ASSOCIATION OF WEIGHT CHANGE IN BREAST CANCER PATIENTS UNDERGOING TAMOXIFEN TREATMENT AT A TERTIARY CARE CENTRE, SINDH, PAKISTAN
AbstractBackground: Tamoxifen is a selective oestrogen receptor modulator; in the breast, it decreases the growth and proliferation of breast epithelial cells. We assessed the weight change after Tamoxifen use in breast cancer patients. Methods: This was a single-centred, prospective, observational cohort study. All patients diagnosed with breast cancer with ER and/or PR positivity were enrolled in the study. Out of these, 90 patients who have been prescribed Tamoxifen treatment either in adjuvant or palliative setting gave their consent to participate. Demographic data, treatment plan, menstrual status, weight, BMI, serum fasting lipid profile, change in diet, and change in physical activity were recorded at the time of diagnosis and then quarterly until 1 year of treatment. Results: A mean age of 42.12±8.5 years was reported, and the mean weight was 62.22±10.6 kg. The majority of the patients, i.e., 68 (75.55%) had advanced tumour stages (III and IV). The study reported that the mean weight of the patients changed significantly at different time intervals during the treatment course (p<0.0005). Moreover, there was an upward trend in weight from the time of starting Tamoxifen to 3-months (62.22±1.51 kg vs 62.88±1.45 kg, respectively). There was a statistically significant increase in weight at 6-month, 9-month, and 12-month of Tamoxifen treatment (63.72±1.46 kg, 64.35±1.42 kg, 65.12±1.44 kg, respectively). Also, most of the patients gained weight as time passed by. Conclusion: This study indicated that Tamoxifen has a significant correlation with the increase in weight in hormone receptor-positive breast cancer patients in our population
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 2018;68(6):394–424.
Ghoncheh M, Pournamdar Z, Salehiniya H. Incidence and mortality and epidemiology of breast cancer in the world. Asian Pac J Cancer Prev 2016;17(S3):43–6.
Athar A. Knowledge, attitude and practices of Pakistani women for early breast cancer detection. Breast 2018;41:S21.
Xia Y, Fan C, Hoadley KA, Parker JS, Perou CM. Genetic determinants of the molecular portraits of epithelial cancers. Nat Commun 2019;10(1):5666.
van Seijen M, Lips EH, Thompson AM, Nik-Zainal S, Futreal A, Hwang ES, et al. Ductal carcinoma in situ: to treat or not to treat, that is the question. Br J Cancer 2019;121(14):285–92.
Thorneloe RJ, Hall LH, Walter FM, Side L, Lloyd KE, Smith SG. Knowledge of potential harms and benefits of tamoxifen among women considering breast cancer preventive therapy. Cancer Prev Res (Phila) 2020;13(4):411–22.
Yan Y, Zhang L, Tan L, Ma X, Zhang Y, Shao S, et al. Endocrine Therapy for Ductal Carcinoma In Situ (DCIS) of the Breast with Breast Conserving Surgery (BCS) and Radiotherapy (RT): a Meta-Analysis. Pathol Oncol Res 2020;26(1):521–31.
Raghavendra A, Sinha AK, Valle-Goffin J, Shen Y, Tripathy D, Barcenas CH. Determinants of weight gain during adjuvant endocrine therapy and association of such weight gain with recurrence in long-term breast cancer survivors. Clin Breast Cancer 2018;18(1):e7–13.
Zhang X, de Oliveira Andrade F, Zhang H, Cruz I, Clarke R, Gaur P, et al. Maternal obesity increases offspring’s mammary cancer recurrence and impairs tumour immune response. Endocr Relat Cancer 2020;27(9):469–82.
DeCensi A, Puntoni M, Guerrieri-Gonzaga A, Caviglia S, Avino F, Cortesi L, et al. Randomized placebo controlled trial of low-dose tamoxifen to prevent local and contralateral recurrence in breast intraepithelial neoplasia. J Clin Oncol 2019;37(19):1629–37.
Davies C, Godwin J, Gray R, Clarke M, Cutter D, Darby S, et al. Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet 2011;378(9793):771–84.
Zivian MT. 2–60 Side effects of aromatase inhibitors versus tamoxifen: the patients' perspective. Breast Dis 2007;2(18):201–2.
Nyrop KA, Lee JT, Deal AM, Ki Choi S, Muss HB. Weight-Related Communications Between Oncology Clinicians and Women with Obesity at Early Breast Cancer Diagnosis: Findings From a Review of Electronic Health Records. Nutr Cancer 2020;72(4):576–83.
Nyrop KA, Deal AM, Lee JT, Muss HB, Choi SK, Wheless A, et al. Carey LA, Shachar SS. Weight gain in hormone receptor-positive (HR+) early-stage breast cancer: is it menopausal status or something else? Breast Cancer Res Treat 2018;167(1):235–48.
Hoskin PJ, Ashley S, Yarnold JR. Weight gain after primary surgery for breast cancer-effect of tamoxifen. Breast Cancer Res Treat 1992;22(2):129–32.
Kim KW, Kim HA, Park JC, In HU, Oh BH. Prevalence of Obesity in Patients with Postoperative Breast Cancer: Effect of Tamoxifen and Abdominal Fat Distribution on Computed Tomography. Korean J Fam Med 2016;6(3):148–54.
Pan HJ, Chang HT, Lee CH. Association between tamoxifen treatment and the development of different stages of nonalcoholic fatty liver disease among breast cancer patients. J Formos Med Assoc 2016;115(6):411–7.
Nyrop KA, Williams GR, Muss HB, Shachar SS. Weight gain during adjuvant endocrine treatment for early-stage breast cancer: what is the evidence? Breast Cancer Res Treat 2016;158(2):203–17.
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