Abstract P1-10-08: Effect of a structured group intervention on obesity in breast cancer survivors
Authors: Kitagawa H , Hosaka T , Takeda N , Matsumoto N , Tomita M , Takahashi M , Yamauchi H 
Published: May 2016

Background: Obesity is associated with an increased risk of breast cancer and poor outcomes. Endocrine therapy, including aromatase inhibitors (AI) is a key part of adjuvant treatment. However, it may produce some side effects, including musculoskeletal pain and weight gain.This study aimed to examine the effect of a structured group intervention for breast cancer patients with obesity and abnormal lipid metabolism during adjuvant endocrine therapy.

Methods: The subjects were 32 breast cancer survivors with obesity who were undergoing endocrine therapy (AI or tamoxifen) and had undergone surgery at least 12 months before enrollment. Median age was 51 years (range 37-67). We performed a single-arm pre-post study of combined interventions. The intervention consisted of 15 minutes of nutrition education delivered by a registered dietitian, a 30-minute group health coaching program by a coaching staff, and a 45-minute group aerobic exercise.

Before and after the intervention, body weight (BW), body mass index (BMI), mid-upper arm circumference, triceps skinfold, liver enzyme levels (alanine aminotransferase [ALT], aspartate aminotransferase [AST]), total cholesterol (CHO) level, and triglyceride (TG) level were determined and compared. We also compared the results of the Japanese version of K6, Cancer Fatigue Scale (CFS), and Self-efficacy Scale for Cancer Patients (SES) before and after intervention.These weekly structured interventions were held in 3 consecutive weeks. Participants were asked to practice to exercise at home with a DVD, performing the same activities. Pre- and post-intervention data were compared by using paired t tests with IBM SPSS version 21.

Results: Significant decreases were found in BW(p &lt; 0.01), BMI (p &lt; 0.01), TG level (p &lt; 0.05), CHO level (p &lt; 0.01), K6 result (p &lt; 0.05), and CFS result (p &lt; 0.01). In contrast, no statistically significant change at the 5% level was observed in the mid-upper arm circumference, triceps skinfold, AST level, ALT level, and SES result.

Comparison of measured values between pre- and post-group intervention Unadjusted mean±standard deviationUnadjusted mean±standard deviationp Value Before interventionAfter intervention BW(kg)60.5±10.959.5 ± 11.00.000BMI (kg/m2)24.5 ± 4.424.0 ±4.40.000Mid-upper arm circumference (cm)28.8 ±3.728.5± 3.70.104Triceps skinfold (cm)33.6 ±10.431.7±10.50.143TG (mg/dL)121.1 ± 62.3101.2 ± 43.30.044CHO (mg/dL)206.6 ± 34.7192.9 ±33.70.000

Comparison of self-administered questionnaires between pre- and post-group intervention Unadjusted mean ±standard deviationUnadjusted mean ± standard deviationp Value Before interventionAfter intervention K64.9 ± 5.13.3 ±3.80.011CFS22.2 ± 10.818.6 ±10.40.003SES30.5 ± 5.131.3 ±5.70.247

Conclusion: This study showed that a short-term, three-session, structured intervention is effective for behavioral changes to promote health among breast cancer survivors, resulting in favorable changes in not only obesity but also in TG/CHO levels.These results suggest its potential as an effective intervention for cancer-related fatigue and mental health of survivors.

Further studies with more participants and with a control group are needed to demonstrate the long-term effects of the structured intervention, particularly its possible impact on breast cancer prognosis.

Citation Format: Kitagawa H, Hosaka T, Takeda N, Matsumoto N, Tomita M, Takahashi M, Yamauchi H. Effect of a structured group intervention on obesity in breast cancer survivors. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-10-08.