Changes in body composition in early breast cancer patients treated with aromatase inhibitors.

Aromatase inhibitors Body composition Breast cancer Fat body mass Lean body mass

Journal

Journal of endocrinological investigation
ISSN: 1720-8386
Titre abrégé: J Endocrinol Invest
Pays: Italy
ID NLM: 7806594

Informations de publication

Date de publication:
10 Jun 2024
Historique:
received: 16 12 2023
accepted: 20 05 2024
medline: 10 6 2024
pubmed: 10 6 2024
entrez: 10 6 2024
Statut: aheadofprint

Résumé

The aim of the study was to analyze the modification of total and regional body composition in early breast cancer patients treated with aromatase inhibitors (AIs). This is a prospective, single-center, observational, longitudinal study. Four-hundred and twenty-eight patients treated with adjuvant aromatase inhibitors were enrolled at the Medical Oncology and Breast Unit of Spedali Civili Hospital in Brescia from September 2014 to June 2022. Several body composition parameters including total and regional fat and lean body mass were investigated with dual-energy X-ray absorptiometry (DXA) scan at baseline and after 18 months of treatment with aromatase inhibitors. A significant increase in fat body mass (mean + 7.2%, 95% confidence interval [CI]: 5.5;8.9%) and a reduction in lean body mass (mean -3.1%, 95% CI -3.9; -2.4) were documented in this population. The changes in fat and lean body mass varied considerably according to different body districts ranging between + 3.2% to + 10.9% and from-1.3% to -3.9%, respectively. Aromatase inhibitor adjuvant therapy in early breast cancer is associated with changes in body composition, with a wide variability among different body districts, leading to a risk of sarcopenic obesity. Supervised physical exercise that focuses on single body parts that may display detrimental variations may be beneficial for AIs treated patients.

Identifiants

pubmed: 38856966
doi: 10.1007/s40618-024-02401-7
pii: 10.1007/s40618-024-02401-7
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

