Body weight change in women receiving adjuvant chemotherapy for breast cancer: A French prospective study

Trédan, Olivier; Bajard, Agathe; Meunier, Anne; Roux, Pascale; Fiorletta, Ingrid; Gargi, Thérèse; Bachelot, Thomas; Guastalla, Jean‐Paul; Lallemand, Y.; Faure, C.; Pérol, David; Bachmann, Patrick

doi:10.1016/j.clnu.2009.08.003

Cited by 76 publications

(75 citation statements)

References 26 publications

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“…Gains are greatest amongst patients receiving adjuvant chemotherapy (3-7 kg) [1][2][3] and are on average more modest with adjuvant endocrine therapy (1-2 kg) [4]. However, subsets of patients gain a significant amount of weight on endocrine therapy [5].…”

Section: Introductionmentioning

confidence: 99%

Weight change associated with anastrozole and tamoxifen treatment in postmenopausal women with or at high risk of developing breast cancer

Šestak

Harvie

Howell

et al. 2012

Breast Cancer Res Treat

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Weight gain is commonly reported by breast cancer patients on tamoxifen or aromatase inhibitors. Since weight gain may impact on outcome and compliance we have prospectively assessed the effects of these agents on weight change in three randomised trials for the treatment or prevention of breast cancer. Data on weight change in postmenopausal women from three large clinical trials investigating endocrine therapy for the treatment or prevention of breast cancer were analysed (ATAC, IBIS-I and IBIS-II). In the IBIS-I study, mean weight change on tamoxifen was +0.1 kg (SD 0.1) compared with +0.3 kg (SD 0.1) in women taking the placebo (P = 0.3) between baseline and 12 months of follow-up. In the IBIS-II trial, no statistically significant difference was found between anastrozole and placebo after 12 months of follow-up [+0.8 kg (SD 5.3) vs. +0.5 kg (SD 7.4), P = 0.5]. In the ATAC trial, no statistically significant differences in weight gain between anastrozole and tamoxifen were found after 12 months of follow-up [+1.4 kg (SD 3.9) vs. +1.5 kg (SD 4.0), P = 0.4]. Significant baseline predictors for gaining more than 5 kg of weight after 12 months of follow-up were: being younger than 60 years old, smoking and mastectomy. All three trials demonstrate that weight gain occurs primarily within the first 12 months of active treatment in a subset of patients. In the prevention trials, weight gain does not differ between anastrozole, tamoxifen and placebo and also did not differ between anastrozole and tamoxifen in the treatment trial.

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Section: Introductionmentioning

confidence: 99%

Weight change associated with anastrozole and tamoxifen treatment in postmenopausal women with or at high risk of developing breast cancer

Šestak

Harvie

Howell

et al. 2012

Breast Cancer Res Treat

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“…Over the previous two decades, weight gain has been shown to be a dominant event among Western breast cancer patients following adjuvant chemotherapy, exerting a negative effect on the quality of life of the patients, since weight gain is associated with secondary diseases, such as diabetes and cardiovascular diseases (1)(2)(3)(4)(5)(6)(7). Furthermore, weight gain is also associated with cancer recurrence and poor prognosis (8)(9)(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

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

Wang

Cai

Wang

et al. 2013

Molecular and Clinical Oncology

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Abstract. Weight gain commonly occurs in breast cancer patients who receive adjuvant chemotherapy. Weight gain may cause psychosocial stress and is associated with patient prognosis and survival. Several factors contributing to weight gain have been identified in Western populations. However, there was lack of information associated with body weight changes following adjuvant chemotherapy in Chinese breast cancer patients. To the best of our knowledge, this is the first such study to be conducted in the Chinese population. A total of 98 patients who received adjuvant chemotherapy following a modified radical mastectomy were included in this study. Their weight was measured prior to the first and following the last cycle of chemotherapy. A weight gain, or loss, of >1 kg following adjuvant chemotherapy was considered to be significant. Cancer stage, treatment modalities, menopausal status and other clinical information were obtained through medical record review. The results revealed that the weight changes ranged from -11 to +9 kg, with a mean value of -0.4±4.4 kg. A total of 66.7% of the patients exhibited weight changes (34.6% gained >1 kg and 32.1% lost weight), whereas 33.3% of the patients maintained a stable weight (P<0.001). Patients aged ≤40 years [odds ratio (OR)=1.429, P=0.028], with a weight of ≥60 kg at diagnosis (OR=2.211, P=0.023), who received ≥4 cycles of chemotherapy (OR=1.591, P=0.039) and a total hormone dose of ≥200 mg (OR=2.75, P=0.013) exhibited a higher risk of weight gain. In conclusion, the body weight changes observed in Chinese breast cancer patient post-adjuvant chemotherapy were different from those observed among Western populations, represented predominantly by weight gain and were reflected by approximately equal percentages of weight gain, stable weight and weight loss. IntroductionOver the previous two decades, weight gain has been shown to be a dominant event among Western breast cancer patients following adjuvant chemotherapy, exerting a negative effect on the quality of life of the patients, since weight gain is associated with secondary diseases, such as diabetes and cardiovascular diseases (1-7). Furthermore, weight gain is also associated with cancer recurrence and poor prognosis (8-13). 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).The causes of weight gain may include reduced physical activity and menopause prior to diagnosis. However, the exact mechanisms have not been fully elucidated. In addition, the previous observations were focus...

