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.

Bioelectrical impedance vector applied to body composition evaluation of women survivors of breast cancer: A longitudinal study.

BACKGROUND AND AIMS: Thus, the aim of this study was to assess the changes in the body composition of the women survivors of breast cancer and its association with clinical staging, using the bioelectrical impedance vector analysis (BIVA), over five years of follow-up. METHODS: At baseline time 114 patients (T0) were selected and after 5 years (T1) of follow-up (n = 35) data of weight, body mass index, waist circumference, phase angle, resistance/height, reactance/height, %fat free mass and %fat mass were monitored. Bioelectrical impedance vector analysis (BIVA) and the vector displacement assessment took place according to the initial and advanced clinical staging (CS 1 and 2, respectively) and time of follow-up and have been showed using mean graph and RXc score graph. RESULTS: Patients on CS 1 showed a reduction in reactance/height, phase angle, %fat free mass and an increase in %fat mass. The same group presented during the follow-up significant vector displacement by mean graph and a change to the 95% ellipse by the RXc score graph. CONCLUSIONS: Women with breast cancer in the initial CS showed a more significant displacement of bioelectric vectors, indicating worsening in body composition.

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.