Abstract
Purpose
To assess the change of body mass index (BMI), muscle mass, visceral and subcutaneous fat in patients with metastatic breast cancer.
Methods
In this retrospective chart analysis, patients with metastatic breast cancer as initial diagnosis between 2012 and 2016 were analyzed. Patients had received either chemotherapy (CTH) or endocrine therapy (ETH) according to the German S3 Guideline. BMI was calculated from the patients’ weight and height. Change of muscle mass, visceral and subcutaneous fat was determined by comparing the surface area of these tissues on transverse CT images at the level of the third lumbar vertebrae (L3) at baseline and during treatment.
Results
A total of 45 patients were included in the study, 29 on CTH and 16 on ETH. BMI, visceral and subcutaneous fat remained stable over time for both treatment groups. When taking both treatment groups together, muscle mass decreased significantly by 5.0 ± 2.5 cm2 per year (p < 0.05).
Conclusion
In patients with metastatic breast cancer, a slight reduction of muscle mass was observed, independent of therapy regimes.
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References
GLOBOCAN 2012 (IARC), section of cancer surveillance (5/6/2018). http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx. Accessed 6 Dec 2018
Deutsches Krebsregister Robert Koch Institut 05/2018. https://www.krebsdaten.de/Krebs/DE/Content/Publikationen/Krebs_in_Deutschland/kid_2017/kid_2017_c50_brust.pdf. Accessed 6 Dec 2018
Neuhouser ML, Aragaki AK, Prentice RL, Manson JE, Chlebowski R, Carty CL et al (2015) Overweight, obesity, and postmenopausal invasive breast cancer risk: a secondary analysis of the women’s health initiative randomized clinical trials. JAMA Oncol 1:611–621
Haykowsky MJ, Scott JM, Hudson K, Denduluri N (2017) Lifestyle interventions to improve cardiorespiratory fitness and reduce breast cancer recurrence. Am Soc Clin Oncol Educ Book 37:57–64
Ligibel JA, Strickler HD (2013) Obesity and its impact on breast cancer: tumor incidence, recurrence, survival, and possible interventions. Am Soc Clin Oncol Educ Book 2013:52–59. https://doi.org/10.1200/EdBook_AM.2013.33.52
Arce-Salinas C, Aguilar-Ponce JL, Villarreal-Garza C, Lara-Medina FU, Olvera-Caraza D, Alvarado Miranda A et al (2014) Overweight and obesity as poor prognostic factors in locally advanced breast cancer patients. Breast Cancer Res Treat 146:183–188
Chan DS, Vieira AR, Aune D, Bandera EV, Greenwood DC, McTiernan A et al (2014) Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol 25:1901–1914
Demark-Wahnefried W, Peterson BL, Winer EP, Marks L, Aziz N, Marcom PK et al (2001) Changes in weight, body composition, and factors influencing energy balance among premenopausal breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol 19:2381–2389
Morimoto LM, White E, Chen Z, Chlebowski RT, Hays J, Kuller L et al (2002) Obesity, body size, and risk of postmenopausal breast cancer: the Women’s Health Initiative (United States). Cancer Causes Control 13:741–751
Caan BJ, Cespedes Feliciano EM, Prado CM, Alexeeff S, Kroenke CH, Bradshaw P et al (2018) Association of muscle and adiposity measured by computed tomography with survival in patients with nonmetastatic breast cancer. JAMA Oncol 4:798–804
Tan BH, Birdsell LA, Martin L, Baracos VE, Fearon KC (2009) Sarcopenia in an overweight or obese patient is an adverse prognostic factor in pancreatic cancer. Clin Cancer Res 15:6973–6979
Rutten IJ, van Dijk DP, Kruitwagen RF, Beets-Tan RG, Olde Damink SW, van Gorp T (2016) Loss of skeletal muscle during neoadjuvant chemotherapy is related to decreased survival in ovarian cancer patients. J Cachexia Sarcopenia Muscle 7:458–466
Leitlinie Mammacarcinom Version 4.0, 2017. http://www.leitlinienprogramm-onkologie.de/leitlinien/mammakarzinom. Accessed 6 June 2018
Rier HN, Jager A, Sleijfer S, van Rosmalen J, Kock M, Levin MD (2017) Low muscle attenuation is a prognostic factor for survival in metastatic breast cancer patients treated with first line palliative chemotherapy. Breast 31:9–15
