Skeletal Muscle Deconditioning in Breast Cancer Patients Undergoing Chemotherapy: Current Knowledge and Insights From Other Cancers

Breast cancer represents the most commonly diagnosed cancer while neoadjuvant and adjuvant chemotherapies are extensively used in order to reduce tumor development and improve disease-free survival. However, chemotherapy also leads to severe off-target side-effects resulting, together with the tumor itself, in major skeletal muscle deconditioning. This review first focuses on recent advances in both macroscopic changes and cellular mechanisms implicated in skeletal muscle deconditioning of breast cancer patients, particularly as a consequence of the chemotherapy treatment. To date, only six clinical studies used muscle biopsies in breast cancer patients and highlighted several important aspects of muscle deconditioning such as a decrease in muscle fibers cross-sectional area, a dysregulation of protein turnover balance and mitochondrial alterations. However, in comparison with the knowledge accumulated through decades of intensive research with many different animal and human models of muscle atrophy, more studies are necessary to obtain a comprehensive understanding of the cellular processes implicated in breast cancer-mediated muscle deconditioning. This understanding is indeed essential to ultimately lead to the implementation of efficient preventive strategies such as exercise, nutrition or pharmacological treatments. We therefore also discuss potential mechanisms implicated in muscle deconditioning by drawing a parallel with other cancer cachexia models of muscle wasting, both at the pre-clinical and clinical levels.

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Skeletal muscle atrophy and dysfunction in breast cancer patients: role for chemotherapy-derived oxidant stress

AJP Cell Physiology ◽

10.1152/ajpcell.00002.2018 ◽

2018 ◽

Vol 315 (5) ◽

pp. C744-C756 ◽

Cited By ~ 21

Author(s):

Blas A. Guigni ◽

Damien M. Callahan ◽

Timothy W. Tourville ◽

Mark S. Miller ◽

Brad Fiske ◽

...

Keyword(s):

Breast Cancer ◽

Skeletal Muscle ◽

Cancer Patients ◽

Muscle Fiber ◽

Cross Sectional Area ◽

Ros Production ◽

Sectional Area ◽

Breast Cancer Patients ◽

Mitochondrial Content ◽

Cross Sectional

How breast cancer and its treatments affect skeletal muscle is not well defined. To address this question, we assessed skeletal muscle structure and protein expression in 13 women who were diagnosed with breast cancer and receiving adjuvant chemotherapy following tumor resection and 12 nondiseased controls. Breast cancer patients showed reduced single-muscle fiber cross-sectional area and fractional content of subsarcolemmal and intermyofibrillar mitochondria. Drugs commonly used in breast cancer patients (doxorubicin and paclitaxel) caused reductions in myosin expression, mitochondrial loss, and increased reactive oxygen species (ROS) production in C2C12 murine myotube cell cultures, supporting a role for chemotherapeutics in the atrophic and mitochondrial phenotypes. Additionally, concurrent treatment of myotubes with the mitochondrial-targeted antioxidant MitoQ prevented chemotherapy-induced myosin depletion, mitochondrial loss, and ROS production. In patients, reduced mitochondrial content and size and increased expression and oxidation of peroxiredoxin 3, a mitochondrial peroxidase, were associated with reduced muscle fiber cross-sectional area. Our results suggest that chemotherapeutics may adversely affect skeletal muscle in patients and that these effects may be driven through effects of these drugs on mitochondrial content and/or ROS production.

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Complementary and Alternative Medicine Use in Breast Cancer Patients at a Medical Center in Taiwan: A Cross-Sectional Study

Integrative Cancer Therapies ◽

10.1177/1534735420983910 ◽

2020 ◽

Vol 19 ◽

pp. 153473542098391

Author(s):

Chieh-Ying Chin ◽

Yung-Hsiang Chen ◽

Shin-Chung Wu ◽

Chien-Ting Liu ◽

Yun-Fang Lee ◽

...

