BREAST CANCER PATIENTS WITH UNFAVORABLE NUTRITIONAL PARAMETERS CONSEQUENT TO CHEMOTHERAPY EXPOSURE PRESENT HIGHER SUSCEPTIBILITY TO PROGRESSIVE CLINICAL DISEASE

Keywords:

Obesity - Breast cancer - Ttumor resistance to neoadjuvant chemotherapy

Background: Breast cancer (BC) is one of the most frequent neoplasms worldwide, contributing to women’s morbimortality. Obesity can affect the efficacy of cancer treatment. However, the mechanisms to explain such an association is not fully understood. Aims: This study aimed to investigate the association between nutritional status and tumor resistance to neoadjuvant chemotherapy in breast cancer patients. Materials and Methods: This is a prospective study. Clinical and nutritional parameters were assessed from 46 breast cancer patients that completed four cycles of neoadjuvant doxorubicin and cyclophosphamide. Ethics committee approval number 18946313.3.0000.5528. We stratified the patients according to the clinical response as follows: complete clinical response (cCR), partial response (cPR), or Progressive disease (cPD) for further investigation. We analyzed the patients according to the World Health Organization criteria for the body mass index (BMI) and anthropometric measurements (Mid-upper Arm [MUAC], Waist [WC], and Hip [HC] Circumferences), whose parameters we obtained with a tape measure. Tricipital skinfold thickness (TSK) was measured using a clinical adipometer. The Body Roundness Index (BRI) and the Body Shape Index (ABSI) were used to quantify individual body shape and abdominal adiposity as risk factors for premature mortality. Arm muscle area (AMA) was measured to determine muscle mass. We used SPSS and GraphPad Prism® software for statistical analysis. P<0.05 was accepted. Results: The mean age of the patients was 49.5 ± 12.2 years, and 73% of them presented with overweight. When analyzed by clinical response, 05 individuals had cPD, 37 cPR, and 04 cCR. There was no mean age or BMI difference between the groups before chemotherapy (P>0.05). Conversely, the cPD group showed significant weight loss after chemotherapy, reduction in MUAC (8.6%), WC (2.8%), and HC (3.7%) (P<0.05 versus before chemotherapy), which was not observed in the other groups. Group comparison according to clinical response indicated that the cPD group had lower MAUC, BRI, and AMA than the cPR group (P<0.05). Conclusion: The results indicate that patients with unfavorable nutritional parameters consequent to chemotherapy exposure present higher susceptibility to progressive clinical disease. Support: PPSUS/FUNCAP-SESA-Decit/SCTIE/MS-CNPq; Universal/MCTI/CNPQ;Pronex/FUNCAP; and Proex/Capes.