Impact of Nutritional Intervention in Women With Breast Cancer Under Adjuvant Chemotherapy
Condition: Breast Cancer; Adequate Physical Condition
MeSH terms: Breast Neoplasms
Study type: Interventional

Summary: 
      Breast cancer is the most common cancer in women. Weight gain in adulthood, overweight or
      obesity, physical inactivity and alcohol consumption are risk factors commonly associated
      with risk of breast cancer (mainly for post-menopausal for overweight and obesity). Reduced
      physical activity is one factor likely to weight gain in women after adjuvant chemotherapy
      for localized breast cancer. Furthermore, physical activity appropriately could improve many
      prognostic factors and survival of women after breast cancer. Adapted Physical Activity (APA)
      could improve fitness, quality of life, body image, treatment compliance and reduce fatigue.

      After diagnosis of breast cancer, there is many possible risk factors of mortality or
      morbidity related to nutritional factors available to management. These risks prevention
      through management of these patients appears indispensable through an APA program.

      Thus, the investigators propose to test the feasibility of implementing a program of dietary
      intervention and APA to prevent the risk of weight gain (which affects more than half of
      patients) and maintain and/or increase their level of physical activity during and after
      adjuvant chemotherapy.
    

Detailed description: 
      With approximately 52,600 new cases diagnosed in France in 2010, breast cancer is the most
      common cancer in women, according to national projections of the incidence and cancer
      mortality for 2010.

      Weight gain in adulthood, overweight or obesity, physical inactivity and alcohol consumption
      are risk factors commonly associated with risk of breast cancer (mainly for post-menopausal
      for overweight and obesity).

      Several hypotheses explain the association between obesity and breast cancer: obesity,
      metabolic syndrome and diabetes participate to changes in hormone levels (estrogen, leptin,
      insulin) that promotes mammary carcinogenesis and tumor progression.

      The association between obesity and development of breast cancer is partly due to increased
      serum levels of estradiol produced by adipocytes, but the role of insulin resistance and
      inflammation associated with obesity is widely discussed.

      Reduced physical activity is one factor likely to weight gain in women after adjuvant
      chemotherapy for localized breast cancer. Furthermore, physical activity appropriately could
      improve many prognostic factors and survival of women after breast cancer. Thus, several
      large cohort studies of women with breast cancer showed an average mortality reduction of 45%
      associated with moderate physical activity compared with inactivity. Adapted Physical
      Activity (APA) could also improve fitness, quality of life, body image, treatment compliance
      and reduce fatigue.

      A rich fruits and vegetables diet combined with regular physical activity appears to offer
      the best protection from breast cancer. The nature, frequency, duration, intensity and
      arrangement of physical training program meetings are key elements to consider, metabolic
      responses differ according to these factors.

      The optimal management for an improved level of physical activity appear to be an individual
      of at least three sessions per week, 30 to 60 minutes each with a moderate intensity,
      allowing a physiological response to chronic exercise and an adequate recovery.

      After diagnosis of breast cancer, there is thus many possible risk factors of mortality or
      morbidity related to nutritional factors available to management. These risks prevention
      through management of these patients appears indispensable through an APA program.

      Thus, the investigators propose to test the feasibility of implementing a program of dietary
      intervention and APA to prevent the risk of weight gain (which affects more than half of
      patients) and maintain and/or increase their level of physical activity during and after
      adjuvant chemotherapy.
    

Intervention name(s): Control arm; Intervention arm
Intervention type(s): Other; Other
Intervention description(s): Dietetic follow-up only; Dietetic follow up + adapted physical activity
Other intervention name(s): APA arm
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Keywords: Breast cancer; Adapted Physical activity; Nutrition; Assessment; Patient education