Keyword(s):

Breast Cancer ◽

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Cancer Patients ◽

Medical Center ◽

Cancer Center ◽

Breast Cancer Patients ◽

Cross Sectional ◽

Cam Use ◽

Complementary And Alternative

Background Complementary and alternative medicine (CAM) is becoming more common in medical practice, but little is known about the concurrent use of CAM and conventional treatment. Therefore, the aim was to investigate the types of CAM used and their prevalence in a regional patient cohort with breast cancer (BC). Methods BC patients were interviewed with a structured questionnaire survey on the use of CAM in southern Taiwan at an Integrative Breast Cancer Center (IBCC). The National Centre for Complementary and Integrative Health (NCCIH) classification was used to group responses. Over a period of 8 months, all patients receiving treatment for cancer at the IBCC were approached. Results A total of 106 BC patients completed the survey (response rate: 79.7%). The prevalence of CAM use was 82.4%. Patients who were employed, were receiving radiotherapy and hormone therapy, and had cancer for a longer duration were more likely to use CAM ( P < .05). Multivariate analysis identified employment as an independent predictor of CAM use (OR = 6.92; 95% CI = 1.33-36.15). Dietary supplementation (n = 69, 82.1%) was the type of CAM most frequently used, followed by exercise (n = 48, 57.1%) and traditional Chinese medicine (n = 29, 34.5%). The main reason for using CAM was to ameliorate the side effects of conventional therapies. Almost half (46.4%) of these CAM users did not disclose that they were using it in medical consultations with their physicians. Most chose to use CAM due to recommendations from family and friends. Conclusion A large portion of BC patients at the IBCC undergoing anti-cancer treatment courses used CAM, but less than half discussed it with their physicians. Given the high prevalence of CAM, it would be justifiable to direct further resources toward this service so that cancer patients can benefit from a holistic approach to their treatment.

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Correlation between ER, PR, HER-2, and Ki-67 with the risk of bone metastases detected by bone scintigraphy in breast cancer patients: A cross sectional study

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2021.102532 ◽

2021 ◽

pp. 102532

Author(s):

Hanif Afkari ◽

Firdian Makrufardi ◽

Basuki Hidayat ◽

Hendra Budiawan ◽

Achmad Hussein Sundawa Kartamihardja

Keyword(s):

Breast Cancer ◽

Bone Metastases ◽

Cancer Patients ◽

Bone Scintigraphy ◽

Cross Sectional Study ◽

Breast Cancer Patients ◽

Sectional Study ◽

Ki 67 ◽

Cross Sectional ◽

Her 2

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The relationship of self-acceptance with decision making duration in cancer patient to perform mastectomy

Breast Disease ◽

10.3233/bd-219016 ◽

2021 ◽

pp. 1-5

Author(s):

Ayu Ratuati Setiawan ◽

Feny Tunjungsari ◽

Mochamad Aleq Sander

Keyword(s):

Breast Cancer ◽

Decision Making ◽

Cancer Patients ◽

Breast Cancer Patients ◽

Cross Sectional ◽

Abnormal Growth ◽

Self Acceptance ◽

Observation Method ◽

Relationship Of ◽

The Relationship

BACKGROUND: Cancer is a disease caused by abnormal growth of body cells that turn malignant and continue to grow uncontrollably. One of the treatments for breast cancer is mastectomy. The quickness of decision-making determines the survival rate of prognosis patients. OBJECTIVE: This study aimed to determine the relationship of self-acceptance with decision-making duration in cancer patients to perform a mastectomy. METHODS: An analytic observation method with cross-sectional design. The samples were taken by purposive sampling method with 50 samples of breast cancer patients. Data collected include age, last level of education, marital status, profession, stage of cancer during mastectomy, self-acceptance score, and decision-making duration to perform a mastectomy. RESULTS: The data analyzed with the Kruskal–Wallis test. The test showed the relationship of self-acceptance (p = 0.027) with decision-making duration in breast cancer patients to perform a mastectomy. CONCLUSION: In Conclusion, there is a relationship of self-acceptance with decision-making duration in breast cancer patients to perform a mastectomy.