Références

Sung H, Ferlay J, Siegel RL et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71(3):209–249. https://doi.org/10.3322/caac.21660
doi: 10.3322/caac.21660 pubmed: 33538338
Munoz D, Near AM, van Ravesteyn NT et al (2014) Effects of screening and systemic adjuvant therapy on ER-specific US breast cancer mortality. J Natl Cancer Inst. https://doi.org/10.1093/jnci/dju289
doi: 10.1093/jnci/dju289 pubmed: 25255803 pmcid: 4271026
Reinbolt RE, Mangini N, Hill JL et al (2015) Endocrine therapy in breast cancer: the neoadjuvant, adjuvant, and metastatic approach. Semin Oncol Nurs. https://doi.org/10.1016/j.soncn.2015.02.002 . (Published online 2015)
doi: 10.1016/j.soncn.2015.02.002 pubmed: 25951743
Runowicz CD, Leach CR, Henry NL et al (2016) American cancer society/American society of clinical oncology breast cancer survivorship care guideline. CA Cancer J Clin. https://doi.org/10.3322/caac.21319 . (Published online 2016)
doi: 10.3322/caac.21319 pubmed: 26641959
Vance V, Mourtzakis M, Mccargar L, Hanning R (2011) Weight gain in breast cancer survivors: prevalence, pattern and health consequences. Obes Rev. https://doi.org/10.1111/j.1467-789X.2010.00805.x . (Published online 2011)
doi: 10.1111/j.1467-789X.2010.00805.x pubmed: 20880127
Berg MMGA, Winkels RM, Kruif JTCM et al (2017) Weight change during chemotherapy in breast cancer patients: a meta-analysis. BMC Cancer. https://doi.org/10.1186/s12885-017-3242-4
doi: 10.1186/s12885-017-3242-4 pubmed: 28526008 pmcid: 5438506
Goodwin PJ, Ennis M, Pritchard KI et al (1999) Adjuvant treatment and onset of menopause predict weight gain after breast cancer diagnosis. J Clin Oncol 17(1):120–129. https://doi.org/10.1200/JCO.1999.17.1.120
doi: 10.1200/JCO.1999.17.1.120 pubmed: 10458225
Nyrop KA, Williams GR, Muss HB, Shachar SS (2016) Weight gain during adjuvant endocrine treatment for early-stage breast cancer: What is the evidence? Breast Cancer Res Treat. https://doi.org/10.1007/s10549-016-3874-0 . (Published online 2016)
doi: 10.1007/s10549-016-3874-0 pubmed: 27342454
Pedersini R, Laganà M, Bosio S et al (2023) Is weight gain preventable in women with early breast cancer undergoing chemotherapy? a real-world study on dietary pattern, physical activity, and body weight before and after chemotherapy. Breast Cancer Res Treat 202(3):461–471. https://doi.org/10.1007/s10549-023-07095-8
doi: 10.1007/s10549-023-07095-8 pubmed: 37695400 pmcid: 10564810
Nissen MJ, Shapiro A, Swenson K (2011) Changes in weight and body composition in women receiving chemotherapy for breast cancer. Clin Breast Cancer. https://doi.org/10.3816/CBC.2011.n.009 . (Published online 2011)
doi: 10.3816/CBC.2011.n.009 pubmed: 21421523
Sestak I, Singh S, Cuzick J et al (2014) Changes in bone mineral density at 3 years in postmenopausal women receiving anastrozole and risedronate in the IBIS-II bone substudy: an international, double-blind, randomised, placebo-controlled trial. Lancet Oncol. https://doi.org/10.1016/S1470-2045(14)71035-6 . (Published online 2014)
doi: 10.1016/S1470-2045(14)71035-6 pubmed: 25497694
Prentice AM, Jebb SA (2001) Beyond body mass index. Obes Rev. https://doi.org/10.1046/j.1467-789x.2001.00031.x . (Published online 2001)
doi: 10.1046/j.1467-789x.2001.00031.x pubmed: 12120099
Zong G, Zhang Z, Yang Q, Wu H, Hu FB, Sun Q (2016) Total and regional adiposity measured by dual-energy X-ray absorptiometry and mortality in NHANES 1999–2006. Obesity. https://doi.org/10.1002/oby.21659 . (Published online 2016)
doi: 10.1002/oby.21659 pubmed: 27667735
Okorodudu DO, Jumean MF, Montori VM et al (2010) Diagnostic performance of body mass index to identify obesity as defined by body adiposity: a systematic review and meta-analysis. Int J Obes. https://doi.org/10.1038/ijo.2010.5 . (Published online 2010)
doi: 10.1038/ijo.2010.5
Gallagher D, Visser M, Sepúlveda D, Pierson RN, Harris T, Heymsfieid SB (1996) How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups? Am J Epidemiol. https://doi.org/10.1093/oxfordjournals.aje.a008733 . (Published online 1996)
doi: 10.1093/oxfordjournals.aje.a008733 pubmed: 8561156
Harris TB (2002) Invited commentary: Body composition in studies of aging: new opportunities to better understand health risks associated with weight. Am J Epidemiol. https://doi.org/10.1093/aje/kwf024 . (Published online 2002)
