Abstract P2-18-07: Weight and body composition’s analysis in chemotherapy-treated women with breast cancer under nutritional follow up in a private oncology service in Brazil

Abstract

Abstract INTRODUCTION: The obesity/overweight is closely related to poorer breast cancer prognosis, as well as higher mortality rates. In postmenopausal women, the main source of estrogen is in the adipose tissue. Due to that, overweight/obesity leads to an increase in breast cancer development and disease progression. This is a consequence of not only to high estrogen levels, but also to an increase in circulating factors that influence in inflammatory pathway activations and insulin resistance increase. OBJECTIVES: This study aims at analyzing weight and body composition variation in breast cancer women under nutritional monitoring during adjuvant chemotherapy (CT). METHOD/DESIGN: This is an observational, prospective study with estrogen receptor (ER) and/or progesterone receptor (PR) positives, HER2 negative breast cancer women, who underwent adjuvant CT, from 07/17/2018 to 06/19/2019. Nutritionists followed up these patients during all of CT cycles, and data on body composition were collected through bioelectric impedance in the first and last days of chemotherapy. In between cycles, body weight assessments, nutritional guidelines orientations adherence were checked against the information, which had been offered. RESULTS: 51 women were selected and 4 excluded according to study criteria (3 patients turned HER2 positive by FISH and 1 patient had metastatic cancer confirmation). By the data analysis, 36 patients completed chemotherapy. The CT regimens used were doxorrubicin, cyclophosphamide and paclitaxel (ACT) (59%), AC plus docetaxel (4%), cyclophosphamide, methotrexate and Fluorouracil (CMF) (10%), AC (6%) and docetaxel and cyclophosphamide (TC) (21%). The mean age was 51 years, with 12 women aged ≥ 60 years. At the beginning the mean Body Mass Index (BMI) was 27.94 kg / m2. 37% of them were classified as eutrophic, 33% were overweight and 30% obese, according to the World Health Organization (WHO) criteria. Weight gain was observed in 64% of patients, with a significant increase in lean mass (kg) as well as body water (in 75% of patients). There was a reduction in fat percentage due to the reduction of fat mass in kilos (52.8% of patients) and the increase of lean mass (kg). The mean BMI at the end of treatment was 27.08 kg / m2, with a decrease in obesity and eutrophic index (reduction of 5.8% and 32.9%, respectively) and an increase in overweight by 41.7%. If considered the weight variation per CT protocol, the women submitted to the ACT scheme had a higher prevalence of weight gain, distributed in lean mass (80%), body water (75%) and fat mass reduction in 55% of these patients. On the other hand, there was a reduction in the mean of BMI value between the first evaluation (26.7 kg / m2) and the last one (22.4 kg / m2), as well as a lower fat mass in 62.5% of women who were submitted to TC protocol. In addition, in CMF and AC protocol, only one patient in each regimen finished the treatment until the deadline. In this case, the results were immature and not been reported in this abstract. CONCLUSIONS: There was an improvement in body composition, considering lean and fat mass in the study population, probably due to the nutritional monitoring during all cycles of chemotherapy. Nutritional therapy certainly influenced adherence to better eating habits. Full data of the 51 patients will be presented during the meeting. It should reinforce the need of developing prospective controlled studies, targeting nutritional intervention in breast cancer treatment. Citation Format: Flavia Rocha Paes, Anna Nogueira Verano, Julia SM de Sá, Rafaela M Peixoto, Juliana CO Pena, Maria Clara A Zocrato, Patricia C Christo, Fernanda CMJ Oliveira, Bruno L Ferrari. Weight and body composition’s analysis in chemotherapy-treated women with breast cancer under nutritional follow up in a private oncology service in Brazil [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-18-07.