Energy balance in women with breast cancer during adjuvant treatment

Objective To compare weight, body composition, and major determinants of en ergy balance of women treated with adjuvant chemotherapy (n=8) using Adriam ycin and cyclophosphamide (AC), or radiation therapy (n=10). Design The study used a nonrandomized prospective design. Pretreatment and posttreatment measurements, obtained at baseline and 12 weeks, respectively , included weight, body composition (determined using dual-energy x-ray abs orptiometry), energy intake (determined using 3-day food records), resting energy expenditure (determined in indirect calorimetry), and physical activ ity (determined using 3-day physical activity records). Poststudy follow-up weights were obtained for 13 women. Subjects/setting Eighteen premenopausal women with breast cancer in the ear ly stage, recruited from outpatient clinics, participated in and completed the study. Statistical analyses performed Unpaired Student t tests or X-2 tests were u sed to test for differences in baseline subject-characteristics, and repeat ed measures analysis of variance was used to compare groups before and afte r treatment. Results Body weight was unchanged in both treatment groups during the study , although poststudy follow-up weights (n=13) suggested a tendency for weig ht gain in both groups. Significant changes in body composition for both gr oups included a mean loss of 0.8 kg total lean body mass (LBM), a mean loss of 0.4 kg LBM in the leg region, and a mean 1.3% increase in percent body fat,from 40.0% to 41.3%. Overall, no between-group differences were observe d in any factors associated with energy balance. Applications In this short-term study, AC chemotherapy using fewer antineop lastic agents and number of treatments than most chemotherapy protocols for breast cancer, did not result in weight gain during treatment. Regardless of weight gain, changes in body composition may occur in women with breast cancer during or after treatment. These potential changes have important im plications for preventive nutrition counseling.