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Hospital Processes and the Nurse-Patient Interaction in Breast Cancer Care. Findings from a Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158224 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8224

Author(s):

Johanna Sophie Lubasch ◽

Susan Lee ◽

Christoph Kowalski ◽

Marina Beckmann ◽

Holger Pfaff ◽

...

Keyword(s):

Breast Cancer ◽

Social Support ◽

Cancer Patients ◽

Perceived Social Support ◽

Patient Characteristics ◽

Patient Survey ◽

Breast Cancer Patients ◽

Cross Sectional ◽

Patient Interaction ◽

Hospital Structures

(1) Background: Evidence suggests that organizational processes of hospitals have an impact on patient-professional interactions. Within the nurse-patient interaction, nurses play a key role providing social support. Factors influencing the nurse-patient interaction have seldomly been researched. We aimed to examine whether the process organization in hospitals is associated with breast cancer patients’ perceived social support from nurses.; (2) Methods: Data analysis based on a cross-sectional patient survey (2979 breast cancer patients, 83 German hospitals) and information on hospital structures. Associations between process organization and perceived social support were analyzed with logistic hierarchical regression models adjusted for patient characteristics and hospital structures.; (3) Results: Most patients were 40–69 years old and classified with UICC stage II or III. Native language, age and hospital ownership status showed significant associations to the perception of social support. Patients treated in hospitals with better process organization at admission (OR 3.61; 95%-CI 1.67, 7.78) and during the hospital stay (OR 2.11; 95%-CI 1.04; 4.29) perceived significantly more social support from nurses.; (4) Conclusions: Designing a supportive nursing work environment and improving process organization in hospitals may create conditions conducive for a supportive patient-nurse interaction. More research is needed to better understand mechanisms behind the associations found.

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Breast Cancer in the Elderly

Journal of Clinical Oncology ◽

10.1200/jco.2006.10.2079 ◽

2007 ◽

Vol 25 (14) ◽

pp. 1882-1890 ◽

Cited By ~ 117

Author(s):

Diana Crivellari ◽

Matti Aapro ◽

Robert Leonard ◽

Gunter von Minckwitz ◽

Etienne Brain ◽

...

Keyword(s):

Breast Cancer ◽

Clinical Trials ◽

Life Expectancy ◽

Cancer Patients ◽

Disease Free Survival ◽

Cost Benefit ◽

The Elderly ◽

Breast Cancer Patients ◽

Younger Women ◽

Based Medicine

Screening and adjuvant postoperative therapies have increased survival among women with breast cancer. These tools are seldom applied in elderly patients, although the usually reported incidence of breast cancer is close to 50% in women 65 years or older, reaching 47% after 70 years in the updated Surveillance, Epidemiology, and End Results (SEER) database. Elderly breast cancer patients, even if in good medical health, were frequently excluded from adjuvant clinical trials. Women age 70 years who are fit actually have a median life expectancy of 15.5 years, ie, half of them will live much longer and will remain exposed for enough time to the potentially preventable risks of a relapse and specific death. In the last few years, a new concern about this issue has developed. Treatment now faces two major end points, as in younger women: to improve disease-free survival in the early stages, and to palliate symptoms in advanced disease. However, in both settings, the absolute benefit of treatment is critical because protecting quality of life and all its related aspects (especially functional status and independence), is crucial in older persons who have more limited life expectancy. Furthermore, the new hormonal compounds (aromatase inhibitors) and chemotherapeutic drugs (capecitabine, liposomal doxorubicin), are potentially less toxic than and equally as effective as older more established therapies. These new treatments bring new challenges including higher cost, and defining their benefit in elderly breast cancer must include an analysis of the cost/benefit ratio. These issues emphasize the urgent need to develop and support clinical trials for this older population of breast cancer patients both in the adjuvant and metastatic settings, a move that will take us from a prejudiced, age-based medicine to an evidence-based medicine.

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