Sobreviventes do câncer de mama tem menos massa magra e menor ângulo de fase após o tratamento oncológico

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Palavras-chave:

câncer de mama, sobreviventes, tratamento farmacológico, composição corporal

Resumo

Objetivo: Avaliar o estado do peso e a composição corporal de mulheres sobreviventes do câncer de mama após tratamento oncológico. Metodologia: Trata-se de estudo clínico do tipo antes e depois, em que 27 pacientes sobreviventes do câncer de mama foram avaliadas antes (T0) e depois (T1) do tratamento oncológico (cirúrgico e clínico). Aferiram-se peso atual e estatura para definição do índice de massa corporal (IMC). A avaliação da composição corporal deu-se por impedância bioelétrica tetrapolar, sendo aferidos percentual de massa gorda e de massa magra e ângulo de fase. Aplicou-se o teste t de Student para avaliar a diferença de médias das variáveis antropométricas e de composição corporal entre T0 e T1, bem como o teste de McNemar para avaliar diferenças na prevalência de sobrepeso, adotando significância de 5%. Resultados: As pacientes têm aumento médio de 2,6 kg após o tratamento (p=0,00) e 1,15 kg/m2 no IMC (p=0,00). O percentual de massa gorda aumenta 0,6% (p=0,003) e há redução na massa magra (p=0,03) no T1. Em relação ao ângulo de fase, há diminuição média de 0,6 (p=0,026) após o tratamento. Conclusão: Mulheres sobreviventes do câncer de mama têm aumento de adiposidade, redução da massa magra e piora da integridade celular após o tratamento oncológico, o que sugere acréscimo de fatores de risco para recidiva da doença.

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Referências

Brasil. Ministerio da Saude. Instituto Nacional de Cancer. Estimativa 2018: incidencia de cancer no Brasil [Internet]. Rio de Janeiro: Inca; 2017 [accessed on February 7, 2019]. Available on: http://www1.inca.gov.br/estimativa/2018/estimativa-2018.pdf

Stewart BW, Wild CP. World Cancer Report [Internet]. Lyon: IARC; 2014 [accessed on February 13, 2019]. Available on: https://publications.iarc.fr/Non-Series-Publications/World-Cancer-Reports/World-Cancer-Report-2014

World Health Organization, International Agency for Research on Cancer. GLOBOCAN 2018: Global Cancer Observatory [Internet]. Lyon: IARC [accessed on October 1, 2018]. Available on: http://gco.iarc.fr/tomorrow/graphic-isotype

Greer JA, Amoyal N, Nisotel L, Fishbein JN, MacDonald J, Stagl J, et al. A Systematic Review of Adherence to Oral Antineoplastic Therapies. Oncologist. 2016;21(3):354-76. https://doi.org/10.1634/theoncologist.2015-0405

Trestini I, Carbognin L, Monteverdi S, Zanelli S, De Toma A, Bonaiuto C, et al. Clinical implication of changes in body composition and weight in patients with early-stage and metastatic breast cancer. Crit Rev Oncol Hematol. 2018;129:54- 66. https://doi.org/10.1016/j.critrevonc.2018.06.011

Shachar SS, Deal AM, Weinberg M, Nyrop KA, Williams GR, Nishijima TF, et al. Skeletal Muscle Measures as Predictors of Toxicity, Hospitalization, and Survival in Patients with Metastatic Breast Cancer Receiving Taxane-Based Chemotherapy. Clin Cancer Res. 2017;23(3):658-65. https://doi.org/10.1158/1078-0432.CCR-16-0940

Simone V, D’avenia M, Argentiero A, Felici C, Rizzo FM, Pergola G, et al. Obesity and Breast Cancer: Molecular Interconnections and Potential Clinical Applications. Oncologist. 2016;21(4):404- 17. https://doi.org/10.1634/theoncologist.2015-0351

Caan BJ, Cespedes Feliciano EM, Kroenke CH. The Importance of Body Composition in Explaining the Overweight Paradox in Cancer-Counterpoint. Cancer Res. 2018;78(8):1906-12. https://doi.org/10.1158/0008-5472.CAN-17-3287

da Silva EY, Carioca AA, Verde SM, Aubin E da C, Damasceno NR. Effect of chemotherapy on dietary glycemic index and load in patients with breast cancer and their relationships to body fat and phase angle. Nutr Cancer. 2015;67(4):587-93. https://doi.org/10.1080/01635581.2015.1019638

World Health Organization. Obesity: preventing and managing the global epidemic. Genebra: WHO; 2000. WHO Technical Report Series 894.

