Impact of primary breast cancer therapy on energetic capacity and body composition

Tarah J. Ballinger, Anurag Reddy, Sandra K. Althouse, Emily M. Nelson, Kathy Miller, Jeffrey S. Sledge

Research output: Contribution to journalArticle

Abstract

Purpose: This observational study was designed to measure baseline energy parameters and body composition in early-stage breast cancer patients, and to follow changes during and after various modalities of treatment. This will provide information to aid in the development of individualized physical activity intervention strategies. Methods: Patients with newly diagnosed stage 0–III breast cancer were enrolled into three cohorts: A (local therapy alone), B (endocrine therapy), or C (chemotherapy with or without endocrine therapy). At baseline, 6 months, and 12 months, subjects underwent a stationary bicycle protocol to assess power generation and DEXA to assess body composition. Results: Eighty-three patients enrolled. Patients had low and variable levels of power generation at baseline (mean power per kilogram lean mass 1.55 W/kg, SD 0.88). Power normalized to lean body mass (W/kg) decreased significantly, and similarly, by 6 months in cohorts B (1.42–1.04 W/kg, p = 0.008) and C (1.53–1.18 W/kg, p < 0.001). In all cohorts, there was no recovery of power generation by 12 months. Cohort C lost lean body mass (− 1.5 kg, p = 0.007), while cohort B maintained lean body mass (− 0.2 kg, p = 0.68), despite a similar trajectory in loss of power. Seven patients developed sarcopenia during the study period, including four patients who did not receive any chemotherapy (cohort B). Conclusions: The stationary bike protocol was feasible, easy, and acceptable to patients as a way to measure energetic capacity in a clinical setting. Early-stage breast cancer patients had low and variable levels of power generation, which worsened following primary therapy and did not show evidence of ‘spontaneous recovery’ by 12 months. Effective physical activity interventions will need to be personalized, accounting for both baseline ability and the effect of treatment.

Original languageEnglish (US)
JournalBreast Cancer Research and Treatment
DOIs
StateAccepted/In press - Jan 1 2018

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Body Composition
Breast Neoplasms
Therapeutics
Exercise
Sarcopenia
Drug Therapy
Observational Studies

Keywords

  • Body composition
  • Breast cancer
  • Energetic capacity
  • Physical activity
  • Power
  • Sarcopenia

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Impact of primary breast cancer therapy on energetic capacity and body composition. / Ballinger, Tarah J.; Reddy, Anurag; Althouse, Sandra K.; Nelson, Emily M.; Miller, Kathy; Sledge, Jeffrey S.

In: Breast Cancer Research and Treatment, 01.01.2018.

Research output: Contribution to journalArticle

Ballinger, Tarah J. ; Reddy, Anurag ; Althouse, Sandra K. ; Nelson, Emily M. ; Miller, Kathy ; Sledge, Jeffrey S. / Impact of primary breast cancer therapy on energetic capacity and body composition. In: Breast Cancer Research and Treatment. 2018.
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abstract = "Purpose: This observational study was designed to measure baseline energy parameters and body composition in early-stage breast cancer patients, and to follow changes during and after various modalities of treatment. This will provide information to aid in the development of individualized physical activity intervention strategies. Methods: Patients with newly diagnosed stage 0–III breast cancer were enrolled into three cohorts: A (local therapy alone), B (endocrine therapy), or C (chemotherapy with or without endocrine therapy). At baseline, 6 months, and 12 months, subjects underwent a stationary bicycle protocol to assess power generation and DEXA to assess body composition. Results: Eighty-three patients enrolled. Patients had low and variable levels of power generation at baseline (mean power per kilogram lean mass 1.55 W/kg, SD 0.88). Power normalized to lean body mass (W/kg) decreased significantly, and similarly, by 6 months in cohorts B (1.42–1.04 W/kg, p = 0.008) and C (1.53–1.18 W/kg, p < 0.001). In all cohorts, there was no recovery of power generation by 12 months. Cohort C lost lean body mass (− 1.5 kg, p = 0.007), while cohort B maintained lean body mass (− 0.2 kg, p = 0.68), despite a similar trajectory in loss of power. Seven patients developed sarcopenia during the study period, including four patients who did not receive any chemotherapy (cohort B). Conclusions: The stationary bike protocol was feasible, easy, and acceptable to patients as a way to measure energetic capacity in a clinical setting. Early-stage breast cancer patients had low and variable levels of power generation, which worsened following primary therapy and did not show evidence of ‘spontaneous recovery’ by 12 months. Effective physical activity interventions will need to be personalized, accounting for both baseline ability and the effect of treatment.",
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AU - Sledge, Jeffrey S.

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AB - Purpose: This observational study was designed to measure baseline energy parameters and body composition in early-stage breast cancer patients, and to follow changes during and after various modalities of treatment. This will provide information to aid in the development of individualized physical activity intervention strategies. Methods: Patients with newly diagnosed stage 0–III breast cancer were enrolled into three cohorts: A (local therapy alone), B (endocrine therapy), or C (chemotherapy with or without endocrine therapy). At baseline, 6 months, and 12 months, subjects underwent a stationary bicycle protocol to assess power generation and DEXA to assess body composition. Results: Eighty-three patients enrolled. Patients had low and variable levels of power generation at baseline (mean power per kilogram lean mass 1.55 W/kg, SD 0.88). Power normalized to lean body mass (W/kg) decreased significantly, and similarly, by 6 months in cohorts B (1.42–1.04 W/kg, p = 0.008) and C (1.53–1.18 W/kg, p < 0.001). In all cohorts, there was no recovery of power generation by 12 months. Cohort C lost lean body mass (− 1.5 kg, p = 0.007), while cohort B maintained lean body mass (− 0.2 kg, p = 0.68), despite a similar trajectory in loss of power. Seven patients developed sarcopenia during the study period, including four patients who did not receive any chemotherapy (cohort B). Conclusions: The stationary bike protocol was feasible, easy, and acceptable to patients as a way to measure energetic capacity in a clinical setting. Early-stage breast cancer patients had low and variable levels of power generation, which worsened following primary therapy and did not show evidence of ‘spontaneous recovery’ by 12 months. Effective physical activity interventions will need to be personalized, accounting for both baseline ability and the effect of treatment.

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KW - Breast cancer

KW - Energetic capacity

KW - Physical activity

KW - Power

KW - Sarcopenia

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