Nutritional status, Muscle Mass, and Body Fat Percentage in Patients with Breast Cancer Undergoing Adjuvant Chemotherapy

Abstract

Aims: To evaluate alterations in weight, body composition, and nutritional parameters, and to identify the clinical, anthropometric, and dietary determinants of these changes among patients with breast cancer (BC) treated with adjuvant chemotherapy (AC). 

Methods: This study involved a cohort of 252 BC patients treated with AC. Anthropometric measurements were collected using standardized equipment and body composition was evaluated via bioelectrical impedance analysis (BIA). Clinical data were retrieved from the hospital's information system. Adherence to the Mediterranean Diet (MedDiet) was evaluated using a validated food frequency questionnaire.

Results: Post-AC, 29.3% and 22.7% of patients experienced moderate/high weight gain (WG ≥ 5%) and moderate/severe weight loss (MSWL ≥ 5%), respectively. The prevalence of patients with low muscle mass (LMM) and sarcopenic obesity increased from 11.5% and 2.8% pre-treatment to 15.1% and 7.9% post-treatment, respectively. Younger women (aged 24 – 39 years) exhibited reduced odds of experiencing MSWL (OR = 0.31, 95%CI: 0.08 – 1.20) and LMM (OR = 0.19, 95%CI: 0.02 – 1.61) compared to those aged ≥ 60 years. Patients with BC stages I and II were associated with increased odds of WG (OR = 2.10, 95%CI: 0.44 – 9.89; and OR = 2.13, 95%CI: 0.46 – 9.68, respectively). Relative to obese individuals, normal-weight/underweight individuals exhibited a significantly higher likelihood of WG (OR = 2.29; 95%CI: 1.03 – 5.08) and MSWL (OR = 3.23, 95%CI: 1.19 – 8.80), but a lower likelihood of LMM (OR = 0.33, 95%CI: 0.13 – 0.87). The Anthracycline-Taxane and Monoclonal-antibodies-Taxane regimens were associated with higher odds of MSWL (OR = 3.64, 95%CI: 0.35 – 36.98, and OR = 2.63, 95%CI: 1.03 – 6.72, respectively). Low and moderate adherence to the MedDiet were independently associated with an elevated risk of both WG and MSWL.

Conclusions: A substantial proportion of patients with BC experience significant weight fluctuation or deterioration in muscle mass following AC. These adverse outcomes are modulated by patient age, cancer stage or duration, baseline BMI, the specific chemotherapy regimen employed, and MeDiet adherence.

Keywords: Adjuvant chemotherapy; Body composition; Body mass index; Breast cancer; Mediterranean diet; Weight change.