Meme kanserli bireylerin vücut bileşimindeki kısa-dönem değişimlerin biyoelektrik empedans analizi ile incelenmesi

Abstract

Amaç: Meme kanseri cerrahisi geçiren bireylerin cerrahi sonrası erken dönemde vücut kompozisyonunu incelemektir.
Gereç ve yöntem: Cerrahi planlanan 50 kadının (ortalama yaş 52.46±10.19 yıl) vücut kompozisyonu, cerrahi öncesi, 7 gün sonrası ve 6 ay sonrası biyoelektrik empedans analizi ile incelendi. Katılımcılar beden kütle indeksi <30 ve beden kütle indeksi ≥30 olanlar, aksiller lenf nodu diseksiyonu ve sentinel lenf nodu biyopsisi uygulananlar, neoajuvan kemoterapi alan ve almayanlar ile radyoterapi alan ve almayanlar şeklinde alt gruplara ayrılarak, vücut kompozisyonları karşılaştırıldı.
Bulgular: Katılımcıların ağırlık ve BKİ postoperatif azalırken, 6 ay sonrasında arttı (p<0.05). Beden kütle indeksi <30 olanların ağırlık, beden kütle indeksi, vücut yağ yüzdesi arttı (p<0.05); visseral yağ seviyesi ve vücut su oranı azaldı (p<0.05). Aksiller lenf nodu diseksiyonu yapılanların vücut yağ yüzdesi ve visseral yağ seviyesi arttı (p<0.05). Neoadjuvan kemoterapi alanların beden kütle indeksi, vücut yağ yüzdesi, visseral yağ seviyesi arttı (p<0.05); kas kütlesi ve vücut su oranı azaldı (p<0.05). Radyoterapi alanların ağırlık, beden kütle indeksi, vücut yağ yüzdesi, visseral yağ seviyesi arttı (p<0.05); vücut su oranı azaldı (p<0.05). Sentinel lenf nodu biyopsisi yapılanların, neoadjuvan kemoterapi almayanların veya radyoterapi almayanların vücut bileşimlerinde anlamlı değişim görülmedi (p>0.05).
Sonuç: Meme kanserli bireylerin vücut kompozisyonu cerrahi sonrası erken dönemde vücutta adipozite artışı yönünde değişti. Özellikle beden kütle indeksi <30 olan, aksiller lenf nodu diseksiyonu yapılan, neoadjuvan kemoterapi ve radyoterapi alan hastalarda daha belirgin değişim gözlendi.

Keywords

• Meme kanseri
• vücut kompozisyonu
• beden kütle indeksi
• yağ oranı
• kas kütlesi

Ethical Statement

Çalışma için Pamukkale Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu'ndan 05/10/2021 tarih ve 18 sayılı (E-60116787-020-113944 sayılı) izin alındı. Projenin tüm aşamaları Helsinki Bildirgesi'ne uygun olarak yürütüldü. Katılımcılardan aydınlatılmış onam alındı.

Thanks

Çalışmamıza dahil olan tüm katılımcılarımıza katkı ve destekleri için teşekkür ederiz.

Investigation of short-term changes in body composition of individuals with breast cancer using bioelectrical impedance analysis

