Obesity and overweight are established risk factors for the development of breast cancer. They are also associated with poor prognosis for higher risk of disease recurrence and lower overall survival (OS). The aim of this study was to evaluate the influence of overweight and obesity in OS in patients with locally advanced breast cancer (LABC) treated with neoadjuvant chemotherapy. This is a retrospective analysis that included 819 patients diagnosed with LABC between January 2004 and December 2008. The patients were treated with neoadjuvant chemotherapy (NAT) based on anthracyclines, taxanes, or both, followed by surgery. For comparison, patients were divided into the normal weight (NW) group or the overweight/obesity (OW/OB) group. The prevalence of overweight/obesity was 74 %. General characteristics of the patients, including age, tumor size, clinical stage, nuclear grade, hormone receptors, and HER2 expression, were similar between both groups. At a median follow-up of 28 months, we found a statistically significant difference in OS between the two groups, achieving a 91.5 % in NW patients versus 85.9 % in the OW/OB group (P = 0.050). Cox multivariate analysis demonstrated that obesity was an independent factor for poor prognosis, with a hazard ratio of 1.79 (95 % CI (Confidence Interval) 1.09-2.96; P = 0.022). This is the first Mexican study that confirms the role of OW/OB as a risk factor for poor outcome among patients with LABC. Obesity in our country is a public health problem and requires strong preventive intervention strategies for its control, especially among patients diagnosed with breast cancer.

He leído con gran atención el artículo "Variabilidad de la composición corporal medida por bioimpedanciometría eléctrica según condiciones de realización: influencia del ayuno y el reposo", publicado en la revista Nutrición Hospitalaria por los autores Cáceres y cols. (1) y desearía realizar unas puntualizaciones que creo han podido afectar a los resultados presentados.La bioimpedancia eléctrica (BIA) es un método de evaluación de la composición corporal que está muy extendido en diferentes situaciones, tanto en la hospitalaria como fuera de ella (2). El trabajo presentado por Cáceres y cols. parte de una premisa de trabajo realista que tiene que ver con la disponibilidad de tiempo en los centros hospitalarios, sobrecargados por la actividad asistencial, pero la realización de una BIA requiere el cumplimiento escrupuloso de una serie de requisitos metodológicos de gran importancia en estas evaluaciones que aseguren la fiabilidad y la precisión de las medidas.Por tanto, en este trabajo se parte de una situación de base presuntamente alteradora, como es el mantener a los sujetos de estudio a 60 minutos de decúbito supino, previa a la evaluación inicial (tomando esta medición como medición basal), para posteriormente comparar con las dos situaciones planteadas: de ayuno-no reposo y no ayuno-no reposo. Los análisis de los cambios de la composición corporal presentados en el trabajo son inicialmente congruentes con los producidos por las dos situaciones, pero la valoración inicial probablemente esta distorsionada e invalida las comparaciones estadísticas.Existen múltiples factores bien conocidos que alteran los resultados, como es la posición en decúbito supino. Con la posición de decúbito supino se pueden producir variaciones en la primera hora de hasta 10-15 Ω (3-5), lo cual puede comportar variaciones tanto para la masa libre de grasa como por sustracción a la masa grasa hasta de un 2% (4).Otro asunto es la ligera discrepancia en las variaciones de la resistencia encontradas entre el grupo de hombres y mujeres a través de las diversas mediciones. Las mayores variaciones en las estimaciones de la composición corporal no están en los instrumentos de medida, sino en los factores que pueden distorsionar dichas medidas y que pueden ser acumulables, influyendo en las estimaciones finales por el llamado error de propagación. BIBLIOGRAFÍA 1. Cáceres DI, Messagi-Sartor M, Rodríguez DA, FE, Gea J, Orozco-Levi M. Variabilidad de la composición corporal medida con bioimpedanciometría eléctrica según condiciones de realización: influencia del ayuno y del reposo. Nutr Hosp 2014;30(6):1359-65. 2. Alvero-Cruz JR, Correas-Gómez L, Ronconi MF, Fernandez-Vázquez R, Porta J. Bioelectrical impedance analysis as a method of body composition estimation: a practical approach. Rev Med Deport 2011;4(4):167-74. 3. Slinde F, Bark A, Jansson J, Rossander-Hulthén L. Bioelectrical impedance variation in healthy subjects during 12 h in the supine position. Clin Nutr 2003;22(2):153-7.

No abstract

No abstract

The aim of this study was to determine the benefits of supplementation with eicosapentaenoic (EPA) and docosahexaenoic (DHA) polyunsaturated fatty acids (PUFA) in terms of chemotoxicity and inflammatory status, to Mexican women with locally advanced breast cancer (LABC), receiving a standard neoadjuvant chemotherapy (NeoCT AC-taxol regimen). We performed a randomized double-blind, placebo-controlled, clinical trial, in which we studied 44 LABC patients (stages IIA to IIIA) who took 2.4g/d (1.6 g EPA and 0.8 g DHA, ratio 2:1) (N=22) or placebo (N=22) during NeoCT with doxorubicin/ cyclophosphamide followed paclitaxel weekly. Edmonton Scale and Common Terminology Criteria for Adverse Events (CTCAE) v4. assessment were performed before each CT, and also blood total leukocytes, and percentage lymphocytes and monocytes by standard lab methods. Serum inflammatory proteins and adipokines, were quantified by multiplexed analysis using a luminometer (MAGPIX) at basal time (0) and after cessation (+6 months) of AC and paclitaxel regimen. RESULTS: There were no differences in age between the supplemented and the placebo groups (51.6y vs. 49.1y, p=0.4), neither in body mass index (BMI, 28.7 kg/m2 and 28.9 kg/m2, p=0.8). After 6 months of supplementation, patients who were supplemented with PUFAs had significant changes (time 0 vs 6, respectively) in total leukocytes (from 6.3 to 5.1 x103/mL, p =0.002) lymphocytes (from 33.5 to 25.2%, p =0.002), leptin (from 60.2 to 36.1 pg/mL, p=0.04) and adiponectin (from 36.8 to 43.3 mg/mL, p=0.05 ). On the other hand, placebo group had significant changes in the number of leukocytes (from 6.8 to 10.0 x103/mL, p =0.04), monocytes (from 6.7 to 10.1%, p=0.03) and an increase in leptin (from 22.7 to 46.3 pg/mL, p=0.04). CONCLUSIONS: Supplementation with 2.4g/d of EPA and DHA (ratio 2:1) during 6 months in Mexican LABC patients receiving NeoCT resulted in a less inflammatory status when compared to patients who received none. Our results clearly suggest that this type of supplementation may be beneficial to these type of patients. Currently, we are analyzing if treatment with omega-3 PUFAs are associated with lower incidence of side effects due to chemotherapy. Citation Format: DelaRosa-Oliva F, Ruiz-Garcia E, Gomez E, Arce-Salinas C, Lara-Medina F, Alvarado-Miranda A, Matus-Santos J, Flores-Díaz D, Deneken-Hernandez Z, Bargalló- Rocha J, Cabrera P, Guadarrama-Orozco J, Ruiz-Calzada H, Meneses-García A, Astudillo-de la Vega H. Effect of supplementation with eicosapentaenoic and docosahexaenoic omega-3 polyunsaturated fatty acid on the chemotoxicity in Mexican patients with locally advanced breast cancer (LABC) treated with neoadjuvant chemotherapy (NeoCT) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-11-10.