Why women gain weight with adjuvant chemotherapy for breast cancer.

1993 ◽  
Vol 11 (7) ◽  
pp. 1418-1429 ◽  
Author(s):  
W Demark-Wahnefried ◽  
E P Winer ◽  
B K Rimer
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Dietary Intervention ◽  
Early Stage ◽  
Common Side Effect ◽  
Breast Cancer Patients ◽  
Energy Imbalance ◽  
Underlying Mechanisms

PURPOSE Among breast cancer patients receiving adjuvant chemotherapy, weight gain is a common side effect that may decrease quality of life and potentially threaten survival. Weight gain during treatment is a problem that is clinically well appreciated, and one that has been studied by a number of investigators. DESIGN A literature review was conducted to address each of the following issues: (1) the prevalence and magnitude of weight gain in women receiving adjuvant chemotherapy for early-stage breast cancer, (2) factors that might affect the amount of weight gained, (3) adverse consequences of weight gain, (4) mechanisms potentially responsible for weight gain, and (5) current dietary intervention programs directed toward women receiving adjuvant chemotherapy. RESULTS Weight gain is associated with a number of adverse effects in breast cancer patients receiving adjuvant chemotherapy. Weight gains are exaggerated in premenopausal women and women receiving multiagent regimens. Little research has been conducted to investigate the underlying mechanisms that contribute to weight gain in this population. CONCLUSION Interventions to prevent weight gain during adjuvant chemotherapy are underway; however, little research has been conducted to investigate the underlying mechanisms of energy imbalance. Although changes in resting metabolic rate, thermogenesis, physical activity, and dietary intake are all plausible, no firm data exist to support any of these mechanisms. There is a need for research that explores the relative contribution of each of these factors to energy imbalance, so that optimally effective interventions can be created and implemented to combat this problem.

Impact of breast cancer treatment on body mass index (BMI) over time.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 94-94
Author(s):  
Raquel E. Reinbolt ◽  
Xueliang Jeff Pan ◽  
Kaitlin K. Wandell ◽  
Robert Pilarski ◽  
Rachel M. Layman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Weight Gain ◽  
Cancer Patients ◽  
Endocrine Therapy ◽  
Body Mass ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Cancer Tissue ◽  
Breast Cancer Patients

94 Background: Weight gain concerns breast cancer patients, can impact quality of life, may lead to therapy non-adherence, and is associated with increased recurrence risk and mortality. Early placebo-controlled trials did not identify a clear correlation between Tamoxifen (TAM) and weight gain; gain due to aromatase inhibitors (AIs) is not well characterized. We hypothesized that weight gain occurs more frequently than previously reported in breast cancer patients receiving endocrine therapy. Methods: This is a retrospective chart review investigating body mass index (BMI) change in women after breast cancer therapy. Patients with early stage breast cancer and whom had BMI and treatment data (at least 90 days) from 2003-2012 were identified in The Columbus Breast Cancer Tissue Bank. Patients were separated by treatment received: chemotherapy with and without endocrine therapy vs. endocrine therapy alone (including both TAM and AIs) vs. no other treatment. Results: A total of 970 subjects were included in the analysis. At diagnosis and/or treatment initiation, patients’ mean BMI was 29.2 ± 7.0 kg/m2; mean age 53.7± 11.6 years; and average length of therapy/follow up per patient, 1833 days (range 90-3,990). Patients who received an AI alone had significantly decreased BMIs during therapy (-0.65± 0.29 kg/m2, p = 0.025), whereas patients receiving chemotherapy alone, chemotherapy with TAM, or TAM followed by AI therapy, had significantly increased BMIs (0.51 ± 0.25, 0.73 ± 0.26, 1.01 ± 0.51 kg/m2; p = 0.039, 0.005, 0.045, respectively). Both older age and a higher BMI at diagnosis were associated with a significantly greater decline in BMI over treatment time (p < 0.001 and p < 0.001, respectively). In a multivariate regression model, after adjusting for age and initial BMI effect, the BMI change noted among different treatment groups was no longer significantly different (p = 0.43). BMI change was not statistically associated with treatment length (p = 0.26). Conclusions: Our review of a large, early stage breast cancer patient cohort showed no association between weight gain and endocrine therapy after adjusting for the effect of initial BMI and age at diagnosis. Additional study is needed to identify other factors impacting weight in this population.

scholarly journals Weight Changes According to Treatment in a Diverse Cohort of Breast Cancer Patients

2021 ◽  
Author(s):  
Jami Fukui ◽  
Kami White ◽  
Timothy Frankland ◽  
Caryn Oshiro ◽  
Lynne Wilkens
Keyword(s):  
Breast Cancer ◽  
Weight Loss ◽  
Weight Gain ◽  
Cancer Patients ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Therapeutic Window ◽  
Breast Cancer Patients ◽  
Weight Changes ◽  
Time Points