Abstract

Purpose: The aim of the study was to examine the changes in body composition in the early postoperative period in individuals who underwent breast cancer surgery.
Materials and methods: The body composition of 50 women scheduled for surgery (mean age 52.46±10.19 years) was assessed using bioelectrical impedance analysis before, 7 days after, and 6 months after surgery. Participants were divided into subgroups: body mass index<30 and ≥30 group, axillary lymph node dissection and sentinel lymph node biopsy group, neoadjuvant and non-neoadjuvant chemotherapy group, and radiotherapy and non-radiotherapy group. Body compositions were compared.
Results: Participants' weight and BMI (body mass index) decreased postoperatively but increased after 6 months (p<0.05). In the BMI<30 group, weight, BMI, and body fat percentage increased (p<0.05); visceral fat level and body water percentage decreased (p<0.05). Body fat percentage and visceral fat level increased in the axillary lymph node dissection group (p<0.05). BMI, body fat percentage, and visceral fat levels increased (p<0.05); muscle mass and body water percentage decreased (p<0.05) in the neoadjuvant chemotherapy group. There were increases in the radiotherapy group; in terms of weight, BMI, body fat percentage, and visceral fat levels (p<0.05); and body water percentage decreased (p<0.05). No significant change was observed in the body composition of the sentinel lymph node biopsy group, non-neoadjuvant chemotherapy, or non-radiotherapy (p>0.05).
Conclusion: Body composition in breast cancer patients changed towards an increase in body adiposity in the early postoperative period. More pronounced changes were observed in patients with a BMI<30 who underwent axillary lymph node dissection and received neoadjuvant chemotherapy or radiotherapy.

Keywords

• Breast cancer
• body composition
• body mass index
• fat ratio
• muscle mass

Ethical Statement

Permission was obtained from Pamukkale University Non-Interventional Clinical Research Ethics Committee for the study (number 18 dated 05/10/2021, E-60116787-020-113944). All stages of the project were conducted in accordance with the Helsinki Declaration. Informed consent was obtained from the participants.

Thanks

We would like to thank all participants in our study for their contributions and support.

References

1. Artese AL, Simonavice E, Madzima TA, et al. Body composition and bone mineral density in breast cancer survivors and non-cancer controls: A 12- to 15-month follow-up. Eur J Cancer Care (Engl). 2018;27(2):e12824. doi:10.1111/ecc.12824
2. Berry DA, Cronin KA, Plevritis SK, et al. Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med. 2005;353(17):1784-1792. doi:10.1056/NEJMoa050518
3. Branco MG, Mateus C, Capelas ML, et al. Bioelectrical Impedance Analysis (BIA) for the Assessment of Body Composition in Oncology: A Scoping Review. Nutrients. 2023;15(22). doi:10.3390/nu15224792
4. Iwase T, Wang X, Shrimanker TV, Kolonin MG, Ueno NT. Body composition and breast cancer risk and treatment: mechanisms and impact. Breast Cancer Res Treat. 2021;186(2):273-283. doi:10.1007/s10549-020-06092-5
5. Cereda E, Pedrazzoli P, Lobascio F, et al. The prognostic impact of BIA-derived fat-free mass index in patients with cancer. Clin Nutr. 2021;40(6):3901-3907. doi:10.1016/j.clnu.2021.04.024
6. Brown JC, Cespedes Feliciano EM, Caan BJ. The evolution of body composition in oncology-epidemiology, clinical trials, and the future of patient care: facts and numbers. J Cachexia Sarcopenia Muscle. 2018;9(7):1200-1208. doi:10.1002/jcsm.12379
7. Houtkooper LB, Lohman TG, Going SB, Howell WH. Why bioelectrical impedance analysis should be used for estimating adiposity. Am J Clin Nutr. 1996;64(3 Suppl):436-448. doi:10.1093/ajcn/64.3.436S
8. Izuegbuna OO, Sodiq T, Olawumi HO, Olatoke SA, Agodirin O. Body composition, energy expenditure and caloric intake among breast cancer patients at a teaching hospital in Nigeria-a cross sectional study. ecancermedicalscience. 2023;17:1600. doi:10.3332/ecancer.2023.1600

