• Assessment
    Are the measured energy needs of breast cancer patients undergoing chemotherapy different from estimated needs?
    • Conclusion

      Two time-series studies (neutral quality) expressed the measured REE of breast cancer patients as a percentage of estimated REE as predicted by the HBE equation.

      One of the studies found that the measured REE of patients with advanced metastatic breast cancer was comparable to REE as predicted by HBE (98.6 ± 9.6% HBE). Average measured and estimated energy needs of patients with advanced metastatic breast cancer were comparable to those of healthy controls (within 5% of each other).

      In the second study that reported a comparison between measured and estimated energy expenditure, the researchers found that patients with early-stage breast cancer receiving adjuvant chemotherapy had a measured REE that was comparable to REE as estimated by HBE (100.5 ± 8.0% HBE).  However, the breast cancer patients' REE was significantly higher than that of healthy control subjects (100.5 ± 8.0% HBE vs. 94.5 + 8.5% HBE respectively; P < 0.05).

      Further study is needed to determine the effects of breast cancer and breast cancer treatment on patients' actual energy expenditure. 

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Calorie Needs vs. RDA: chemotherapy 2006
       
  • Intervention
    What is the relationship between the use of an arginine oral supplement and a reduction in cancer symptoms in patients with breast cancer?
    • Conclusion

      One (1) RCT of positive quality with oral L-arginine supplementation (30 g/day for 3 days prior to start of neoadjuvant chemotherapy), by patients with breast cancer (tumors < 6 cm diameter in size) experienced significant histopathological responses (types III, IV, and V responses, 88% vs. 52%, p < 0.05) compared to the placebo group. There were no significant differences in clinical response rates between the two groups.  More research is needed.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Search Plan and Results: Arginine and Symptoms/Complications 2005