Impact of Perioperative Nutrition Intervention on Bioimpedance Phase Angle in Patients With Breast Cancer: A Systematic Review

CONTEXT: Breast cancer, the most common malignancy in women, often leads to nutritional challenges exacerbated by treatments such as mastectomy. Perioperative nutrition interventions show promise in improving outcomes, but their effectiveness is limited by the lack of reliable biomarkers. Bioimpedance phase angle (PhA), a measure of cellular integrity and nutritional status, offers potential as a biomarker. However, research on its relationship with perioperative nutrition in patients with breast cancer remains scarce. OBJECTIVE: This systematic review aims to synthesize existing evidence, evaluate the role of PhA, and guide personalized nutrition strategies to enhance recovery and outcomes. DATA SOURCES: A systematic review on the impact of perioperative nutrition intervention on bioimpedance PhA in patients with breast cancer was carried out based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed using the modified Newcastle-Ottawa scale for observational studies, whereas the revised Cochrane risk-of-bias tool for randomized trials (RoB2) was used to evaluate randomized studies. DATA EXTRACTION: A database search was performed in PubMed and Karger for studies published between January 1, 2005, and December 31, 2024. DATA ANALYSIS: Of 689 articles identified in the literature search, 8 prospective studies, 4 reviews, and 3 randomized trials describing breast cancer, nutrition, and PhA were included in the review. A total of 42 301 participants were involved. Five of the total observational studies had a Newcastle-Ottawa scale score of 5 and above. In addition, 2 randomized trials recorded a low overall bias. CONCLUSION: Perioperative nutrition interventions may positively influence PhA, reflecting changes in nutritional status and recovery. However, further higher-quality studies are needed to establish PhA as a standardized biomarker for nutritional assessment and prognosis in patients with breast cancer. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42024625703.