9. Wilczyński J, Sobolewski P, Zieliński R, Kabała M. Body Composition in Women after Radical Mastectomy. Int J Environ Res Public Health. 2020;17(23). doi:10.3390/ijerph17238991
10. van den Berg M, Kok DE, Visser M, 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. doi:10.1007/s00520-019-04951-6
11. Pedersen B, Delmar C, Lörincz T, Falkmer U, Grønkjær M. Investigating Changes in Weight and Body Composition Among Women in Adjuvant Treatment for Breast Cancer: A Scoping Review. Cancer Nurs. 2019;42(2):91-105. doi:10.1097/NCC.0000000000000590
12. Morlino D, Cioffi I, Marra M, Di Vincenzo O, Scalfi L, Pasanisi F. Bioelectrical Phase Angle in Patients with Breast Cancer: A Systematic Review. Cancers (Basel). 2022;14(8):e1-e15. doi:10.3390/cancers14082002
13. Kang H, Kim I, Park H, Ahn W, Kim SK, Lee S. Prognostic value of body composition measures in breast cancer patients treated with chemotherapy. Sci Rep. 2024;14(1):23309. doi:10.1038/s41598-024-74060-w
14. Bellini A, Keegan THM, Li Q, et al. The effect of body mass index on breast cancer stage and breast cancer specific survival. Breast Cancer Res Treat. 2025;211(3):649-656. doi:10.1007/s10549-025-07678-7
15. Bellini A, Keegan THM, Li Q, et al. The effect of body mass index on breast cancer stage and breast cancer specific survival. Breast Cancer Res Treat. 2025;211(3):649-656. doi:10.1007/s10549-025-07678-7
16. Aleixo GFP, Valente SA, Wei W, Moore HCF. Association of body composition and surgical outcomes in patients with early-stage breast cancer. Breast Cancer Res Treat. 2023;202(2):305-311. doi:10.1007/s10549-023-07060-5
17. Takada K, Kashiwagi S, Asano Y, et al. Clinical verification of body mass index and tumor immune response in patients with breast cancer receiving preoperative chemotherapy. BMC Cancer. 2021;21(1):1129. doi:10.1186/s12885-021-08857-7
18. Cho HJ, Song S, Kim Z, et al. Associations of body mass index and weight change with circulating levels of high-sensitivity C-reactive protein, proinflammatory cytokines, and adiponectin among breast cancer survivors. Asia Pac J Clin Oncol. 2023;19(1):113-125. doi:10.1111/ajco.13779
19. Heidari Almasi M, Barzin M, Serahati S, et al. Body Composition Assessment by Bioelectrical Impedance Analysis in Prediction of Cardio-Metabolic Risk Factors: Tehran Lipid and Glucose Study (TLGS). Iran J Public Health. 2022;51(4):851-859. doi:10.18502/ijph.v51i4.9246
20. Liu LN, Lin YC, Miaskowski C, Chen SC, Chen ML. Association between changes in body fat and disease progression after breast cancer surgery is moderated by menopausal status. BMC Cancer. 2017;17(1):863. doi:10.1186/s12885-017-3869-1
21. Jung GH, Kim JH, Chung MS. Changes in weight, body composition, and physical activity among patients with breast cancer under adjuvant chemotherapy. Eur J Oncol Nurs. 2020;44:101680. doi:10.1016/j.ejon.2019.101680
22. Lee DH, Giovannucci EL. The Obesity Paradox in Cancer: Epidemiologic Insights and Perspectives. Curr Nutr Rep. 2019;8(3):175-181. doi:10.1007/s13668-019-00280-6
23. Zhuang B, Xiao S, Zhang L, et al. Association between body composition and survival in head and neck cancer patients undergoing radiotherapy. Head Neck. 2022;44(9):2046-2054. doi:10.1002/hed.27065
24. Lee J, Chen TC, Jan YT, Li CJ, Chen YJ, Wu MH. Association of Patient-Reported Outcomes and Nutrition with Body Composition in Women with Gynecologic Cancer Undergoing Post-Operative Pelvic Radiotherapy: An Observational Study. Nutrients. 2021;13(8). doi:10.3390/nu13082629
25. De Rose F, Carmen De Santis M, Lucidi S, et al. Dose constraints in breast cancer radiotherapy. A critical review. Radiother Oncol. 2025;202:110591. doi:10.1016/j.radonc.2024.110591
26. Maurya AK, Aggarwal LM, Choudhary S. Body Composition Analysis Techniques and Its Application in Oncology: A Review. Nutr Cancer. 2024;76(8):666-675. doi:10.1080/01635581.2024.2353942