Test of a Weight Gain Prevention Intervention in Stage II and III Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Purpose: Weight gain is common in women with breast cancer and is worrisome, as it may affect prognosis and risk of other chronic diseases. This randomized pilot test was conducted to evaluate the feasibility and preliminary effectiveness of a weight gain prevention intervention for breast cancer patients receiving neoadjuvant chemotherapy.

Method: Breast cancer patients receiving neoadjuvant chemotherapy were randomized to the weight gain prevention intervention or usual care. The intervention used a size acceptance approach, which emphasized changes in diet (low energy density food) and exercise behavior (resistance training) rather than focusing on weight loss. It was administered in weekly sessions delivered in-person and by telephone. Assessments were done at baseline, mid-chemotherapy, end of chemotherapy, after surgical recovery, after a post-surgical booster intervention, and 6 months after surgery. The data from baseline (BL), mid-chemotherapy (MC), and end of chemotherapy (EC) are presented.

Results: 38 participants were randomized to the intervention (n = 19) or usual care (n = 19). 68% had stage II and 32% had stage III breast cancer. Their mean age was 50.0 (SD = 11.0), and 55% were premenopausal. Mean BMI was 29.1 (SD = 6.2) and 69% were physically inactive. The sample was diverse with regard to self-reported ethnicity (58% white, 27% African-American, 8% Hispanic, 6% other). Data collected at MC and EC indicated a trend toward greater reduction in BMI in the intervention than the control group (intent to treat analysis, P = 0.10). When the analysis was conducted without the 4 intervention participants who attended less than 60% of the sessions (analyze as treated) the differences were more marked (group difference: 0.5 kg/m2 at MC and 0.9 kg/m2 at EC, P = 0.025). Similar results were found for waist circumference and SF-36 physical component score, but no differences were found in the SF-36 mental component score.

Conclusions: Based on a preliminary analysis, there was a trend toward improvements in body composition and physical aspects of quality of life from a diet and exercise intervention based on the size acceptance approach. These results indicate this intervention should be tested in a larger randomized controlled trial.