Web-based self-monitoring for weight loss among overweight/obese women at increased risk for breast cancer: the HELP pilot study

2012 ◽  
Vol 22 (8) ◽  
pp. 1821-1828 ◽  
Author(s):  
Lisa Cadmus-Bertram ◽  
Julie B. Wang ◽  
Ruth E. Patterson ◽  
Vicky A. Newman ◽  
Barbara A. Parker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Loss ◽  
Pilot Study ◽  
Obese Women ◽  
Self Monitoring ◽  
Web Based ◽  
Increased Risk

Training overweight/obese older women at high risk for breast cancer to use web-based weight loss tools: The HELP pilot study.

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. e11128-e11128
Author(s):  
L. A. Cadmus Bertram ◽  
J. P. Pierce ◽  
R. E. Patterson ◽  
H. Ojeda-Fournier ◽  
B. A. Parker
Keyword(s):  
Breast Cancer ◽  
Weight Loss ◽  
Pilot Study ◽  
High Risk ◽  
Older Women ◽  
Web Based

Training overweight/obese older women at high risk for breast cancer to use web-based weight loss tools: The HELP pilot study.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 233-233 ◽  
Author(s):  
L. A. Cadmus Bertram ◽  
J. P. Pierce ◽  
R. E. Patterson ◽  
H. Ojeda-Fournier ◽  
V. A. Newman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Weight Loss ◽  
Pilot Study ◽  
Comparison Group ◽  
Intervention Group ◽  
Initial Weight ◽  
Web Based ◽  
Internet Users

233 Background: Excess weight is one of the few modifiable risk factors for incident breast cancer. Many programs can achieve a 7% weight loss but few can maintain it over time. Training women to use self-help resources over the internet has potential for reducing intervention costs and ensuring program maintenance. Methods: 50 overweight/obese (BMI≥27.5 kg/m2) women at increased risk of breast cancer (Gail score≥1.7) were identified from a mammography registry and enrolled in the HELP pilot study and randomized with 2:1 probability to a 12-week lifestyle intervention or a comparison group. Twelve telephone-based coaching calls trained participants to use a free, publicly available website to set goals and track performance for dietary intake and physical activity. The comparison group received information but no training. At baseline and 12 weeks, participants were weighed, fitted with an accelerometer for physical activity pattern, and completed questionnaires. Results: At baseline, participants were 60.9±0.79 years of age with a BMI of 33.1±0.60 kg/m2; 39% were daily internet users. Thirty-three were randomized to the intervention group with 91% completing follow-up. Fifty-four percent were able to use the website reliably and found it to be helpful, including 44% of previously nondaily internet users. At 12 weeks, intervention group participants who found the website helpful had lost 5.6±0.7 kg, or 6.7% of initial weight, intervention participants who did not find it helpful lost 0.8±0.9kg or 1.1% of initial weight and the comparison group gained 1.0±0.94 kg (89% follow-up) The between-group difference weight change was 4.2 kg (p<.0001). 74% of intervention group participants lost weight, compared to only 34% of women assigned to the comparison group. Conclusions: A 12-session telephone coaching program to train women to use publicly available web-based weight loss programs effectively achieved a large short-term weight loss among the majority of participants. Further follow-up is needed to identify how well the initial weight loss is maintained without further intervention assistance.

Effect of bariatric surgery on breast tissue and biomarkers in obese women at increased risk for breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. TPS1592-TPS1592
Author(s):  
Tarah Jean Ballinger ◽  
Kathy Miller ◽  
Kandice Ludwig ◽  
Sunil S. Badve ◽  
Don Selzer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Breast Cancer Risk ◽  
Breast Tissue ◽  
Obese Women ◽  
Increased Risk ◽  
Menopausal Women ◽  
Post Menopausal