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“…Weight gain occurs because of a positive energy balance and some studies report an increase in the ingestion of calories due to hyperphagia 5 . Others describe reductions in the energy expended, basal metabolic rate, and physical activity 9,10 . Another important factor is the combination of glucocorticoids and antiemetics used to minimize the side effects of CTx agents 8,11 .…”

Section: Introductionmentioning

confidence: 99%

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

Ricci

Formigoni

Zuliani

et al. 2014

Rev. Bras. Ginecol. Obstet.

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PURPOSE: To evaluate variations in the body mass index in patients undergoing adjuvant chemotherapy for breast cancer, and to associate these changes with patient's age and adjuvant chemotherapy regimen. METHODS: We performed a retrospective cohort study in order to correlate any variation in the body mass index before and after adjuvant chemotherapy with patient's age and adjuvant chemotherapy regimen. Patients who received any form of prior hormone therapy, such as tamoxifen or aromatase inhibitors, were excluded. We selected data for 196 patients with stage I to III breast cancer who were treated by radical or conservative surgery and received adjuvant chemotherapy at the Cancer Institute of the State of São Paulo, Brazil. RESULTS: Before adjuvant chemotherapy, 67.8% of patients were classified as overweight or obese according to their body mass indices. Around 66.3% (95% CI 59.7-73.0) of the patients exhibited an increase in the body mass index after adjuvant chemotherapy. The average age of all patients was 56.3±11.3 years. Participants whose body mass index increased were younger than those with no increase (54.7±11.1 versus 59.3±11.2 years; p=0.007). Patients were treated with the following adjuvant chemotherapy regimens: doxorubicin, cyclophosphamide, and paclitaxel (AC-T, 129 patients, 65.8%); 5-fluoracil, doxorubicin, and cyclophosphamide (36 patients, 18.4%); cyclophosphamide, methotrexate, and 5-fluoracil (16 patients, 8.2%); docetaxel and cyclophosphamide (7 patients, 3.6%); and other regimen (8 patients, 4.1%). The AC-T regimen showed a statistically significant association with increase in the body mass index (p<0.001 by ANOVA). CONCLUSIONS: Most patients with breast cancer showed an increase in the body mass index after adjuvant chemotherapy, especially after the AC-T chemotherapy regimen. ResumoOBJETIVO: Avaliar variações no índice de massa corpórea em pacientes que estão passando por quimioterapia devido ao câncer de mama, e relacionar tais alterações com a idade da paciente e o regime de quimioterapia. MÉTODOS: Estudo de coorte retrospectivo que correlacionou variações no índice de massa corpórea pré-e pós-quimioterapia com a idade da paciente e o regime de quimioterapia. Foram excluídas as pacientes que receberam terapia hormonal prévia, seja como tamoxifeno ou inibidores da aromatase. Os dados de 196 pacientes com estágio I a III de câncer de mama foram selecionados, e elas foram tratadas por cirurgia radical ou conservadora que receberam quimioterapia adjuvante no Instituto do Câncer do Estado de São Paulo, Brasil. RESULTADOS: Antes da quimioterapia adjuvante, 67,8% das pacientes foram classificadas com sobrepeso ou obesas de acordo com seus índices de massa corpórea. Aproximadamente 66,3% (IC95% 59,7-73,0) das pacientes exibiram aumento no índice de massa corpórea após a quimioterapia adjuvante. A média de idade das pacientes foi de 56,3±11,3 anos. Pacientes que apresentaram aumento no índice de massa corpórea eram mais jovens do que aquelas que não apresentaram aumento algum (54,7...

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Body weight change in women receiving adjuvant chemotherapy for breast cancer: A French prospective study

Cited by 76 publications

References 26 publications

Weight change associated with anastrozole and tamoxifen treatment in postmenopausal women with or at high risk of developing breast cancer

Weight change associated with anastrozole and tamoxifen treatment in postmenopausal women with or at high risk of developing breast cancer

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

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

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