doi: 10.1093/aje/kwf024 pubmed: 12117701
Oikonomou EK, Antoniades C (2019) The role of adipose tissue in cardiovascular health and disease. Nat Rev Cardiol. https://doi.org/10.1038/s41569-018-0097-6 . (Published online 2019)
doi: 10.1038/s41569-018-0097-6 pubmed: 30287946
Park J, Morley TS, Kim M, Clegg DJ, Scherer PE (2014) Obesity and cancer - Mechanisms underlying tumour progression and recurrence. Nat Rev Endocrinol. https://doi.org/10.1038/nrendo.2014.94 . (Published online 2014)
doi: 10.1038/nrendo.2014.94 pubmed: 24935119 pmcid: 4374431
Cruz-Jentoft AJ, Bahat G, Bauer J et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. https://doi.org/10.1093/ageing/afy169 . (Published online 2019)
doi: 10.1093/ageing/afy169 pubmed: 31081853 pmcid: 6593317
Caan BJ, Cespedes Feliciano EM, Prado CM et al (2018) Association of muscle and adiposity measured by computed tomography with survival in patients with nonmetastatic breast cancer. JAMA Oncol. https://doi.org/10.1001/jamaoncol.2018.0137 . (Published online 2018)
doi: 10.1001/jamaoncol.2018.0137 pubmed: 29621380 pmcid: 6584322
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. https://doi.org/10.1007/s00520-017-3902-6 . (Published online 2018)
doi: 10.1007/s00520-017-3902-6 pubmed: 28948392
Pang Y, Wei Y, Kartsonaki C (2022) Associations of adiposity and weight change with recurrence and survival in breast cancer patients: a systematic review and meta-analysis. Breast Cancer. https://doi.org/10.1007/s12282-022-01355-z . (Published online 2022)
doi: 10.1007/s12282-022-01355-z pubmed: 35579841
Van Londen GJ, Perera S, Vujevich K, Rastogi P, Lembersky B, Brufsky A, Vogel V, Greenspan S (2009) Changes in body composition in women with breast cancer on aromatase inhibitors: A two-year trial. J Clin Oncol 27(15_suppl):9528–9528
doi: 10.1200/jco.2009.27.15_suppl.9528
Francini G, Petrioli R, Montagnani A et al (2006) Exemestane after tamoxifen as adjuvant hormonal therapy in postmenopausal women with breast cancer: effects on body composition and lipids. Br J Cancer. https://doi.org/10.1038/sj.bjc.6603258 . (Published online 2006)
doi: 10.1038/sj.bjc.6603258 pubmed: 16835585 pmcid: 2360614
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP (2014) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. https://doi.org/10.1016/j.ijsu.2014.07.013 . (Published online 2014)
doi: 10.1016/j.ijsu.2014.07.013
Kendler DL, Borges JLC, Fielding RA et al (2013) The official positions of the international society for clinical densitometry: indications of use and reporting of DXA for body composition. J Clin Densitom. https://doi.org/10.1016/j.jocd.2013.08.020 . (Published online 2013)
doi: 10.1016/j.jocd.2013.08.020 pubmed: 24206867
Guerri S, Mercatelli D, Gómez MPA et al (2018) Quantitative imaging techniques for the assessment of osteoporosis and sarcopenia. Quant Imaging Med Surg. https://doi.org/10.21037/qims.2018.01.05 . (Published online 2018)
doi: 10.21037/qims.2018.01.05 pubmed: 29541624 pmcid: 5835658
Bazzocchi A, Ponti F, Albisinni U, Battista G, Guglielmi G (2016) DXA: technical aspects and application. Eur J Radiol. https://doi.org/10.1016/j.ejrad.2016.04.004 . (Published online 2016)
doi: 10.1016/j.ejrad.2016.04.004 pubmed: 27368763
Imboden MT, Welch WA, Swartz AM et al (2017) Reference standards for body fat measures using GE dual energy x-ray absorptiometry in Caucasian adults. PLoS One. https://doi.org/10.1371/journal.pone.0175110 . (Published online 2017)
doi: 10.1371/journal.pone.0175110 pubmed: 28426779 pmcid: 5398591
Messina C, Maffi G, Vitale JA, Ulivieri FM, Guglielmi G, Sconfenza LM (2018) Diagnostic imaging of osteoporosis and sarcopenia: a narrative review. Quant Imaging Med Surg 8(1):86–99. https://doi.org/10.21037/qims.2018.01.01
doi: 10.21037/qims.2018.01.01 pubmed: 29541625 pmcid: 5835659
Van Soom T, Tjalma W, Papadimitriou K, Gebruers N, van Breda E (2023) The effects of chemotherapy on resting energy expenditure, body composition, and cancer-related fatigue in women with breast cancer: a prospective cohort study. Cancer Metab 11(1):1–11. https://doi.org/10.1186/s40170-023-00322-2
doi: 10.1186/s40170-023-00322-2
Battisti S, Guida FM, Coppa F et al (2014) Modification of abdominal fat distribution after aromatase inhibitor therapy in breast cancer patients visualized using 3-D computed tomography volumetry. Clin Breast Cancer. https://doi.org/10.1016/j.clbc.2014.02.003 . (Published online 2014)
