Abstract
BackgroundWith increasing number of breast cancer survivors, more attention is drawn to long-term consequences of curative cancer treatment. Adjuvant treatment of breast cancer patients is associated with several unfavorable medical conditions, including dyslipidemia, insulin resistance, and obesity, potentially leading to cardiovascular disease and/or the metabolic syndrome. The aim of this explorative study is to investigate metabolic side effects of adjuvant treatment in breast cancer patients.MethodsA cohort of 13 premenopausal and 20 postmenopausal women with early stage breast cancer were extensively examined prior to, immediately after and 1 year after ended adjuvant chemotherapy and compared with healthy controls (N = 36) matched by age and menopausal status. Repeated examinations included: anthropometric measures, DEXA scans, 24-h blood pressure measurements, and blood samples [high sensitivity CRP, lipid profile and glucose metabolism, including homeostatic model assessment (HOMA)].ResultsAt baseline, breast cancer patients were similar to healthy controls regarding all measures. From baseline to 1-year post-treatment specific components of the metabolic syndrome increased significantly in premenopausal breast cancer patients; body fat (P = 0.01), triglycerides (P = 0.03), waist circumference (P = 0.008) and diastolic blood pressure (P = 0.04). In postmenopausal patients, waist circumference also increased significantly (P = 0.03), and High density lipoprotein (HDL) cholesterol decreased significantly (P = 0.05).ConclusionsSpecific components of the metabolic syndrome changed significantly during chemotherapy in early stage breast cancer patients. After 1 year, several key parameters remained pathologically changed. Premenopausal breast cancer patients seemed to be especially prone to develop these unfavorable changes.Trial registration ClinicalTrial.gov, registration number NCT02652975. Registered 15 December 2015—Retrospectively registered, https://clinicaltrials.gov/.
Highlights
With increasing number of breast cancer survivors, more attention is drawn to long-term consequences of curative cancer treatment
Women going through a course of adjuvant treatment for breast cancer (BC) potentially receive several cardiotoxic agents, as anthracyclines, cyclophosphamide, and trastuzumab, and agents that can interfere with the metabolic and hormonal balance of the women, e.g. aromatase inhibitors (AIs), selective estrogen receptor modulators (SERMs) and corticosteroids
Metabolic parameters and female hormones in all postmenopausal BC patients In the postmenopausal group of BC patients, we found a significant increase in waist circumference from time point 0 (T0) to T2, while weight, body fat and lean body mass was unchanged (Table 5)
Summary
With increasing number of breast cancer survivors, more attention is drawn to long-term consequences of curative cancer treatment. Adjuvant treatment of breast cancer patients is associated with several unfavorable medical conditions, including dyslipidemia, insulin resistance, and obesity, potentially leading to cardiovascular disease and/or the metabolic syndrome. The aim of this explorative study is to investigate metabolic side effects of adjuvant treatment in breast cancer patients. Several studies have found that BC survivors are at increased risk of cardiovascular disease (CVD) compared with matched controls [2, 3]. Diabetes and the metabolic syndrome are more prevalent among BC survivors compared to age matched controls [6,7,8]. Metabolic syndrome (MetS) is a cluster of disorders including hypertension, type II diabetes, dyslipidemia and obesity. Visceral adiposity is considered to be a major driving force in the development of MetS [9]
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