title: Premature ovarian failure and body composition changes with adjuvant chemotherapy for breast cancer.
abstract: OBJECTIVE
  Premature ovarian failure and weight gain are both common in women receiving adjuvant chemotherapy for breast cancer. The objective of this preliminary analysis was to characterize changes in weight and body composition in premenopausal women receiving adjuvant chemotherapy for early stage breast cancer and investigate whether these changes were associated with chemotherapy-induced ovarian failure (CIOF).
  
  
  METHODS
  The body composition of 43 premenopausal women with stage I or II breast cancer was measured using dual-energy x-ray absorptiometry within 4 weeks before beginning chemotherapy and after 12 months from baseline. At 12 months, the CIOF was determined using the history of amennorhea for 3 months or more and serum follicle-stimulating hormone.
  
  
  RESULTS
  Of the 43 women, 30 (70%) developed CIOF by the 12-month follow-up. Significant weight gain occurred in women with and without CIOF and consisted of fat but not lean mass in the trunk and legs. In women who developed CIOF, truncal fat increased by a median of 1.8 kg (P = 0.0004), whereas truncal lean mass decreased by 0.6 kg (P = 0.02). Women who retained ovarian function gained a median of 0.9 kg (P = 0.06) in truncal fat with no significant change in truncal lean mass. Women with CIOF tended to lose lean mass. Loss of total body lean mass was directly correlated with the decrease in bone density as measured by bone mineral density at the femoral neck (Spearman correlation coefficient, 0.4; P = 0.03). Energy intake decreased similarly in women with and without CIOF (-184 vs -290 kcal, respectively; P = 0.77).
  
  
  CONCLUSIONS
  The results of this small preliminary analysis suggest that body composition changes in women receiving adjuvant chemotherapy for breast cancer include an increase in fat mass in the trunk and leg regions without an increase in fat-free mass. Future research with a larger study cohort and longer follow-up is needed to further investigate the role of CIOF in body composition changes in women with breast cancer. Further research is also needed to evaluate the potential effects of body composition changes on breast cancer outcomes.
authors.affiliation: Skeletal Health and Osteoporosis Center, Endocrinology, Diabetes and Hypertension Division, Brigham and Women's Hospital, Boston, MA 02115, USA.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Gordon
authors.forename: Shelley
authors.initials: S
authors.lastname: Hurwitz
authors.forename: Charles L
authors.initials: CL
authors.lastname: Shapiro
authors.forename: Meryl S
authors.initials: MS
authors.lastname: LeBoff
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001823:Body Composition; D001943:Breast Neoplasms / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D017697:Premenopause; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced* / Q000503:physiopathology; D011446:Prospective Studies; D013629:Tamoxifen / Q000008:administration & dosage / Q000009:adverse effects; D015430:Weight Gain
chemical_list: D000970:Antineoplastic Agents; D013629:Tamoxifen; D004317:Doxorubicin; D003520:Cyclophosphamide; D005472:Fluorouracil; D008727:Methotrexate