TPS1592 Background: Obesity represents a challenging epidemic associated with increased risk of several malignancies, including breast cancer in post-menopausal women. Proposed mechanisms for the association between obesity and breast cancer risk include increased insulin resistance, elevated levels of circulating estrogens, and chronic inflammation. Intentional weight loss from bariatric surgery has been associated with decreased risk of breast cancer. While rapid improvements in serologic markers of metabolism and inflammation are seen following bariatric surgery, short- and long- term changes in breast tissue remain less clear. This study investigates the effect of bariatric surgery on breast density and biomarkers of increased risk in breast tissue. Methods: This pilot, single institution, observational study (NCT02681120) is recruiting pre- and post-menopausal women with BMI ≥30 from a University bariatric surgery clinic using the Hughes risk application as a screening tool. Eligible patients must have a lifetime risk for breast cancer of ≥20%. Participants are evaluated by imaging, breast biopsy, and blood samples at baseline, 14 days post-operatively to determine the effects of rapid metabolic changes, and 1 year post-operatively to determine the effects of significant weight loss. The impact of bariatric surgery on known imaging parameters of breast cancer risk is assessed by background parenchymal enhancement on MRI and breast density on mammogram. Breast tissue is evaluated for changes in immune infiltrates, aromatase expression, and the presence of crown-like structures, a marker of inflammation seen in the breast tissue of obese women. Tissue samples at each time point are also compared to samples from lean women in the Susan G. Komen Tissue Bank at the IU Simon Cancer Center. Blood is collected for correlative studies evaluating markers of inflammation, insulin resistance, metabolism, and hormone synthesis. Enrollment is currently ongoing with a planned accrual of 40 patients, and data collection is estimated to complete by the end of 2018. Clinical trial information: NCT02681120.

scholarly journals Double Discourse: Qualitative Perspectives on Breast Screening Participation among Obese Women and Their Health Care Providers

2019 ◽  
Vol 16 (4) ◽  
pp. 534
Author(s):  
Kate McBride ◽  
Catharine Fleming ◽  
Emma George ◽  
Genevieve Steiner ◽  
Freya MacMillan
Keyword(s):  
Breast Cancer ◽  
Body Image ◽  
Health Care Providers ◽  
Breast Screening ◽  
Health Concern ◽  
Obese Women ◽  
Health Providers ◽  
Care Providers ◽  
Screening Participation ◽  
Increased Risk

Obesity in Australia is rising rapidly, and is a major public health concern. Obesity increases the risk of breast cancer and worsens associated outcomes, yet breast screening participation rates in Australia are suboptimal and can be lower in higher risk, obese women. This study qualitatively explored barriers to breast screening participation in obese women in Australia. In-depth interviews (n = 29), were conducted with obese women (body mass index ≥ 30) and key health providers. A disconnect between providers’ and women’s perceptions was found. For women, low knowledge around a heightened need to screen existed, they also reported limited desire to prioritize personal health needs, reluctance to screen due to poor body image and prior negative mammographic experiences due to issues with weight. Providers perceived few issues in screening obese women beyond equipment limitations, and health and safety issues. Overall, weight was a taboo topic among our interviewees, indicating that a lack of discourse around this issue may be putting obese women at increased risk of breast cancer morbidity and mortality. Consideration of breast screening policy in obese women is warranted. Targeted health promotion on increased breast cancer risk in obese women is required as is a need to address body image issues and encourage screening participation.

Brain metastases in HER2-overexpressing metastatic breast cancer: Comparative analysis of trastuzumab levels in serum and cerebrospinal fluid

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 1525-1525 ◽  
Author(s):  
J. Stemmler ◽  
M. Schmitt ◽  
A. Willems ◽  
H. Bernhard ◽  
N. Harbeck ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Pilot Study ◽  
Serum Level ◽  
Metastatic Breast ◽  
Whole Brain Radiotherapy ◽  
Test System ◽  
Meningeal Carcinomatosis ◽  
Brain Radiotherapy ◽  
Increased Risk

