Weight and Body Composition Changes during and after Adjuvant Chemotherapy in Women with Breast Cancer

Abstract

Uncontrolled trials have reported significant weight gain in women with breast cancer during treatment with adjuvant chemotherapy. We prospectively evaluated body composition before (visit 1), immediately after (visit 2), and 6 months after (visit 3) chemotherapy in 20 women with stages I-IIIA breast cancer [body mass index (BMI): 24.1 +/- 3.9 kg/m(2)]. We compared their weight change to 51 age- and BMI-matched healthy controls (BMI: 25.5 +/- 3.8 kg/m(2)). In women with breast cancer, there was no weight change from visit 1-2, or from visit 1-3, but weight increased from visit 2-3 (+1.09 +/- 2.46 kg; P = 0.05). Weight change was not different from controls during either interval. In the breast cancer group, the percentage of body fat assessed by air displacement plethysmography increased, and fat-free mass decreased from visit 1-2 (+2.3 +/- 4% and -2.2 +/- 4%; P = 0.02) and from visit 1-3 (+4.0 +/- 6% and -3.8 +/- 6%; P = 0.01). By dual energy x-ray absorptiometry, the percentage of body fat increased from visit 2-3 (+0.9 +/- 1.6%; P = 0.02). Bone mineral content decreased from visit 2-3 (-0.02 +/- 0.04 kg; P = 0.02) and from visit 1-3 (-0.04 +/- 0.06 kg; P = 0.005). By computed tomography, the visceral adipose to sc adipose tissue ratio decreased from visit 1-3 (-0.02 +/- 0.05 ml; P = 0.02). We conclude that, compared with controls, women with breast cancer receiving modern adjuvant chemotherapy regimens show no significant changes in weight during the first year of their treatment. They do, however, appear to undergo unfavorable changes in body composition.

Variations in the body mass index in Brazilian women undergoing adjuvant chemotherapy for breast cancer

“…Changes in BMI during anthracycline-based CTx have been associated with poorer prognosis, in terms of increased recurrence and mortality rates 13,14 . However, other studies have recorded only slight weight gains or unchanged weight with anthracycline-based regimens 22,24,32 .…”

“…Even though many studies have recorded increases in weight and BMI after breast cancer treatment, a systematic review, which included variations in body composition based on the use of imaging exams that quantified adipose tissue and lean body mass, such as densitometry, tomography, and magnetic resonance, did not record a consistent increase in the body weight 6 . Even when there was no weight gain, these patients often had changes to their bodies, with an increase in body fat and reductions in muscle mass and bone density 6,24 . Two other reviews showed that 50 to 96% of the patients with initial-stage breast cancer gained significant weight during adjuvant treatment, ranging from 2.5 to 6.2 kg 25 .…”

Telephone-delivered nutrition and exercise counselling after auto-SCT: a pilot, randomised controlled trial

“…Loss of fat may be temporary. Results on adult 32 and paediatric 33 PBSC transplantation survivors (both ⩾ 4-6 years survival), and breast cancer survivors (⩾6 months survival) 34 showed weight recovery favoured fat gain over LBM. This trend of change is not desirable as excess FM can mask a LBM deficit, as well as increase the risks of overweight-related health issues.…”

Body weight changes in breast cancer patients following adjuvant chemotherapy and contributing factors

“…However, other studies did not report a significant difference in weight gain between breast cancer patients receiving adjuvant chemotherapy and healthy controls (14). Therefore, the frequency and extent of body weight gain reported by previous studies may be considered to be overestimated (14,15).…”

“…Several previous studies have demonstrated that the majority of breast cancer survivors exhibited a mean body weight gain of 1-6 kg following chemotherapy and identified adjuvant chemotherapy as an independent prognostic factor for weight gain, with a potential long-term effect (2,3,5,6,11). However, other studies did not report a significant difference in weight gain between breast cancer patients receiving adjuvant chemotherapy and healthy controls (14). Therefore, the frequency and extent of body weight gain reported by previous studies may be considered to be overestimated (14,15).…”