Energy balance in women with breast cancer during adjuvant treatment

To compare weight, body composition, and major determinants of energy balance of women treated with adjuvant chemotherapy (n = 8) using Adriamycin and cyclophosphamide (AC), or radiation therapy (n = 10).

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 absorptiometry), energy intake (determined using 3-day food records), resting energy expenditure (determined in indirect calorimetry), and physical activity (determined using 3-day physical activity records). Poststudy follow-up weights were obtained for 13 women.

Eighteen premenopausal women with breast cancer in the early stage, recruited from outpatient clinics, participated in and completed the study.

Unpaired Student t tests or X2 tests were used to test for differences in baseline subject characteristics, and repeated measures analysis of variance was used to compare groups before and after treatment.

Body weight was unchanged in both treatment groups during the study, although poststudy follow-up weights (n = 13) suggested a tendency for weight gain in both groups. Significant changes in body composition for both groups 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 observed in any factors associated with energy balance.

In this short-term study, AC chemotherapy using fewer antineoplastic 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 implications for preventive nutrition counseling.