Abstract BackgroundWeight changes are common among breast cancer patients. The majority of studies to date have focused on weight gain after a breast cancer diagnosis and its implications on health in survivors. Fewer studies have examined weight loss and its related characteristics. Weight changes have been reported to be influenced by several factors such as age, treatment, stage and pre-diagnostic weight. We evaluated weight changes during key treatment time points in early stage breast cancer patients.MethodsWe characterized 389 female patients diagnosed in Hawaii with early stage breast cancer from 2003-2017 in the Multiethnic Cohort (MEC) linked with Kaiser Permanente Hawaii electronic medical record data. We evaluated weight changes from surgery to 4 years post-diagnosis with six time points along a patient’s treatment trajectory (chemotherapy, radiation, endocrine, or surgery alone) and annually thereafter, adjusting for age, race/ethnicity and initial body mass index (BMI).ResultsWe found key time points of significant weight change for breast cancer patients according to their adjuvant treatment. In patients who had surgery alone (S), surgery-radiation (SR), or surgery-endocrine therapy (SE), the majority of patients had stable weight, although this consistently decreased over time. However, the percentages of patients with weight loss and weight gain during this time steadily increased up to 4 years after initial surgery. Weight loss was more common than weight gain by about 2 fold in these treatment groups. For patients with surgery-chemotherapy (SC), there was significant weight loss seen within the first 3 months after surgery, during the time when patients receive chemotherapy. And this weight loss persisted until year 4. Weight gain was less commonly seen in this treatment group.ConclusionsWe identified key time points during breast cancer treatment that may provide a therapeutic window to positively influence outcomes. Tailored weight management interventions should be utilized to promote overall health and long term survivorship.

scholarly journals Weight changes according to treatment in a diverse cohort of breast cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12513-e12513
Author(s):  
Jami Aya Fukui ◽  
Kami White ◽  
Timothy Frankland ◽  
Caryn Oshiro ◽  
Lynne Wilkens
Keyword(s):  
Breast Cancer ◽  
Weight Loss ◽  
Weight Gain ◽  
Cancer Patients ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Therapeutic Window ◽  
Breast Cancer Patients ◽  
Weight Changes ◽  
Time Points

e12513 Background: Weight changes are common among breast cancer patients. The majority of studies to date have focused on weight gain after a breast cancer diagnosis and its implications on health in survivors. Fewer studies have examined weight loss and its related characteristics. Weight changes have been reported to be influenced by several factors such as age, treatment, stage and pre-diagnostic weight. We evaluated weight changes during key treatment time points in early stage breast cancer patients. Methods: We characterized 389 female patients diagnosed in Hawaii with early stage breast cancer from 2003-2017 in the Multiethnic Cohort (MEC) linked with Kaiser Permanente Hawaii electronic medical record data. We evaluated weight changes from surgery to 4 years post-diagnosis with six time points along a patient’s treatment trajectory (chemotherapy, radiation, endocrine, or surgery alone) and annually thereafter, adjusting for age, race/ethnicity and initial body mass index (BMI). Results: We found key time points of significant weight change for breast cancer patients according to their adjuvant treatment. In patients who had surgery alone (S), surgery-radiation (SR), or surgery-endocrine therapy (SE), the percentage of patients with stable weight, while generally comprising the majority, consistently decreased over time. However, the percentages of patients with weight loss and weight gain during this time steadily increased up to 4 years after initial surgery. Weight loss was more common than weight gain by about 2 fold in these treatment groups (weight loss 33.2%-42% vs weight gain 11.6%-21.4%). For patients with surgery-chemotherapy (SC), there was significant increase in patients with weight loss seen within the first 3 months after surgery (16.2% to 43.7%), during the time when patients receive chemotherapy. And this weight loss trend persisted until year 4. Weight gain was less commonly seen in this treatment group. Conclusions: We identified key time points during breast cancer treatment that may provide a therapeutic window to positively influence outcomes. Tailored weight management interventions should be utilized to promote overall health and long term survivorship.

Cardiovascular risk profile of breast cancer patients treated with anthracycline-taxane containing adjuvant chemotherapy and/or trastuzumab

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 666-666 ◽  
Author(s):  
L. W. Jones ◽  
M. Haykowsky ◽  
C. J. Peddle ◽  
A. A. Joy ◽  
E. N. Pituskin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Sinus Tachycardia ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Cvd Risk Factors ◽  
Cvd Risk

