Prognostic Impact of Weight Change During Adjuvant Chemotherapy in Patients With High-Risk Early Breast Cancer: Results From the ADEBAR Study

Mutschler, Nikola S.; Scholz, Christoph; Friedl, Thomas W. P.; Zwingers, Thomas; Fasching, Peter A.; Beckmann, Matthias W.; Fehm, Tanja; Mohrmann, Svjetlana; Salmen, J; Ziegler, Carola; Jäger, Bernadette; Widschwendter, Peter; Gregorio, Nikolaus de; Schochter, Fabienne; Mahner, Sven; Harbeck, Nadia; Weißenbacher, Tobias; Jückstöck, Julia; Janni, Wolfgang; Rack, Brigitte

doi:10.1016/j.clbc.2018.01.008

Cited by 23 publications

(24 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Excess body weight is a recognized breast cancer risk factor and also a factor of poor prognosis at diagnosis (high recurrence and mortality rates) [1,2]. Weight gain during breast cancer treatment, in particular during chemotherapy, is also linked to poor prognosis [3][4][5][6][7]. The mechanisms that explain weight change are not clearly understood [8].…”

Section: Introductionmentioning

confidence: 99%

A decrease in brown adipose tissue activity is associated with weight gain during chemotherapy in early breast cancer patients

et al. 2020

View full text Add to dashboard Cite

Background: A decrease in thermogenesis is suspected to be implicated in the energy expenditure reduction during breast cancer treatment. This study aimed to investigate the impact of chemotherapy on the metabolic activity of brown adipose tissue (BAT) and the link with weight variation.Methods: This was an ancillary analysis of a multicentre trial involving 109 HER2+ breast cancer patients treated with neoadjuvant chemotherapy. A centralised review of 18 F-FDG uptake intensity (SUV max ) in specific BAT regions (cervical and supraclavicular) was conducted on two PET-CT scans for each patient (before and after the first course of chemotherapy). Results: Overall, after one course of chemotherapy a significant decrease of 4.4% in 18 F-FDG-uptake intensity was observed. It was not correlated to initial BMI, age or season. During chemotherapy, 10.1% (n = 11) of the patients lost weight (− 7.7 kg ± 3.8 kg; ie, − 9.4% ± 3.7%) and 29.4% (n = 32) gained weight (+ 5.1 kg ± 1.7 kg; ie, + 8.5% ± 2.6%). Among these subgroups, only the patients who had gained weight underwent a significant decrease (13.42%) in 18 F-FDG uptake intensity (p = 0.042). Conclusion:This study is the first to highlight in a large cohort of patients the negative impact of chemotherapy on brown adipose tissue activity. Weight gain during chemotherapy could thus potentially be explained in part by a decrease in brown adipose tissue activity.

show abstract

Section: Introductionmentioning

confidence: 99%

A decrease in brown adipose tissue activity is associated with weight gain during chemotherapy in early breast cancer patients

et al. 2020

View full text Add to dashboard Cite

show abstract

“…However, this was no longer evident after exclusion of patients that had died within one year after the 1-year postoperative visit, which suggests reverse causality and a symptom of an underlying disease where frailty and muscle wasting might be present. Multiple observational studies have reported poor breast cancer prognosis associated with weight loss [6,7,9,11,12,15,16,18]. However, a systematic review indicated a considerable risk of bias in some studies because of lack of information on whether the weight loss was intentional or not [39].…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative body sizes increased significantly 2002-2016 with a negative prognostic impact [5]. Weight change has been investigated in multiple studies, but the impact on breast cancer prognosis remains unclear [6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Yet, overweight breast cancer patients in Sweden are often recommended to lose weight.…”

Section: Introductionmentioning

confidence: 99%

“…Weight change following breast cancer diagnosis and treatment is common but might differ according to patients' age and treatments [6,[20][21][22]. A possible U-shaped relationship with increased risk for both weight gain and loss has been suggested [7,9,12,15,16,18]. Adipose tissue is biologically active, and multiple pro-carcinogenic processes associated with weight gain have been identified [3].…”

Section: Introductionmentioning

confidence: 99%

“…Adipose tissue is biologically active, and multiple pro-carcinogenic processes associated with weight gain have been identified [3]. Less is known about the mechanisms behind the poor breast cancer prognosis associated with weight loss in observational studies [6,7,9,11,12,15,16,18].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The impact of body size changes on recurrence risk depends on age and estrogen receptor status in primary breast cancer

Tryggvadottir

Rödström

Markkula

et al. 2019

Cancer Causes Control

View full text Add to dashboard Cite

Purpose To investigate the prognostic impact of body size changes during the first postoperative year in breast cancer. Methods A cohort of 1,317 primary breast cancer patients included in Sweden (2002-2014) underwent body size measurements at the preoperative and 1-year visits (n = 1,178). Landmark survival analyses were used to investigate how postoperative weight gain or loss (> 5%) or change in waist-hip ratio (WHR) categories (≤ 0.85 or > 0.85) impact prognosis. Results Median age at inclusion was 61 years and body mass index 25.1 kg/m 2. After a median follow-up of 5.0 years from inclusion, 165 recurrences and 77 deaths occurred. Weight gain (17.0%) conferred over twofold recurrence risk only in patients < 50 years (P interaction = 0.033). Weight loss (8.6%) was only associated with a poor prognosis in patients ≥ 70 years, but not after restriction analysis. Weight change did not impact prognosis in patients 50 to < 70 years. Changes between WHR categories were associated with differential recurrence risk depending on estrogen receptor (ER) status (P interaction = 0.007), with higher recurrence risk in patients with ER+ tumors and lower recurrence risk with ER− tumors. Conclusion Both changes in terms of weight and WHR category yielded independent prognostic information. Further research is imperative before recommending weight loss for all overweight breast cancer patients.

show abstract

Body weight management in overweight and obese breast cancer survivors

Shaikh

Bradhurst

et al. 2020

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Prognostic Impact of Weight Change During Adjuvant Chemotherapy in Patients With High-Risk Early Breast Cancer: Results From the ADEBAR Study

Cited by 23 publications

References 40 publications

A decrease in brown adipose tissue activity is associated with weight gain during chemotherapy in early breast cancer patients

A decrease in brown adipose tissue activity is associated with weight gain during chemotherapy in early breast cancer patients

The impact of body size changes on recurrence risk depends on age and estrogen receptor status in primary breast cancer

Body weight management in overweight and obese breast cancer survivors

Contact Info

Product

Resources

About