ? CC, tratamiento), socioeconómicos (escolaridad y renta mensual), antropométricos (peso, estatura, índice de masa corporal ? IMC) y de consumo alimentario. Para la evaluación del consumo, fue utilizado un cuestionario cuantitativo de frecuencia alimentaria (QQFA) validado para mujeres del Nordeste, y el consumo a diário de cada alimento fue definido en gramos/ml, siendo agrupados, según su composición nutricional, en 10 grupos, siguiendo La pirámide alimentaria adaptada a la población brasileña. Se definió el patrón alimentario por componentes alimentarios a partir del análisis factorial exploratorio de los diez grupos de alimentos, con la utilización del SPSS, versión 20.0. Resultados: Edad media de 50,9±10,2 años, con prevalencia de carcinoma ductal (n=83; 83%) en CC III (n=60; 60%). La media del IMC indico exceso de peso (28,3±4,4 kg/m2) y la circunferencia de La cintura estaba por encima del recomendado (98,6±10,9 cm). Se identificaron cuatro componentes alimentarios y el 21% de La variancia de la dieta fue explicada por el componente alimentario 1 (Risk), con la matriz formada por carne roja y procesada, aceites, grasas y cereales. Conclusión: El patrón alimentario de las pacientes fue caracterizado por una dieta de riesgo que puede contribuir positivamente para la recidiva de la enfermedad.