Background: Breast cancer and its treatment are associated with nutritional and metabolic alterations that may increase the risk of metabolic comorbidities. However, few studies have evaluated these parameters in sub-Saharan African populations, particularly comparing patients receiving chemotherapy versus those not on treatment.
Objective: To determine the effects of chemotherapy on the nutritional and metabolic status of breast cancer patients at the Yaoundé General Hospital, Cameroon, by comparing parameters between patients receiving chemotherapy and those not on treatment.
Methods: A cross-sectional study was conducted among 40 histologically confirmed female breast cancer patients (15 newly diagnosed, 25 on chemotherapy) aged 21-55 years from November 2024 to January 2025. Nutritional status was assessed through anthropometric measurements (BMI, waist circumference), dietary habits (food frequency questionnaire, dietary diversity score), and physical activity levels. Metabolic status was evaluated via fasting glucose, lipid profile (total cholesterol, triglycerides), and calculated indices, included Lipid Accumulation Product (LAP) for cardiovascular risk and Triglyceride-Glucose (TyG) index for insulin resistance. Independent t-tests and chi-square tests compared groups, with p<0.05 considered significant.
Results: The overall prevalence of excess weight was high, with similar rates in both the chemotherapy and non-chemotherapy groups (76.0% vs 73.3%). However, patients on chemotherapy exhibited significantly worse metabolic profiles. Hyperglycemia was more than twice as prevalent in the chemotherapy group (19.0% vs 8.3%). Hyperlipidemia was markedly higher among those receiving chemotherapy: hypertriglyceridemia (19.0% vs 8.3%) and hypercholesterolemia (57.1% vs 8.3%, p=0.044). Total cholesterol levels were significantly elevated in chemotherapy patients (191.4±46.9 vs 157.0±41.9 mg/dl, p=0.044). Patients on chemotherapy were 13.3 times more likely to develop hypercholesterolemia (OR=13.333, 95%CI: 1.434-123.999, p=0.023). Metabolic comorbidities were more prevalent in the chemotherapy group: metabolic syndrome (33.3% vs 16.7%), cardiovascular disease risk via LAP index (57.1% vs 50.0%), and insulin resistance via TyG index (23.8% vs 16.7%), though these differences did not reach statistical significance.
Conclusion: Chemotherapy significantly impacts metabolic status in breast cancer patients in Cameroon, particularly affecting lipid metabolism and increasing cardiovascular risk factors. These findings emphasize the critical need for routine metabolic monitoring and nutritional interventions during cancer treatment in low and middle-income country settings. Integrating nutritional support and metabolic management into standard breast cancer care could potentially reduce treatment-related complications and improve long-term survival outcomes in underrepresented African populations. This research, conducted through collaboration between the University of Yaoundé I and Yaoundé General Hospital, builds local capacity in cancer survivorship research and provides evidence to inform clinical practice guidelines in Central Africa.