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Weight and Body Composition Changes during and after Adjuvant Chemotherapy in Women with Breast Cancer

Unit on Growth and Obesity, Developmental Endocrinology Branch (R.J.F., J.A.Y.), National Institute of Child Health and Human Development, National Institutes of Health; Office of Cancer Survivorship, Division of Cancer Control and Population Sciences (N.A.), National Cancer Institute; Nutritional Epidemiology Branch (D.A.), Division of Cancer Epidemiology and Genetics; Cancer Prevention Studies Branch, Center for Cancer Research (T.H.), National Cancer Institute; Surgery Branch, Center for Cancer Research (D.D.), National Cancer Institute; Diagnostic Radiology Department (S.H., J.C.R.); and Nutrition Department, Warren Grant Magnuson Clinical Center (N.S.), National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892

Address all correspondence and requests for reprints to: Renee J. Freedman, M.D., Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, 10 Center Drive, Building 10, Room 10N262, MSC 1862, Bethesda, Maryland 20892-1862. E-mail: freedmar{at}mail.nih.gov.

Uncontrolled trials have reported significant weight gain in women with breast cancer during treatment with adjuvant chemotherapy. We prospectively evaluated body composition before (visit 1), immediately after (visit 2), and 6 months after (visit 3) chemotherapy in 20 women with stages I-IIIA breast cancer [body mass index (BMI): 24.1 ± 3.9 kg/m²]. We compared their weight change to 51 age- and BMI-matched healthy controls (BMI: 25.5 ± 3.8 kg/m²).

In women with breast cancer, there was no weight change from visit 1–2, or from visit 1–3, but weight increased from visit 2–3 (+1.09 ± 2.46 kg; P = 0.05). Weight change was not different from controls during either interval.

In the breast cancer group, the percentage of body fat assessed by air displacement plethysmography increased, and fat-free mass decreased from visit 1–2 (+2.3 ± 4% and –2.2 ± 4%; P = 0.02) and from visit 1–3 (+4.0 ± 6% and –3.8 ± 6%; P = 0.01). By dual energy x-ray absorptiometry, the percentage of body fat increased from visit 2–3 (+0.9 ± 1.6%; P = 0.02). Bone mineral content decreased from visit 2–3 (–0.02 ± 0.04 kg; P = 0.02) and from visit 1–3 (–0.04 ± 0.06 kg; P = 0.005). By computed tomography, the visceral adipose to sc adipose tissue ratio decreased from visit 1–3 (–0.02 ± 0.05 ml; P = 0.02).

We conclude that, compared with controls, women with breast cancer receiving modern adjuvant chemotherapy regimens show no significant changes in weight during the first year of their treatment. They do, however, appear to undergo unfavorable changes in body composition.

J.A.Y., N.S., and D.A. are commissioned officers in the United States Public Health Service, Department of Health and Human Services.

Abbreviations: AC, Doxorubicin and cyclophosphamide; ADP, air displacement plethysmography; BIA, bioelectrical impedance analysis; BMC, bone mineral content; BMI, body mass index; CI, confidence interval; CMF, cyclophosphamide, methotrexate, and 5-fluorouracil; DXA, dual energy x-ray absorptiometry; IAT, intraabdominal adipose tissue; SAT, sc abdominal adipose tissue.

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