MRI study of long-term body composition alterations in HER2+ breast cancer survivors
Notice bibliographique
Résumé
Abstract Background Early breast cancer (EBC) remains the most common invasive cancer in North American women. With improvements in detection, systemic therapies and supportive care, long-term survival in early stage disease now approaches 90%. In EBC survivors, fat pool distribution, specifically visceral and intermuscular fat (IMF) is associated with increased cardiovascular disease risk regardless of pre-existing risk factors or cancer treatments. We previously showed that 1 year after trastuzumab initiation, visceral fat and IMF volumes increased significantly while muscle volume decreased in HER2+ EBC patients. However, the longer-term effects of such exposures on body composition remain unknown. Purpose We hypothesized that over time, deleterious changes would progress with increasing fat and decreasing skeletal muscle in EBC patients exposed to trastuzumab-based chemotherapy. Methods A follow-up MRI study was conducted with prior participants of the MANTICORE (Multidisciplinary Approach to Novel Therapies In Cardio-Oncology REsearch) trial. Enrolment was limited to those without recurrent disease; 54 patients consented to participate. Eight scans were not included (tissues outside field of view, files unevaluable) thus 46 scans were included. The identical MRI protocol was used at all timepoints with five slices centered at the 3rd lumbar vertebra. Sum of volumes of muscle, IMF and visceral fat were measured using custom semi-automated software. Bones and organs were removed from the visceral fat pool. Repeated measures of ANOVA with appropriate post-hoc correction for multiple comparisons were performed at baseline, 3-month, 12-month, 24-month and 5 years. Results Participants were 58.6 ± 8.6 years of age and median 5.5 years had elapsed since trastuzumab completion. All were living independently with no cardiac events occurring in the intervening years. Ten had initiated cardiometabolic pharmacotherapy (beta-blockade, ACEI/ARB, diuretic or diabetes). Muscle mass increased over the 5 years (main effect of time, p=0.002); however, was lower at 1 year versus 3 months (Fig 1A). IMF also increased over 5 years (main effect of time, p=0.005) but the pattern was different with increases observed as early as 3-months (Fig 1B). Visceral fat increased up to 2 years then plateaued (main effect of time, p= 0.038; Fig 1C). Conclusions To our knowledge, this is the first and longest prospective study assessing changes in body composition in EBC using MRI both during and years after trastuzumab-based chemotherapy. Our data suggests that there may be ‘targetable’ timepoints for interventions such as pharmacotherapy, nutrition and exercise-based rehabilitation aiming to improve the quality and quantity of life in EBC survivors.Figure 1
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».