ERKEN EVRE MEME KANSERLİ HASTALARDA BEDEN KİTLE İNDEKSİ DEĞİŞİMİ VE OBEZİTEYE BAĞLI SAĞLIK KOMPLİKASYONLARI
Abstract
Amaç
Görüntüleme yöntemlerindeki gelişmeler ve multimodal
tedaviler, sağ kalan meme kanserli hasta sayısında
artışa neden olmuştur. Bu durum sağ kalımı
artıracak değiştirilebilir risk faktörlerinin araştırılması
gerektiğini düşündürmektedir. Biz bu çalışmada erken
evre meme kanserli hastaların takibinde ortaya çıkan
beden kitle indeksi (BKİ) değişikliklerini ve bu değişikliklerin
yol açabileceği obezite ile ilişkili sağlık sorunlarını
tespit etmeyi amaçladık.
Gereç ve Yöntem
Kliniğimize başvuran ‘‘Erken evre meme kanseri’’ tanısı
almış 142 hastanın BKİ (tanı anındaki), güncel
BKİ (tanita) ile karşılaştırılmıştır. BKİ’deki değişimlerle
obezite ilişkili sağlık sorunları arasındaki ilişki araştırılmıştır.
Bulgular
Hastaların ortalama yaşı 52,7 ± 1,1 (31-78) olup tamamı
kadın hasta idi. Tanı anında hastaların % 56,3
premenapozal, % 43,7 postmenapozal idi. Hastaların
tanıda BKİ ortalaması 27,9 ± 5,3 iken güncel BKİ
ortalaması 30,7 ± 5,7 olarak hesaplandı (p<0,0001).
Hastaların %90,8’inde (n=129) BKİ’de artış, %8’ inde
(n=11) BKİ’de azalma, % 1,2’sinde (n=2) ise BKİ'de
değişme olmadığı tespit edildi. BKİ’de artış olan hastalar,
hastalık yaşına göre incelendiğinde hastalığının
ilk yılında olanlarda BKİ artışı 2,1±1,6 kg/m² iken
hastalığının 5. yılı ve üzerinde olanlarda BKİ artışı
4,0±2,9 kg/m² olarak bulundu (p<0,017). BKİ’nde artış
tespit edilen hastaların %22.5’inde Diyabetes Mellitus,
%46.5’inde hipertansiyon, %40.3’ünde hiperlipidemi
ve %40.3’ünde dejeneratif osteoartrit tespit
edildi. Hastalığın başlangıcına göre karşılaştırıldığında
BKI’de artış tespit edilen hastalarda tüm bu tanılar
anlamlı oranda daha yüksekti (p<0,0001).
Sonuç
Erken evre meme kanserli hastalarda BKİ artışı yaygın
görülen bir problemdir. Kilo artışı obeziteye bağlı
gelişen kronik hastalıklarda artışa neden olmaktadır.
Meme kanseri hastalarını kilo artışı yönünden bilgilendirmek
tedavi yönetiminin bir parçası olmalıdır.
Supporting Institution
Yok
References
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- Referans3. Harbeck N, Penault-Llorca F, Cortes J, Gnant M, Houssami N, Poortmans P, et al. Breast cancer. Nat Rev Dis Primers. 2019 Sep 23;5(1):66.
- Referans4. Makari-Judson G, Judson CH, Mertens WC. Longitudinalpatterns of weight gain after breast cancer diagnosis: observations beyond the first year. Breast J 2007; 13: 258–265.
- Referans5. Ekenga CC, Wang X, Pérez M, Schootman M, Jeffe DB. A Prospective Study of Weight Gain in Women Diagnosed with Early-Stage Invasive Breast Cancer, Ductal Carcinoma In Situ, and Women Without Breast Cancer. J Womens Health (Larchmt). 2020;29(4):524-533.
- Referans6. Van den Berg MMGA, Kok DE, Visser M, de Kruif JTCM, de Vries Y, et al. Changes in body composition during and after adjuvant or neo-adjuvant chemotherapy in women with breast cancer stage I-IIIB compared with changes over a similar timeframe in women without cancer. Support Care Cancer. 2020;28(4):1685-1693.
- Referans7. Visovsky C. Muscle strength, body composition, and physical activity in women receiving chemotherapy for breast cancer. Integr Cancer Ther 2006; 5: 183–191.