doi: 10.1016/j.clbc.2014.02.003 pubmed: 24850544
Ali PA, Al-Ghorabie FH, Evans CJ, El-Sharkawi AM, Hancock DA (1998) Body composition measurements using DXA and other techniques in tamoxifen-treated patients. Appl Radiat Isot. https://doi.org/10.1016/S0969-8043(97)00082-1
doi: 10.1016/S0969-8043(97)00082-1 pubmed: 9606085
Nguyen MC, Stewart RB, Banerji MA, Gordon DH, Kral JG (2001) Relationships between tamoxifen use, liver fat and body fat distribution in women with breast cancer. Int J Obes. https://doi.org/10.1038/sj.ijo.0801488 . (Published online 2001)
doi: 10.1038/sj.ijo.0801488
Van Londen GJ, Perera S, Vujevich K et al (2011) The impact of an aromatase inhibitor on body composition and gonadal hormone levels in women with breast cancer. Breast Cancer Res Treat 125(2):441–446. https://doi.org/10.1007/s10549-010-1223-2
doi: 10.1007/s10549-010-1223-2 pubmed: 21046232
Dalla Volta A, Caramella I, Di Mauro P et al (2023) Role of body composition in the prediction of skeletal fragility induced by hormone deprivation therapies in cancer patients. Curr Oncol Rep. https://doi.org/10.1007/s11912-023-01447-9 . (Published online 2023)
doi: 10.1007/s11912-023-01447-9 pubmed: 37624550 pmcid: 10556180
Monteverdi S, Pedersini R, Gallo F et al (2020) The interaction of lean body mass with fat body mass is associated with vertebral fracture prevalence in women with early breast cancer undergoing aromatase inhibitor therapy. JBMR Plus. https://doi.org/10.1002/jbm4.10440 . (Published online 2020)
doi: 10.1002/jbm4.10440 pubmed: 33615109 pmcid: 7872339
Cosentini D, Pedersini R, Di Mauro P et al (2024) Fat body mass and vertebral fracture progression in women with breast cancer. JAMA Netw Open 7(1):E2350950. https://doi.org/10.1001/jamanetworkopen.2023.50950
doi: 10.1001/jamanetworkopen.2023.50950 pubmed: 38198137 pmcid: 10782249
Palumbo C, Dalla Volta A, Zamboni S et al (2022) Effect of degarelix administration on bone health in prostate cancer patients without bone metastases the blade study. J Clin Endocrinol Metab. https://doi.org/10.1210/clinem/dgac489 . (Published online 2022)
doi: 10.1210/clinem/dgac489 pubmed: 35971857
Berruti A, Dogliotti L, Terrone C et al (2002) Changes in bone mineral density, lean body mass and fat content as measured by dual energy x-ray absorptiometry in patients with prostate cancer without apparent bone metastases given androgen deprivation therapy. J Urol. https://doi.org/10.1016/S0022-5347(05)64985-3 . (Published online 2002)
doi: 10.1016/S0022-5347(05)64985-3 pubmed: 11992038
Smith MR, Finkelstein JS, McGovern FJ et al (2002) Changes in body composition during androgen deprivation therapy for prostate cancer. J Clin Endocrinol Metab. https://doi.org/10.1210/jcem.87.2.8299 . (Published online 2002)
doi: 10.1210/jcem.87.2.8299 pubmed: 12466327
Kuryłowicz A (2023) Estrogens in adipose tissue physiology and obesity-related dysfunction. Biomedicines. https://doi.org/10.3390/biomedicines11030690 . (Published online 2023)
doi: 10.3390/biomedicines11030690 pubmed: 36979669 pmcid: 10045924
Greendale GA, Sternfeld B, Huang MH et al (2019) Changes in body composition and weight during the menopause transition. JCI Insight. https://doi.org/10.1172/jci.insight.124865 . (Published online 2019)
doi: 10.1172/jci.insight.124865 pubmed: 30843880 pmcid: 6483504
Karia PS, Joshu CE, Visvanathan K (2021) Association of oophorectomy and fat and lean body mass: evidence from a population-based sample of US women. Cancer Epidemiol Biomarkers Prev. https://doi.org/10.1158/1055-9965.EPI-20-1849 . (Published online 2021)
doi: 10.1158/1055-9965.EPI-20-1849 pubmed: 33879451 pmcid: 8258842
Aloia JF, McGowan DM, Vaswani AN, Ross P, Cohn SH (1991) Relationship of menopause to skeletal and muscle mass. Am J Clin Nutr. https://doi.org/10.1093/ajcn/53.6.1378 . (Published online 1991)
doi: 10.1093/ajcn/53.6.1378 pubmed: 2035465
Dalla Volta A, Palumbo C, Zamboni S et al (2023) Heterogeneity in regional changes in body composition induced by androgen deprivation therapy in prostate cancer patients: potential impact on bone health—the BLADE study. J Endocrinol Invest. https://doi.org/10.1007/s40618-023-02150-z . (Published online 2023)
doi: 10.1007/s40618-023-02150-z pubmed: 37458931 pmcid: 10859344