Feliciano EC, Chen WY (2018) Clinical implications of low skeletal muscle mass in early-stage breast and colorectal cancer. Proc Nutr Soc 77:1–6
Weinberg MS, Shachar SS, Muss HB, Deal AM, Popuri K, Yu H et al (2017) Beyond sarcopenia: characterization and integration of skeletal muscle quantity and radiodensity in a curable breast cancer population. Breast J 24:278–284
Deluche E, Leobon S, Desport JC, Venat-Bouvet L, Usseglio J, Tubiana-Mathieu N (2018) Impact of body composition on outcome in patients with early breast cancer. Support Care Cancer 26:861–868
Villaseñor A, Ballard-Barbash R, Baumgartner K, Baumgartner R, Bernstein L, McTiernan A, Neuhouser ML (2012) Prevalence and prognostic effect of sarcopenia in breast cancer survivors: the HEAL Study. J Cancer Surviv 6(4):398–406. https://doi.org/10.1007/s11764-012-0234-x
Shachar SS, Deal AM, Weinberg M, Nyrop KA, Williams GR, Nishijima TF et al (2017) Skeletal muscle measures as predictors of toxicity, hospitalization, and survival in patients with metastatic breast cancer receiving taxane-based chemotherapy. Clin Cancer Res 23:658–665
Rolland Y, Czerwinski S, Abellan Van Kan G, Morley JE, Cesari M, Onder G et al (2008) Sarcopenia: its assessment, etiology, pathogenesis, consequences and future perspectives. J Nutr Health Aging 12:433–450
Husebo AM, Dyrstad SM, Mjaaland I, Soreide JA, Bru E (2014) Effects of scheduled exercise on cancer-related fatigue in women with early breast cancer. Sci World J 2014:271828
Travier N, Velthuis MJ, Steins Bisschop CN, van den Buijs B, Monninkhof EM, Backx F et al (2015) Effects of an 18-week exercise programme started early during breast cancer treatment: a randomised controlled trial. BMC Med 13:121
Jackson RD, Mysiw WJ (2014) Insights into the epidemiology of postmenopausal osteoporosis: the Women’s Health Initiative. Semin Reprod Med 32:454–462
Scott JM, Iyengar NM, Nilsen TS, Michalski M, Thomas SM, Herndon J 2nd et al (2018) Feasibility, safety, and efficacy of aerobic training in pretreated patients with metastatic breast cancer: a randomized controlled trial. Cancer 124:2552–2560
Yee J, Davis GM, Beith JM, Wilcken N, Currow D, Emery J et al (2014) Physical activity and fitness in women with metastatic breast cancer. J Cancer Surviv 8:647–656
Courneya KS, Segal RJ, McKenzie DC, Dong H, Gelmon K, Friedenreich CM et al (2014) Effects of exercise during adjuvant chemotherapy on breast cancer outcomes. Med Sci Sports Exerc 46:1744–1751
Versteeg KS, Blauwhoff-Buskermolen S, Buffart LM, de van der Schueren MAE, Langius JAE, Verheul HMW et al (2018) Higher muscle strength is associated with prolonged survival in older patients with advanced cancer. Oncologist 23:580–585
Hida T, Harada A (2013) Fall risk and fracture. Diagnosing sarcopenia and sarcopenic leg to prevent fall and fracture: its difficulty and pit falls. Clin Calcium 23:707–712
Kim TH, Chang JS, Kong ID (2017) Effects of exercise training on physical fitness and biomarker levels in breast cancer survivors. J Lifestyle Med 7:55–62
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EFS, EMB, JCR, JE and CG designed the study and drafted the manuscript. EMB, JSMZ and JS performed the measurements. JSMZ and JS helped draft the manuscript. In addition, each author has read and approved the final version of the manuscript.
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As this was exclusively a retrospective review of patient records, no formal ethical approval was required after the regulations of Saarland University and Saarland ethics committee. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Solomayer, EF., Braun, EM., Zimmermann, J.S.M. et al. Muscle mass loss in patients with metastatic breast cancer. Arch Gynecol Obstet 300, 201–206 (2019). https://doi.org/10.1007/s00404-019-05168-y
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DOI: https://doi.org/10.1007/s00404-019-05168-y