- Referans8. Irwin ML, McTiernan A, Baumgartner RN, Baumgartner KB, Bernstein L, Gilliland FD, et al. Changes in body fat and weight after a breast cancer diagnosis: influence of demographic, prognostic and lifestyle factors. J Clin Oncol 2005; 23: 774–782.
- Referans9. Calle EE, Thun MJ, Petrelli JM, Carmen Rodriguez, Clark W Heath. Body mass index and mortality in a prospective cohort of US adults. N Engl J Med 341:1097-1105, 1999
- Referans10. Kopelman P: Obesity as a medical problem. Nature 404:635-643, 2000
- Referans11. Aziz NM: Long-term survivorship: Late effects, in: Berger AM, Portenoyu RK, Weissman DE (ed): Principles and Practice of Palliative Care and Supportive Oncology (ed 2). Philadelphia, PA, Lippincott Williams & Wilkins, 2002, pp 1019-1033
- Referans12. National Institutes of Health, National Heart, Lung, and Blood Institute: Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults-in evidence report. Obes Res 1998;6(Suppl 2):51S-209S.
- Referans13. World Health Organization. WHO fact sheet on overweight and obesity. Updated October 2017. http://www.who.int/mediacentre/factsheets/fs311/en/. Date of access: 8 December 2017.
- Referans14. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206-1252.
- Referans15. Hanas R, John G; International HBA1c Consensus Committee. 2010 consensus statement on the worldwide standardization of the hemoglobin A1C measurement. Diabetes Care. 2010;33(8):1903-1904.
- Referans16. Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001, 285:2486–2497
- Referans17. Henry J, Mankin D: Pathogenesis of Osteoarthritis. Kelley. s Textbook of Rheumatology, sixth edition, volume II, Saunders Company, 2001
- Referans18. Heasman KZ, Sutherland HJ, Campbell JA, Elhakim T, Boyd NF. Weight gain during adjuvant chemotherapy for breast cancer. Breast Cancer Res Treat 1985; 5: 195–200.
- Referans19. Van den Berg MM, Winkels RM, de Kruif JT, van Laarhoven HW, Visser M, de Vries JH et al. Weight change during chemotherapy in breast cancer patients: a meta-analysis. BMC Cancer. 2017;17(1):259.
- Referans20. Schvartsman G, Gutierrez-Barrera AM, Song J, Ueno NT, Peterson SK, Arun B. Association between weight gain during adjuvant chemotherapy for early-stage breast cancer and survival outcomes. Cancer Med. 2017;6(11):2515-2522
- Referans21. Goodwin PJ, Ennis M, Pritchard KI, McCready D, Koo J, Sidlofsky S, et al. Adjuvant treatment and onset of menopause predict weight gain after breast cancer diagnosis. J Clin Oncol 1999; 17: 120–129
- Referans22. Basaran G, Turhal NS, Cabuk D, Yurt N, Yurtseven G, Gumus M, et al. Weight gain after adjuvant chemotherapy in patients with early breast cancer in Istanbul Turkey. Med Oncol. 2010 Mar 20.
- Referans23. Ginzac A, Barres B, Chanchou M, Gadéa E, Molnar I, Merlin C, et al. A decrease in brown adipose tissue activity is associated with weight gain during chemotherapy in early breast cancer patients. BMC Cancer. 2020 Feb 4;20(1):96.
- Referans24. Irwin ML, Smith AW, McTiernan A, Ballard-Barbash R, Cronin K, Gilliland FD, et al. Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity, and lifestyle study. J Clin Oncol. 2008 Aug 20;26(24):3958-64.
- Referans25. Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA. Physical activity and survival after breast cancer diagnosis. JAMA. 2005 May 25;293(20):2479-86.
- Referans26. Heideman WH, Russell NS, Gundy C, Rookus MA, Voskuil DW. The frequency, magnitude and timing of post-diagnosis body weight gain in Dutch breast cancer survivors. Eur J Cancer 2009; 45: 119–126
- Referans27. Tremollieres FA, Pouilles JM, Ribot CA. Relative influence of age and menopause status on total and regional body composition changes in postmenopausal women. Am J Obstet Gynecol 1996; 175: 1594–1600.
