Monitoring Metastasis and Cachexia in a Patient with Breast Cancer: A Case Study
Cachexia, a wasting syndrome associated with advanced cancer and metastasis, is rarely documented in breast cancer patients. However, the incidence of cachexia in breast cancer is now thought to be largely underestimated. In our case report of a breast cancer patient with bone metastasis monitored d...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2016-01-01
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| Series: | Clinical Medicine Insights: Oncology |
| Online Access: | https://doi.org/10.4137/CMO.S40479 |
| _version_ | 1818201020404072448 |
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| author | Nikita Consul Xiaotao Guo Courtney Coker Sara Lopez-Pintado Hanina Hibshoosh Binsheng Zhao Kevin Kalinsky Swarnali Acharyya |
| author_facet | Nikita Consul Xiaotao Guo Courtney Coker Sara Lopez-Pintado Hanina Hibshoosh Binsheng Zhao Kevin Kalinsky Swarnali Acharyya |
| author_sort | Nikita Consul |
| collection | DOAJ |
| description | Cachexia, a wasting syndrome associated with advanced cancer and metastasis, is rarely documented in breast cancer patients. However, the incidence of cachexia in breast cancer is now thought to be largely underestimated. In our case report of a breast cancer patient with bone metastasis monitored during the course of her treatment, we document the development of cachexia by image analysis in relation to her metastatic burden. Elucidation of the link between metastatic burden and cachexia could unveil a highly specific screening process for metastasis, by assessing true muscle mass loss. Our patient was a 49-year-old premenopausal woman, with metastatic invasive ductal breast carcinoma in the vertebral and iliac bones on presentation, which progressed with new metastases to her hips, thigh bones, and vertebrae. In the two-year period, that is between her diagnosis and death, she lost >10% of her baseline weight. During these two years, we retrospectively identified a decrease in paraspinal muscle (PM) at the third lumbar vertebra followed by a sharp decline in weight. The increased tumor burden over time in metastatic sites was accompanied by a decrease in abdominal muscle and visceral and subcutaneous fat and was followed by the patient's demise. The increasing tumor burden in the patient was correlated with the mass of other tissues to determine the tissue that could best serve as a surrogate marker to cachexia and tumor burden. We noted a strong negative correlation between PM area and metastatic tumor area at the third lumbar vertebral level, with PM loss correlating to increasing tumor burden. The monitoring of PM wasting may serve as a marker, and therefore a prognostic factor, for both cachexia and extent of metastatic disease, especially in breast cancer, where metastasis to bone is frequent. Based on our data and review of the literature in this case study, longitudinal monitoring of cachexia in the selected muscle groups can give clinicians early indications of the extent of cachexia in metastatic breast cancer patients. |
| first_indexed | 2024-12-12T02:46:55Z |
| format | Article |
| id | doaj.art-d0dda28fe799439fa4c5aee10a278485 |
| institution | Directory Open Access Journal |
| issn | 1179-5549 |
| language | English |
| last_indexed | 2024-12-12T02:46:55Z |
| publishDate | 2016-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Medicine Insights: Oncology |
| spelling | doaj.art-d0dda28fe799439fa4c5aee10a2784852022-12-22T00:40:59ZengSAGE PublishingClinical Medicine Insights: Oncology1179-55492016-01-011010.4137/CMO.S40479Monitoring Metastasis and Cachexia in a Patient with Breast Cancer: A Case StudyNikita Consul0Xiaotao Guo1Courtney Coker2Sara Lopez-Pintado3Hanina Hibshoosh4Binsheng Zhao5Kevin Kalinsky6Swarnali Acharyya7Department of Medicine, College of Physicians and Surgeons, Columbia University.Department of Radiology, Columbia University Medical Center, New York, NY, USA.Institute for Cancer Genetics, Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA.Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA.Department of Radiology, Columbia University Medical Center, New York, NY, USA.Co-corresponding authors.Co-corresponding authors.Cachexia, a wasting syndrome associated with advanced cancer and metastasis, is rarely documented in breast cancer patients. However, the incidence of cachexia in breast cancer is now thought to be largely underestimated. In our case report of a breast cancer patient with bone metastasis monitored during the course of her treatment, we document the development of cachexia by image analysis in relation to her metastatic burden. Elucidation of the link between metastatic burden and cachexia could unveil a highly specific screening process for metastasis, by assessing true muscle mass loss. Our patient was a 49-year-old premenopausal woman, with metastatic invasive ductal breast carcinoma in the vertebral and iliac bones on presentation, which progressed with new metastases to her hips, thigh bones, and vertebrae. In the two-year period, that is between her diagnosis and death, she lost >10% of her baseline weight. During these two years, we retrospectively identified a decrease in paraspinal muscle (PM) at the third lumbar vertebra followed by a sharp decline in weight. The increased tumor burden over time in metastatic sites was accompanied by a decrease in abdominal muscle and visceral and subcutaneous fat and was followed by the patient's demise. The increasing tumor burden in the patient was correlated with the mass of other tissues to determine the tissue that could best serve as a surrogate marker to cachexia and tumor burden. We noted a strong negative correlation between PM area and metastatic tumor area at the third lumbar vertebral level, with PM loss correlating to increasing tumor burden. The monitoring of PM wasting may serve as a marker, and therefore a prognostic factor, for both cachexia and extent of metastatic disease, especially in breast cancer, where metastasis to bone is frequent. Based on our data and review of the literature in this case study, longitudinal monitoring of cachexia in the selected muscle groups can give clinicians early indications of the extent of cachexia in metastatic breast cancer patients.https://doi.org/10.4137/CMO.S40479 |
| spellingShingle | Nikita Consul Xiaotao Guo Courtney Coker Sara Lopez-Pintado Hanina Hibshoosh Binsheng Zhao Kevin Kalinsky Swarnali Acharyya Monitoring Metastasis and Cachexia in a Patient with Breast Cancer: A Case Study Clinical Medicine Insights: Oncology |
| title | Monitoring Metastasis and Cachexia in a Patient with Breast Cancer: A Case Study |
| title_full | Monitoring Metastasis and Cachexia in a Patient with Breast Cancer: A Case Study |
| title_fullStr | Monitoring Metastasis and Cachexia in a Patient with Breast Cancer: A Case Study |
| title_full_unstemmed | Monitoring Metastasis and Cachexia in a Patient with Breast Cancer: A Case Study |
| title_short | Monitoring Metastasis and Cachexia in a Patient with Breast Cancer: A Case Study |
| title_sort | monitoring metastasis and cachexia in a patient with breast cancer a case study |
| url | https://doi.org/10.4137/CMO.S40479 |
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