Auteurs

R Pedersini (R)

Medical Oncology Department, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 20123, Brescia, Italy.
SSVD Breast Unit, ASST Spedali Civili of Brescia, Brescia, Italy.

G Schivardi (G)

Medical Oncology Department, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 20123, Brescia, Italy. greta.schivardi@gmail.com.

L Laini (L)

Medical Oncology Department, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 20123, Brescia, Italy.

M Zamparini (M)

Medical Oncology Department, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 20123, Brescia, Italy.

A Bonalumi (A)

Medical Oncology Department, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 20123, Brescia, Italy.

P di Mauro (P)

Medical Oncology Department, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 20123, Brescia, Italy.

S Bosio (S)

SSVD Breast Unit, ASST Spedali Civili of Brescia, Brescia, Italy.

V Amoroso (V)

Medical Oncology Department, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 20123, Brescia, Italy.

N Villa (N)

Medical Oncology Department, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 20123, Brescia, Italy.

A Alberti (A)

Medical Oncology Department, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 20123, Brescia, Italy.

N Di Meo (N)

Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Medical Oncology, University of Brescia, ASST Spedali Civili, Brescia, Italy.

C Gonano (C)

Medical Oncology Department, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 20123, Brescia, Italy.

B Zanini (B)

Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

M Laganà (M)

Medical Oncology Department, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 20123, Brescia, Italy.

G Ippolito (G)

Medical Oncology Department, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 20123, Brescia, Italy.

L Rinaudo (L)

Tecnologie Avanzate Srl, Turin, Italy.

D Farina (D)

Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Medical Oncology, University of Brescia, ASST Spedali Civili, Brescia, Italy.

M Castellano (M)

Department of Internal Medicine and Endocrinology, University of Brescia, ASST Spedali Civili, Brescia, Italy.

C Cappelli (C)

Department of Internal Medicine and Endocrinology, University of Brescia, ASST Spedali Civili, Brescia, Italy.

E L Simoncini (EL)

SSVD Breast Unit, ASST Spedali Civili of Brescia, Brescia, Italy.

D Cosentini (D)

Medical Oncology Department, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 20123, Brescia, Italy.

A Berruti (A)

Medical Oncology Department, ASST Spedali Civili of Brescia, Piazzale Spedali Civili 1, 20123, Brescia, Italy.

Classifications MeSH