- Referans28. Messier V, Karelis AD, Lavoie ME, Brochu M, Faraj M, Strychar I, et al. Metabolic profile and quality of life in class 1 sarcopenic overweight and obese postmenopausal women: a MONET study. Appl Physiol Nutr Metab 2009; 34: 18–24.
- Referans29. Hoskin PJ, Ashley S, Yarnold JR. Weight gain after primary surgery for breast cancer. Breast Cancer Res Treat 1992; 22: 129–132.
- Referans30. Saquib N, Flatt SW, Natarajan L, Thomson CA, Bardwell WA, Caan B, et al. Weight gain and recovery of pre-cancer weight after breast cancer treatments: evidence from the women’s healthy eating and living (WHEL) study. Breast Cancer Res Treat 2007; 105: 77–186.
- Referans31. DeSantis CE, Fedewa SA, Goding Sauer A, Kramer JL, Smith RA, Jemal A. Breast cancer statistics, 2015: Convergence of incidence rates between black and white women. CA Cancer J Clin. 2016;66(1):31-42
- Referans32. Protani M, Coory M, Martin, JH. Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat 123, 627–635 (2010)
- Referans33. Chan DSM, Vieira AR, Aune D, Bandera EV, Greenwood DC, McTiernan A, et al. Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol. 2014;25(10):1901-1914
- Referans34. Hooning MJ, Aleman BM, van Rosmalen AJ, Kuenen MA, Klijn JG, van Leeuwen FE. Cause-specific mortality in long-term survivors of breast cancer: A 25-year follow-up study. Int J Radiat Oncol Biol Phys. 2006 Mar 15;64(4):1081-91. Epub 2006 Jan 30. PubMed PMID: 16446057
- Referans35. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625-1638
- Referans36. Nichols HB, Trentham-Dietz A, Egan KM, Titus-Ernstoff L, Holmes MD, Bersch AJ, et al. Cardiovascular Disease Mortality Associations with All-Cause, Breast Cancer, and Body Mass Index Before and After Breast Cancer Diagnosis Cancer Epidemiol Biomarkers Prev 2009;18:1403-1409. Published online April 14, 2009.
- Referans37. Kroenke CH, Chen WY, Rosner B, Holmes MD. Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol 2005; 23: 1370–1378.
- Referans38. Fang Q, Huang J, Gan L, Shen K, Chen X, Wu B. Weight Gain during Neoadjuvant Chemotherapy is Associated with Worse Outcome among the Patients with Operable Breast Cancer. J Breast Cancer. 2019;22(3):399-411.
Abstract
Objective
Advances in imaging methods and multimodal
therapies have led to an increase in the number of
breast cancer patients surviving. This suggests that
modifiable risk factors that will increase survival
should be investigated. In this study, we aimed to
determine the changes in body mass index (BMI) that
occur during the follow-up of patients with early stage
breast cancer and the health problems associated
with obesity that may be caused by these changes.
Material and Methods
Basal BMI (measured at diagnosis) of 142 patients
admitted to our clinic who were diagnosed with "earlystage
breast cancer" was compared with the current
BMI (tanita).The relationship between changes in BMI
and obesity-related health problems investigated.
Results
The mean age of the patients was 52.7 ± 1.1 (31-78),
and all of them were female. At the time of diagnosis,
56.3% of the patients were premenopausal and
43.7% postmenopausal. While the mean BMI of the
patients at diagnosis was 27.9 ± 5.3, the current
BMI was calculated as 30.7 ± 5.7 (p <0.0001). It was
determined that 90.8% (n = 129) of the patients had
an increase in BMI, 8% (n = 11) had a decrease in
BMI, and 1.2% (n = 2) had no change in BMI. When
the patients with an increase in BMI were examined
according to the age of the disease, the BMI increase
was found to be 2.1 ± 1.6 kg / m2 in the first year of the
disease, while the BMI increase was found to be 4.0
± 2.9 kg / m2 in the 5th year and more of the disease
(p <0.017). Diabetes Mellitus was detected in 22.5%
of patients with an increase in BMI, hypertension in
46.5%, hyperlipidemia in 40.3% and degenerative
osteoarthritis in 40.3%. All these diagnoses were
significantly higher in patients with an increase in BMI
compared to the onset of the disease (p <0.0001).
Conclusion
Increased BMI is a common problem in patients with
early stage breast cancer. Weight gain causes an
increase in chronic diseases due to obesity. Informing
breast cancer patients about weight gain should be a
part of treatment management.