1525 Purpose: Patients receiving trastuzumab for HER2-overexpressing MBC suffer from an increased risk to develop BM despite responsive visceral disease. The present pilot study was conducted to explore trastuzumab levels in S and CSF of MBC patients afflicted with BM, and to evaluate whether radiotherapy will lead to impairment the blood-brain barrier (BBB) to allow penetration of trastuzumab into CSF. Methods: Patients with BM from HER2-overexpressing MBC (IHC; DAKO Hercep Test) were included. Trastuzumab levels in S and CSF were determined at different time points by a newly developed immunoenzymatic test for functional, reactive trastuzumab. Results: Six out of 8 eligible patients were evaluable. Prior to whole-brain radiotherapy (WBRT), the median trastuzumab serum level was 52,054 ng/ml compared to a median CSF level of 124 ng/ml (ratio 420:1). After completion of WBRT, the median level of trastuzumab was 20,185 ng/ml in serum and 226 ng/ml in CSF (ratio 76:1). In two cases of concomitant meningeal carcinomatosis, the median serum level of trastuzumab after WBRT was 17,431 ng/ml and 356 ng/ml in CSF (ratio 49:1). Conclusion: These data indicate that the BBB prevent trastuzumab to reach adequate concentrations in CSF. These levels are increased under conditions of an impaired BBB, as is known for meningeal carcinomatosis and for patients receiving WBRT. The new test system in this pilot study provides the basis for the evaluation of radiotherapeutic strategies which allow most favorable penetration of trastuzumab into the CNS in patients receiving concomitant trastuzumab for HER2-overexpressing metastatic breast cancer. [Table: see text]

Genetic testing in young women with breast cancer: Results from a web-based survey

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21093-21093
Author(s):  
J. A. Shin ◽  
S. Gelber ◽  
J. Garber ◽  
R. Rosenberg ◽  
M. Przypyszny ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Genetic Testing ◽  
Family History ◽  
High Risk ◽  
Young Women ◽  
College Education ◽  
Web Based ◽  
Increased Risk ◽  
History Of

21093 Background: Young women with breast cancer have an increased risk of harboring a BRCA1/2 mutation. The frequency of genetic testing in this population is not well described. We evaluated the reported frequency and factors associated with genetic testing among young breast cancer survivors identified through the Young Survival Coalition (YSC), an international advocacy group for young women with breast cancer. Methods: Items regarding family history and genetic testing were included in a large web-based survey addressing quality of life and fertility issues for young women with breast cancer. All YSC members were invited by email in March 2003 (N= 1,703 women) to participate in this cross-sectional survey. Results: 657 women completed the on-line survey; 622 were eligible for this analysis (age <40, no metastatic or recurrent disease). Mean age at breast cancer diagnosis was 33 years; mean age when surveyed 35.5 years. Stages included: 0 (10%), I (27%), II (49%), III (12%), missing (3%). 90% of women were white; 64% married; 49% with children; 78% had at least a college education; 42% of women reported a 1st or 2nd degree relative with breast or ovarian cancer, and 13% considered themselves high-risk for harboring a genetic mutation at the time of diagnosis. At the time of the survey, 23% of women had undergone genetic testing, and 26% of those tested reported that a mutation was found. In a multivariate model, women who were younger (age 36–40 vs. age =30, O.R. 2.26, p=0.004), more educated (< college vs. > college education, O.R. 2.62, p=0.0009), had a family history of breast or ovarian cancer (O.R. 3.15, p<0.0001), and had had a mastectomy (O.R. 1.99, p=0.001) were more likely to have undergone genetic testing. Non-significant covariates included: age at survey, stage, time since diagnosis, race, marital status, employment, finances, insurance, number of children, comorbidities, baseline anxiety and depression, and fear of recurrence. Conclusion: The majority of women diagnosed with breast cancer age 40 and younger do not undergo genetic testing. Younger, more educated women with a family history of breast or ovarian cancer are more likely to get tested. Further research to define the appropriateness of genetic testing in this relatively high-risk population is warranted. No significant financial relationships to disclose.

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