2nd. Dept. Surg., Univ. of Toyama A trial of nutritional support after breast cancer operation. 2nd.Dept. of surgery, University of Toyama T. Nagata, K.

2nd. Dept. Surg., Univ. of Toyama

A trial of nutritional support after breast cancer operation.

2nd.Dept. of surgery, University of Toyama

T. Nagata, K. Matsui, Y. Shimada and K. Tsukada


Purpose: To decrease breast cancer, we tried to induce the Macro biotic meal in our hospital. We evaluated the outcome of this support.

Method: After breast cancer operation, patients were provided “Macro food”,that was mainly consisted by whole grain, vegetables, soy beans and sea weeds, at dinner in hospital.

Results: All patients agreed with the food, and became interested in nutritional support after discharge. Body weight and BMI in Macro biotic group had tendency to decrease.

Abstract

Breast cancer in Japan is increasing with very high speed!

Young women become breast cancer in Japan

Age

/100,000

Breast cancer

Intake the animal fat increase the risk of breast cancer

Report： J.Natl.Cancer Inst. （ 2003）Case： Nurses in America(90,655 females)（ Age26-46y.o）Investigarion： Questionnaire and follow up during 8 years

少　ー動物性脂肪摂取量ー　多Low animal fat intake high

Relativecancerrisk

report： J.Natl.Cancer Inst. （ 2003）case： Japanease women (21,852 female)（ Age 40-59y.o.）Investigarion： Questionnaire and follow up during 10 years

lowー isoflavoneー highMiso soup（ cup/day）

Beans (isoflavone) and vegetables decrease the risk of breast cancer

cancerrisk

(%)

Introduction• The number of breast cancer are increasing in Japan.• It is reported to have relationship with the balance of Estrogen.

(pre-menopausal women) (post-menopausal women)

1. Sigle 2. Change of dietary habit

high-aged delivery 　　　 Obesity, Fatness

　　　　　↓ ↓Prolongation of estrogen Estrogen production

exposed period in adipocyte

↓

Acceleration of breast cancer growth



Nutritional support for breast cancer prevention

１． Eating the well balanced food．２． Variation of dietary habits．３． Eating the green vegetables, moderate Vitamin, and a lot of fiber

containing foods．４． Avoid the over eating and the fatty food．５． Drink a moderate alcohol．

（ Report of Foundation for promotion of cancer research ， 2010）

Additionally-

６． Eating soy-bean meal, like Miso-soup, Tofu and Natto in Japan.

７． Exercise（more than three hour per week） .

Macro biotic meal

• based on Japanese traditional food (whole grain, vegetables, beans and sea plants)

• Key Words

「身土不二」Body and ground can not separate = Eat the food which

are harvested in the place where you grown up

「一物全体」Energy of food spreading in whole body = Eat the food,

all of them (from root（根） to leaf（葉） )


Macrobiotic nutritional support

Beef, Pork

Egg Chicken

Milk

Fish

Sweets

Seeds Nuts

Fruits

Oil（ Sesame， Beef steak plant, etc.）Spice boiled Vegetables

Beans Sea plants

Vegetables Pickles

Whole grain

2~3 times/month

2~3 times/week

Daily

Rate of each ingredients Rate of each food

Whole grain(50~60%)

Beans/Sea plants(10~20%)

Vegetables(20~30%)

Miso-soup(10~20%)


Purpose

・ Analysis of Nutritional Guidance with concept of Macro biotic nutritional method.

・ Nutritional seminar after breast cancer operation.

・ Induction of Macro biotic meals after operation.


Induction of Macro biotic meals as dinner in our hospital.

Whole grain“Sushi”

Sea bream grilledwith salt

Sweet rice cake

Boiled vegetablewith white miso-dressing

Beans and vegetablesoup

Total energy： 742kcal（ protein32.9g,fat17.2g,carbohydrate114.7g）

CasesPeriod： 1997.1〜 2010.12

Case: Primary breast cancer operated patients; 308 cases

• Macro biotic Nutrition group： 170 cases (55.2%)

• Control group： 138 cases (44.8%)

Macro group(n=170) Control group(n=138)　　 p

Age 57.5y.o 56.6y.o 　　　　 n.p

Male:Female 2 : 168 0 : 138 n.p

Tumor size 2.21cm 2.84cm 　　　　 n.p

pN(-) cases(%) 120 (70.6%) 95 (68.8%) 　　　　 n.p

Stage 0,I (%) 78 (45.9%) 60 (43.5%) 　　　　 n.p

Bp:Bt ope(Bp%) 104:66 (61.1%) 81:57 (58.7%) n.p


Method•Next day from breast cancer operation, patient start to eat the Macrobiotic meal at dinner in our hospital (average: 4 days).

•After discharge, patients were guided to continue these type of meals at home.

•When patients had a medical examination, height and weight were measured and BMI were analyzed.

•Their blood were taken, and Albumin, Lymphocytes and cholesterol were analyzed.


Result of Questionnaire (n=60)

•Macro biotic meal at hospital：Good 60 cases (100%)

Not good 0

•Habitual meal after discharge ：100% Macro biotic meal 5 cases (8.5%)

Partial Macro biotic meal 54 cases (91.5%)

Without Macro biotic meal 0

•Change of body condition：Improvement of constipation 11 cases (18.6%)

Improvement of dullness 2 cases (3.4%)

No change 48 cases (81.4%)

Analysis of Nutritional support

Macro group(n=170) Control group(n=138)　　 p

Weight(pre)52.1 kg 53.6 kg 　　　 n.p

Weight(post) 50.4 kg (-1.7kg) 53.0 kg (-0.6kg) n.p

BMI(pre) 22.7 23.0 　　　 n.p

BMI(post) 21.9 (-0.7) 22.8 (-0.2) n.p

ALB(pre) 4.1 g/dl 4.1 g/dl 　　　　　 n.p

ALB(post) 3.8 g/dl 4.0 g/dl n.p

Lymph.(pre) 1471 /mm3 1629 /mm3 n.p

Lymph.(post) 1510 /mm3 1570 /mm3 n.p

Chol.(pre) 208 mg/dl 221 mg/dl n.p

Chol.(post) 194 mg/dl 215 mg/dl n.p

Survival Rate


p=0.5873

OS

Macro group (n=170)

Control (n=138)

DFS

Macro group (n=170)

Control (n=138)

p=0.7583


Conclusion

1． For the purpose of decreasing the recurrence rate of breast cancer, we tried to induce the Macro biotic meal , which was based on Japanese traditional food (whole grain, vegetables, beans and sea plants) at dinner in our hospital.

2． It was effective for patients after breast cancer operation, to recognize the importance of nutritional guidance at home.

3． As a result of nutritional analysis, here was no obvious difference between Macro biotic group and control group, but body weight and BMI in Macro biotic group had tendency to decrease much more than control group.

4．We will continue to assess the importance of nutritional guidance for the patient who had breast cancer operation.

2nd. Dept. Surg., Univ. of Toyama A trial of nutritional support after breast cancer operation. 2nd.Dept. of surgery, University of Toyama T. Nagata, K.

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