666 Background: With improving longevity, post-treatment cardiovascular disorders will become an increasingly important indicator of competing mortality in early-stage breast cancer. As such, we conducted a pilot study to comprehensively evaluate the CVD profile of a subset of early-stage breast cancer patients treated with adjuvant taxane-anthracycline containing chemotherapy and/or trastuzumab. Methods: Twenty-six breast cancer patients (mean 20 months post chemotherapy) who participated in Breast Cancer International Research Group 006 clinical trial and 10 healthy age-matched women were studied. We measured 14 metabolic and vascular established CVD risk factors, BMI, VO2peak and left ventricular systolic function. All assessments were performed within a 14-day period. Results: Cardiac abnormalities were suggested by LVEF <50% in 10% of patients, LVEF remained >10% below pre-treatment values in 38% while 50% presented with resting sinus tachycardia. BNP was significantly elevated in 40% and was correlated with LVEF (r = -0.72, p=<.001). For the majority of CVD risk factors, similar proportions of patients and controls (35% to 60%) were classified as ‘undesirable.’ A significantly higher proportion of patients were classified with low VO2peak (46% vs. 0%, p<0.01), being overweight/obese (72% vs. 50%, p<0.05), and having resting sinus tachycardia (50% vs. 0%, p<0.01) compared with controls. VO2peak and BMI were correlated with CV risk factors (r = -0.64 to 0.63, p<0.05; r = -0.63 to 0.67, p<0.05, respectively). Exploratory analyses revealed several differences between CVD risk factors based on chemotherapy regimen. Conclusions: Breast cancer survivors treated with adjuvant chemotherapy are at a higher risk of developing late-occurring CVD than age matched controls due to direct and indirect treatment-related toxicity. No significant financial relationships to disclose.

Weight gain after adjuvant chemotherapy in early breast cancer patients in Istanbul.

2010 ◽  
Vol 28 (15_suppl) ◽  
pp. e11099-e11099
Author(s):  
N. S. Turhal ◽  
G. Atalay Basaran ◽  
N. Yurt ◽  
G. Yurtseven ◽  
D. Cabuk ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Breast Cancer Patients

Recurrence patterns among T1-2N0 triple-negative breast cancer patients following mastectomy.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 93-93
Author(s):  
Rebekah Young ◽  
Kimberly Gergelis ◽  
Shalom Kalnicki ◽  
Jana Lauren Fox
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Early Stage ◽  
Breast Cancer Patients ◽  
Single Institution ◽  
Early Stage Disease ◽  
Increased Risk

93 Background: Women with early-stage TN breast cancers are at increased risk for recurrence (RR) compared to other molecular subtypes, and are often treated with mastectomy without local adjuvant therapy. We wish to evaluate the RR for these women. Methods: In this single institution retrospective study, women with T1-2N0 TN breast cancer who underwent mastectomy between 2008-12 were identified from tumor registry. Adjuvant chemotherapy was allowed, but adjuvant radiotherapy (RT) was excluded. Of 3,000 cases reviewed, 52 women were identified. Median age was 58.5 (30–90). Lesions were high-grade (83%), and T1-2 (47%, 53%). 21 women (42%) had at least 1 risk factor. 5 women were BRCA+. Women underwent total mastectomy or modified radical mastectomy, and the majority (84%) had adjuvant chemotherapy. Results: At a median follow-up of 3.5 years (6-71 months), there were 8 recurrences (15.4%). 3 (5.8% of cohort) were locoregional (LR) only (2 chest wall (CW) and 1 ipsilateral axilla), 6 (11.5%) involved a concurrent LR and distant recurrence, and 2 (3.8%) were distant only. Median time to recurrence was 17.3 months. The isolated LR recurrences (LRR) were at 14, 15.6 and 15.1 months. Most women (41, 78.8%) were alive with NED. 3 were alive with disease, underdoing treatment, and 1 woman was disease free after treatment for CW recurrence. 8 patients (15.4%) are deceased, half from their cancer. On univariate analysis, there was no significant correlation (p>0.05) between age or high-risk features and RR (STATA v 11). Conclusions: T1-2N0 breast cancer patients are believed to have a low RR following mastectomy. TN disease, however, is more aggressive, and the question of irradiating early stage disease after mastectomy has arisen. A single institution, retrospective study found women with T1-2N0 TN disease fare better with BCT that includes RT, compared to mastectomy alone. Other studies have shown no statistical difference in RR between these 2 groups. We found an isolated LRR rate at 3.5 years of 5.8%. Follow-up and ultimately prospective data is needed to determine whether the isolated LRR warrants a change in treatment recommendations for this pt subset.

scholarly journals Evaluation of the prognostic value of CD3, CD8, and FOXP3 mRNA expression in early-stage breast cancer patients treated with anthracycline-based adjuvant chemotherapy

2018 ◽  
Vol 7 (10) ◽  
pp. 5066-5082 ◽  
Author(s):  
Marinos Tsiatas ◽  
Konstantine T. Kalogeras ◽  
Kyriaki Manousou ◽  
Ralph M. Wirtz ◽  
Helen Gogas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Mrna Expression ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Foxp3 Mrna
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