Lohman TG. Advances in body composition assessment. Current issues in exercise science series (monograph 3). Champaign: Human Kinetics, 1992. https://doi.org/10.1002/ajhb.1310050514

Barbosa-Silva MC, Barros AJ, Wang J, Heymsfield SB, Pierson RN Jr. Bioelectrical impedance analysis: population reference values for phase angle by age and sex. J Clin Nutr. 2005;82(1):49- 52. https://doi.org/10.1093/ajcn.82.1.49

Ruiz MP, Tarifa CM, Valle-Goffin JJ, Friedman ER, Slingerland JM. Obesity and adverse breast cancer risk and outcome: Mechanistic insights and strategies for intervention. CA Cancer J Clin. 2017;67(5):378-97. https://doi.org/10.3322/caac.21405

Ando S, Gelsomino L, Panza S, Giordano C, Bonofigilio D, Barone I, et al. Obesity, Leptin and Breast Cancer: Epidemiological Evidence and Proposed Mechanisms. Cancers. 2019;11(1):62. https://doi.org/10.3390/cancers11010062

Berg MM, Winkels RM, Kruif J, Laarhoven HW, Visser M, Vries JH, et al. Weight change during chemotherapy in breast cancer patients: a meta-analysis. BMC Cancer. 2017;17(1):259. https://doi.org/10.1186/s12885-017-3242-4

Heasman KZ, Sutherland HJ, Campbell JA, Elhakim T, Boyd N. Weight gain during adjuvant chemotherapy for breast cancer. Breast Cancer Res Treat. 1985;5(2):195-200. https://doi.org/10.1007/bf01805994

Araujo MC, Bezerra IN, Barbosa FS, Junger WL, Yokoo EM, Pereira RA, et al. Consumo de macronutrientes e ingestao inadequada de micronutrientes em adultos. Rev Saude Publica. 2013;47(Supl. 1):177S-89S. http://dx.doi.org/10.1590/S0034-89102013000700004

Brasil. Ministerio da Saude. Vigitel Brasil. Vigilancia de fatores risco e protecao para doencas cronicas por inquerito telefonico: estimativas sobre frequencia e distribuicao sociodemografica de fatores de risco e protecao para doencas cronicas nas capitais dos 26 estados brasileiros e no Distrito Federal em 2017 [Internet]. Brasilia: Ministerio da Saude; 2018 [accessed on December 19, 2018]. Available on: http://bvsms.saude.gov.br/bvs/publicacoes/vigitel_brasil_2017_vigilancia_fatores_riscos.pdf

World Health Organization. Recommendations and public health and policy implications. Genebra: WHO; 2018.

Atalay C, Kucuk A. The impact of weight gain during adjuvant chemotherapy on survival in breast cancer. Ulus Cerrahi Derg. 2015;31(3):124-7. https://dx.doi.org/10.5152%2FUCD.2015.3123

Yeo W, Mo F, Pang E, Suen JJ, Koh J, Loong HH, et al. Profiles of lipids, blood pressure and weight changes among premenopausal Chinese breast cancer patients after adjuvant chemotherapy. BMC Womens Health. 2017;17(1):55. https://doi.org/10.1186/s12905-017-0409-8

World Health Organization. Body fatness and weight gain and the risk of cancer. Genebra: WHO; 2018.

Parada H, Sun X, Tse CK, Olshan AF, Troester MA. Lifestyle Patterns and Survival Following Breast Cancer in the Carolina Breast Cancer Study. J Epidemiology. 2019;30(1):83-92. https://doi.org/10.1097/EDE.0000000000000933

Lauby-Secretan B, Scoccianti C, Loomis D, Grosse Y, Bianchini F, Straif K. Body Fatness and Cancer -Viewpoint of the IARC Working Group. N Engl J Med. 2016;375:794-8. https://doi.org/10.1056/NEJMsr1606602

Thomson ZO, Reeves MM. Can weight gain be prevented in women receiving treatment for breast cancer? A systematic review of intervention studies. Obes Rev. 2017;18(11):1364-73. https://doi.org/10.1111/obr.12591

Cisneros KM, Romero JE, Torres AG, Valencia ME, Estrada RO, Ortiz OT, et al. Impacto del tratamiento antineoplasico en el estado nutricional en pacientes con cancer de mama. Nutr Hosp. 2014;30(4):876-82. http://dx.doi.org/10.3305/nh.2014.30.4.7646

Mazzuca F, Onesti CE, Roberto M, Girolamo M, Botticelli A, Begini P, et al. Lean body mass wasting and toxicity in early breast cancer patients receiving anthracyclines. Oncotarget. 2018;9(39):25714-22. https://dx.doi.org/10.18632%2Foncotarget.25394

Tyagi R, Mishra S, Kumar M, Gaur N, Misra R, Prasad A. Bioelectric impedance phase angle in breast carcinoma. J Health Allied Sciences. 2014;3(1):52-5. http://dx.doi.org/10.4103/2278-344X.130617

Gupta D, Lammersfeld CA, Vashi PG, King J, Dahlk SL, Grutsch JF, et al. Bioelectrical impedance phase angle as a prognostic indicator in breast cancer. J BMC Cancer. 2008;8:249. https://doi.org/10.1186/1471-2407-8-249

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Publicado

2019-10-09

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Verde, S. M. M. L., Justa, R. M. D. E., Machado, V. M. Q., Lima, C. A., Castro, Ádila da S., & Araújo, C. O. D. (2019). Sobreviventes do câncer de mama tem menos massa magra e menor ângulo de fase após o tratamento oncológico. Mastology, 29(4), 180–185. Recuperado de https://revistamastology.emnuvens.com.br/revista/article/view/603

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