References
- Referans1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 68, 394–424 (2018).
- Referans2. World Heath Organisation. WHO Classification of Tumours of the Breast, Fourth Edition. (World Health Organization, 2012).
- Referans3. Harbeck N, Penault-Llorca F, Cortes J, Gnant M, Houssami N, Poortmans P, et al. Breast cancer. Nat Rev Dis Primers. 2019 Sep 23;5(1):66.
- Referans4. Makari-Judson G, Judson CH, Mertens WC. Longitudinalpatterns of weight gain after breast cancer diagnosis: observations beyond the first year. Breast J 2007; 13: 258–265.
- Referans5. Ekenga CC, Wang X, Pérez M, Schootman M, Jeffe DB. A Prospective Study of Weight Gain in Women Diagnosed with Early-Stage Invasive Breast Cancer, Ductal Carcinoma In Situ, and Women Without Breast Cancer. J Womens Health (Larchmt). 2020;29(4):524-533.
- Referans6. Van den Berg MMGA, Kok DE, Visser M, de Kruif JTCM, de Vries Y, et al. Changes in body composition during and after adjuvant or neo-adjuvant chemotherapy in women with breast cancer stage I-IIIB compared with changes over a similar timeframe in women without cancer. Support Care Cancer. 2020;28(4):1685-1693.
- Referans7. Visovsky C. Muscle strength, body composition, and physical activity in women receiving chemotherapy for breast cancer. Integr Cancer Ther 2006; 5: 183–191.
- Referans8. Irwin ML, McTiernan A, Baumgartner RN, Baumgartner KB, Bernstein L, Gilliland FD, et al. Changes in body fat and weight after a breast cancer diagnosis: influence of demographic, prognostic and lifestyle factors. J Clin Oncol 2005; 23: 774–782.
- Referans9. Calle EE, Thun MJ, Petrelli JM, Carmen Rodriguez, Clark W Heath. Body mass index and mortality in a prospective cohort of US adults. N Engl J Med 341:1097-1105, 1999
- Referans10. Kopelman P: Obesity as a medical problem. Nature 404:635-643, 2000
- Referans11. Aziz NM: Long-term survivorship: Late effects, in: Berger AM, Portenoyu RK, Weissman DE (ed): Principles and Practice of Palliative Care and Supportive Oncology (ed 2). Philadelphia, PA, Lippincott Williams & Wilkins, 2002, pp 1019-1033
- Referans12. National Institutes of Health, National Heart, Lung, and Blood Institute: Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults-in evidence report. Obes Res 1998;6(Suppl 2):51S-209S.
- Referans13. World Health Organization. WHO fact sheet on overweight and obesity. Updated October 2017. http://www.who.int/mediacentre/factsheets/fs311/en/. Date of access: 8 December 2017.
- Referans14. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206-1252.
- Referans15. Hanas R, John G; International HBA1c Consensus Committee. 2010 consensus statement on the worldwide standardization of the hemoglobin A1C measurement. Diabetes Care. 2010;33(8):1903-1904.
- Referans16. Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001, 285:2486–2497
- Referans17. Henry J, Mankin D: Pathogenesis of Osteoarthritis. Kelley. s Textbook of Rheumatology, sixth edition, volume II, Saunders Company, 2001
- Referans18. Heasman KZ, Sutherland HJ, Campbell JA, Elhakim T, Boyd NF. Weight gain during adjuvant chemotherapy for breast cancer. Breast Cancer Res Treat 1985; 5: 195–200.
- Referans19. Van den Berg MM, Winkels RM, de Kruif JT, van Laarhoven HW, Visser M, de Vries JH et al. Weight change during chemotherapy in breast cancer patients: a meta-analysis. BMC Cancer. 2017;17(1):259.
- Referans20. Schvartsman G, Gutierrez-Barrera AM, Song J, Ueno NT, Peterson SK, Arun B. Association between weight gain during adjuvant chemotherapy for early-stage breast cancer and survival outcomes. Cancer Med. 2017;6(11):2515-2522
- Referans21. Goodwin PJ, Ennis M, Pritchard KI, McCready D, Koo J, Sidlofsky S, et al. Adjuvant treatment and onset of menopause predict weight gain after breast cancer diagnosis. J Clin Oncol 1999; 17: 120–129
- Referans22. Basaran G, Turhal NS, Cabuk D, Yurt N, Yurtseven G, Gumus M, et al. Weight gain after adjuvant chemotherapy in patients with early breast cancer in Istanbul Turkey. Med Oncol. 2010 Mar 20.
