The Impact of Multidisciplinary Weight Management on Body Weight and Body Mass Composition in Women with Breast Cancer Post-Adjuvant Chemotherapy: A Retrospective Chart Review

Abstract

Introduction: Weight gain during chemotherapy for breast cancer is a well-documented adverse effect. The purpose of this study was to investigate how multidisciplinary weight management involving endocrinology, dietitian and exercise physiology care, in a real-life Healthy Weight Clinic (HWC) would impact body weight and mass composition in breast cancer women post-adjuvant chemotherapy compared to a cohort of non-cancer women who have been matched by age, ethnicity, smoking and menopausal status. Methods: Body weight (kg), BMI (kg/m2), skeletal muscle mass (SMM %), fat mass (FM %) and waist circumference (cm) were collected at baseline of the first HWC appointment, three-months after baseline, and six-months after baseline. A total of 32 women were included, 11 in the breast cancer cohort and 21 in the control cohort, that matched inclusion and exclusion criteria based on a retrospective chart review from 28th July 2017 to 19th July 2021. Results: By six-months, the breast cancer women had a mean weight change of -6.99kg (SD=3.87, p=.003, n=11) and change in BMI by -2.72kg/m2 (SD=1.62, p=.004, n=11). There was a change in SMM of 1.21% (SD=0.73, p=.005, n=11), a change in FM of -2.76% (SD=1.33, p=.002, n=11) and a change in waist circumference of -8.13cm (SD=4.21, p=.031, n=3). By six-months in the breast cancer cohort, there was a larger change in body weight in women who did not have MetS (-8.72kg, SD=2.41, n=6) in comparison to women with MetS (-2.65kg, SD=3.75kg, n=3) (p=.045). Conclusion: Findings indicate that multidisciplinary weight management has a positive role in early-stage breast cancer survival through improving body weight and mass composition. These results can add to the development of long-term treatment plans for survivors in order to shine a light on ways to reduce risk recurrence and chronic disease mortality.

A protocol for a multidisciplinary early intervention during chemotherapy to improve dietary management behavior in breast cancer patients: a two-arm, single-center randomized controlled trial

“…This further exacerbates weight gain and muscle strength loss and has a profound negative impact on the quality of life and psychological state of BC survivors [ 4 ]. Possible reasons include the following: first, drug-related toxicity leads to muscle depletion due to decreased protein anabolism and proatrophic mechanisms, resulting in decreased skeletal muscle mass and increased fat mass; second, chemotherapy can cause ovarian failure, which affects hormone levels and is also associated with subsequent weight gain; third, chemotherapy-related fatigue can reduce daily physical activity and energy expenditure at rest, resulting in weight gain; and finally, chemotherapy can lead to changes in taste and smell and can cause changes in eating habits, which can affect weight [ 5 ]. Diet is one of the most important lifestyle factors and is considered a self-management health behavior involving physiological, psychological, environmental, social, and other factors [ 6 ].…”

“…Implementing DMB interventions is highly beneficial. These interventions can stimulate patients’ sense of autonomy, cultivate their nutritional management ability, provide a basis for the implementation of home-based rehabilitation plans after chemotherapy, and ultimately improve their life expectancy and quality of life [ 5 ].…”

Dietary Behavior and Its Association with Nutrition Literacy and Dietary Attitude Among Breast Cancer Patients Treated with Chemotherapy: A Multicenter Survey of Hospitals in China

“… 7 Moreover, the side effects of chemotherapy, such as nausea and vomiting, loss of appetite and taste change, interfere with normal nutritional intake, food perception and food choice, which is subsequently accompanied by a series of abnormal dietary behaviors. 8 This may not only result in weight fluctuations, adverse changes in body composition, and loss of muscle strength 9 but also has profoundly negative consequences on quality of life and the psychological status of breast cancer survivors and increases the risk of recurrence. For example, increased BMI after chemotherapy is an important risk factor for breast cancer recurrence.…”