Introdução: O uso de quimioterápicos para o tratamento de pacientes com câncer de mama tem aumentado a sobrevida dessa população. Entretanto, pode reduzir significativamente a densidade mineral óssea (DMO). Objetivo: Verificar a alteração da densidade mineral óssea em mulheres com câncer de mama submetidas a quimioterapia, assim como as características clínicas e os fatores de risco. Métodos: Revisão integrativa da literatura de artigos publicados no período de 2006 a 2016, realizada por meio de termos específicos nos bancos de dados da PubMed e da SciELO. Resultados: No período selecionado, foram identificados 898 artigos (897 na base PubMed e 1 na SciELO). Entre os seis artigos recuperados para leitura na íntegra, observou-se redução considerável na massa óssea na coluna lombar e no fêmur. Os principais tipos associados à redução foram os regimes doxorrubicina e ciclofosfamida (AC), ciclofosfamida, metotrexato e 5-fluorouracil (CMF) e ciclofosfamida, epirrubicina e 5-fluorouracil (FEC). Além disso, houve maior redução da DMO entre as mulheres com idade acima de 50 anos, caucasianas e que apresentaram falência ovariana precoce induzida pela quimioterapia. Conclusão: O uso de quimioterápicos para tratamento do câncer de mama pode acarretar perda de massa óssea, principalmente quando se utilizam os regimes AC, CMF e FEC em mulheres com idade acima de 50 anos e entre aquelas que apresentam menopausa precoce decorrente desse tratamento. DESCRITORES: Neoplasias da mama; Densidade mineral óssea; Quimioterapia Study carried out at the Advanced Center for Breast Diagnosis (CORA), Hospital das Clínicas (HC)/Universidade Federal de Goiás (UFG)-Goiânia (GO), Brazil.
Objective: To investigate whether breast cancer is associated with body composition, insulin resistance, and lipid profile. Methodology: This was a case-control study with 175 women recently diagnosed with breast cancer and 299 controls. Body composition was assessed by dual-energy X-ray absorptiometry. Waist circumference (WC) was measured as an indirect cardiometabolic risk factor (>80 cm). Total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), triglycerides, fasting blood glucose, glycated hemoglobin and insulin resistance (HOMA-IR<1.65) were assessed in plasma. Logistic regression was adjusted for body mass index (BMI) and age to quantify the association between breast cancer risk and body composition, insulin resistance, dyslipidemias, and abdominal adiposity. Results: The mean age of patients was 52±11 years. The case group had low lean mass compared to controls (35.04±5.09 vs 36.44±5.95 kg, p=0.02), even showing the same BMI (27.21±5.27; vs 27.58±5.17, p=0.26). Women diagnosed with breast cancer had high concentrations of triglycerides (134.07±67.57 vs 123.48±73.75; p=0.03). The logistic regression showed that breast cancer was inversely associated with lean mass and low fat mass (OR 0.93; 95%CI 0.89-0.97 and OR 0.26; 95%CI 0.13-0.53, respectively). Insulin resistance (OR 2.33; 95%CI 1.35-4.04) and abdominal obesity (OR 4.18; 95%CI 1.83-9.57) was positively associated with breast cancer. Conclusions: Lean mass was inversely associated with breast cancer, while abdominal adiposity and insulin resistance increases the chances of developing the cancer.
Objective: To evaluate the influence of lifestyle factors on the chances of developing breast cancer in Brazilian women. Methodology: A case-control study was conducted with 542 women, 197 diagnosed with breast cancer and 345 healthy controls. All analyzes were adjusted for age and BMI. The International Physical Activity Questionnaire-Short form was used to estimate the level of physical activity. A standardized questionnaire was used in order to evaluate whether the volunteers were following dietary recommendations, smoking, and alcohol-related habits. We also collected anthropometric variables: weight (kg), height (m), and waist circumference (cm). A multivariate logistic regression model was performed to estimate the odds ratios (OR) and 95% confidence intervals (CI) of the relative risk of breast cancer with lifestyle factors. Results: The mean age of the patients was 52±11 years. Not following dietary recommendation (OR 1.78, 95%CI 1.12-2.89), smoking habit (OR 1.68, 95%CI 1.12-2.46), alcoholic habit (OR 2.16, 95%CI 1.48-3.16), and sedentary lifestyle (OR 1.89; 95%CI 1.129-2.76) were associated with a greater chance of developing breast cancer, regardless of age and BMI. Conclusions: The sedentary lifestyle, not following dietary recommendations, smoking, and consumption of alcoholic beverages increase the risk of developing breast cancer.
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