- Referans23. Ginzac A, Barres B, Chanchou M, Gadéa E, Molnar I, Merlin C, et al. A decrease in brown adipose tissue activity is associated with weight gain during chemotherapy in early breast cancer patients. BMC Cancer. 2020 Feb 4;20(1):96.
- Referans24. Irwin ML, Smith AW, McTiernan A, Ballard-Barbash R, Cronin K, Gilliland FD, et al. Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity, and lifestyle study. J Clin Oncol. 2008 Aug 20;26(24):3958-64.
- Referans25. Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA. Physical activity and survival after breast cancer diagnosis. JAMA. 2005 May 25;293(20):2479-86.
- Referans26. Heideman WH, Russell NS, Gundy C, Rookus MA, Voskuil DW. The frequency, magnitude and timing of post-diagnosis body weight gain in Dutch breast cancer survivors. Eur J Cancer 2009; 45: 119–126
- Referans27. Tremollieres FA, Pouilles JM, Ribot CA. Relative influence of age and menopause status on total and regional body composition changes in postmenopausal women. Am J Obstet Gynecol 1996; 175: 1594–1600.
- Referans28. Messier V, Karelis AD, Lavoie ME, Brochu M, Faraj M, Strychar I, et al. Metabolic profile and quality of life in class 1 sarcopenic overweight and obese postmenopausal women: a MONET study. Appl Physiol Nutr Metab 2009; 34: 18–24.
- Referans29. Hoskin PJ, Ashley S, Yarnold JR. Weight gain after primary surgery for breast cancer. Breast Cancer Res Treat 1992; 22: 129–132.
- Referans30. Saquib N, Flatt SW, Natarajan L, Thomson CA, Bardwell WA, Caan B, et al. Weight gain and recovery of pre-cancer weight after breast cancer treatments: evidence from the women’s healthy eating and living (WHEL) study. Breast Cancer Res Treat 2007; 105: 77–186.
- Referans31. DeSantis CE, Fedewa SA, Goding Sauer A, Kramer JL, Smith RA, Jemal A. Breast cancer statistics, 2015: Convergence of incidence rates between black and white women. CA Cancer J Clin. 2016;66(1):31-42
- Referans32. Protani M, Coory M, Martin, JH. Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat 123, 627–635 (2010)
- Referans33. Chan DSM, Vieira AR, Aune D, Bandera EV, Greenwood DC, McTiernan A, et al. Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol. 2014;25(10):1901-1914
- Referans34. Hooning MJ, Aleman BM, van Rosmalen AJ, Kuenen MA, Klijn JG, van Leeuwen FE. Cause-specific mortality in long-term survivors of breast cancer: A 25-year follow-up study. Int J Radiat Oncol Biol Phys. 2006 Mar 15;64(4):1081-91. Epub 2006 Jan 30. PubMed PMID: 16446057
- Referans35. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625-1638
- Referans36. Nichols HB, Trentham-Dietz A, Egan KM, Titus-Ernstoff L, Holmes MD, Bersch AJ, et al. Cardiovascular Disease Mortality Associations with All-Cause, Breast Cancer, and Body Mass Index Before and After Breast Cancer Diagnosis Cancer Epidemiol Biomarkers Prev 2009;18:1403-1409. Published online April 14, 2009.
- Referans37. Kroenke CH, Chen WY, Rosner B, Holmes MD. Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol 2005; 23: 1370–1378.
- Referans38. Fang Q, Huang J, Gan L, Shen K, Chen X, Wu B. Weight Gain during Neoadjuvant Chemotherapy is Associated with Worse Outcome among the Patients with Operable Breast Cancer. J Breast Cancer. 2019;22(3):399-411.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Araştırma Makaleleri |
| Authors | |
| Publication Date | December 30, 2021 |
| Submission Date | February 16, 2021 |
| Acceptance Date | July 3, 2021 |
| Published in Issue | Year 2021 Volume: 28 Issue: 4 |
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/Medical Journal of Süleyman Demirel University is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International.