scholarly journals Modifiable Lifestyle Factors: Opportunities for (Hereditary) Breast Cancer Prevention - a Narrative Review

Breast Care ◽  
2018 ◽  
Vol 13 (2) ◽  
pp. 108-113 ◽  
Author(s):  
Jacqueline Lammert ◽  
Sabine Grill ◽  
Marion Kiechle
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Cancer Prevention ◽  
Healthy Lifestyle ◽  
Absolute Risk ◽  
Lifestyle Factors ◽  
Breast Cancer Prevention ◽  
The Impact

Increasing rates of obesity, lack of physical activity, sedentary behavior, and frequent alcohol consumption are major lifestyle-related risk factors for breast cancer. In fact, it has been estimated that about one-third of breast cancer cases are attributable to factors women can change. Most research has focused on examining the impact of one single exposure on breast cancer risk while adjusting for other risk modifiers. Capitalizing on big data, major efforts have been made to evaluate the combined impact of well-established lifestyle factors on overall breast cancer risk. At the individual level, data indicate that even simple behavior modifications could have a considerable impact on breast cancer prevention. Moreover, there is emerging new evidence that adopting a healthy lifestyle may be particularly relevant for women with hereditary susceptibility to breast cancer. On the absolute risk scale, studies suggest that the presence of certain risk factors, such as excessive body weight, had a substantially higher impact on breast cancer risk if women had a hereditary predisposition to cancer. The existing body of knowledge gives the medical professionals guidance as to which factors to focus on when counseling patients. However, well-designed randomized controlled trials utilizing objective methods are crucial to providing concrete recommendations.

scholarly journals Prospective Evaluation of a Breast Cancer Risk Model Integrating Classical Risk Factors and Polygenic Risk in 15 Cohorts from Six Countries

2019 ◽  
Author(s):  
Amber N Wilcox ◽  
Parichoy Pal Choudhury ◽  
Chi Gao ◽  
Anika Hüsing ◽  
Mikael Eriksson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Cancer Prevention ◽  
Risk Model ◽  
European Ancestry ◽  
Polygenic Risk ◽  
The Us ◽  
Prospective Cohorts

ABSTRACTPURPOSERisk-stratified breast cancer prevention requires accurate identification of women at sufficiently different levels of risk. We conducted a comprehensive evaluation of a model integrating classical risk factors and a recently developed 313-variant polygenic risk score (PRS) to predict breast cancer risk.METHODSFifteen prospective cohorts from six countries with 237,632 women (7,529 incident breast cancer patients) of European ancestry aged 19-75 years at baseline were included. Calibration of five-year risk was assessed by comparing predicted and observed proportions of cases overall and within risk categories. Risk stratification for women of European ancestry aged 50-70 years in those countries was evaluated by the proportion of women and future breast cancer cases crossing clinically-relevant risk thresholds.RESULTSThe model integrating classical risk factors and PRS accurately predicted five-year risk. For women younger than 50 years, median (range) expected-to-observed ratio across the cohorts was 0.94 (0.72 to 1.01) overall and 0.9 (0.7 to 1.4) at the highest risk decile. For women 50 years or older, these ratios were 1.04 (0.73 to 1.31) and 1.2 (0.7 to 1.6), respectively. The proportion of women in the general population identified above the 3% five-year risk threshold (used for recommending risk-reducing medications in the US) ranged from 7.0% in Germany (∼841,000 of 12 million) to 17.7% in the US (∼5.3 of 30 million). At this threshold, 14.7% of US women were re-classified by the addition of PRS to classical risk factors, identifying 12.2% additional future breast cancer cases.CONCLUSIONEvaluation across multiple prospective cohorts demonstrates that integrating a 313-SNP PRS into a risk model substantially improves its ability to stratify women of European ancestry for applying current breast cancer prevention guidelines.

scholarly journals Genetic Factors, Adherence to Healthy Lifestyle Behavior, and Risk of Invasive Breast Cancer Among Women in the UK Biobank

2020 ◽  
Vol 112 (9) ◽  
pp. 893-901 ◽  
Author(s):  
Rhonda S Arthur ◽  
Tao Wang ◽  
Xiaonan Xue ◽  
Victor Kamensky ◽  
Thomas E Rohan
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Invasive Breast Cancer ◽  
Genetic Factors ◽  
Healthy Lifestyle ◽  
Premenopausal Women ◽  
Uk Biobank ◽  
The Uk ◽  
The Impact

Abstract Background Breast cancer is considered to result from a combination of genetic and lifestyle-related factors, but the degree to which an overall healthy lifestyle may attenuate the impact of multiple genetic variants on invasive breast cancer risk remains equivocal. Methods Using Cox proportional hazards regression models, we examined the association of a modified healthy lifestyle index (HLI) with risk of invasive breast cancer by genetic risk group among 146 326 women from the UK Biobank. We generated an HLI score based on a combination of diet, physical activity, smoking, alcohol consumption and anthropometry, and a polygenic risk score (PRS) using 304 breast cancer-associated genetic loci. Results Among premenopausal and postmenopausal women, a favorable lifestyle (highest tertile) was associated with 22% and 31% reductions in invasive breast cancer risk, respectively (hazard ratio [HR]high vs low = 0.78, 95% confidence interval [CI] = 0.64 to 0.94; HRhigh vs low = 0.69, 95% CI = 0.63 to 0.77, respectively), whereas a high PRS (highest tertile) was associated with more than a doubling in the risk in both groups. For premenopausal women, the greatest risk reduction in association with the HLI was seen among those with a high PRS (HRhigh vs low = 0.73, 95% CI = 0.75 to 0.95). In postmenopausal women, those with a favorable lifestyle had 30%, 29%, and 32% reductions in risk of invasive breast cancer in the low, intermediate, and high PRS groups, respectively (HRhigh vs low = 0.70, 95% CI = 0.56 to 0.88; HRhigh vs low = 0.71, 95% CI = 0.59 to 0.84; and HRhigh vs low = 0.68, 95% CI = 0.59 to 0.78, respectively). There was an additive but not multiplicative interaction between the HLI score and PRS for postmenopausal and, to a lesser extent, premenopausal women. Conclusion Our findings support the view that an overall healthy lifestyle may attenuate the impact of genetic factors on invasive breast cancer risk among women of European ancestry.

Weight Management and Physical Activity for Breast Cancer Prevention and Control

2019 ◽  
pp. e22-e33 ◽  
Author(s):  
Jennifer A. Ligibel ◽  
Karen Basen-Engquist ◽  
Jennifer W. Bea
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Cancer Prevention ◽  
Weight Management ◽  
Lifestyle Changes ◽  
Lifestyle Interventions ◽  
Secondary Breast Cancer ◽  
The Impact

Observational evidence has consistently linked excess adiposity and inactivity to increased breast cancer risk and to poor outcomes in individuals diagnosed with early-stage, potentially curable breast cancer. There is less information from clinical trials testing the effect of weight management or physical activity interventions on breast cancer risk or outcomes, but a number of ongoing trials will test the impact of weight loss and other lifestyle changes after cancer diagnosis on the risk of breast cancer recurrence. Lifestyle changes have additional benefits beyond their potential to decrease primary or secondary breast cancer risk, including improvements in metabolic parameters, reduction in the risk of comorbidities such as diabetes and heart disease, improvement of physical functioning, and mitigation of side effects of cancer therapy. Despite these myriad benefits, implementation of lifestyle interventions in at-risk and survivor populations has been limited to date. This article reviews the evidence linking lifestyle factors to breast cancer risk and outcomes, discusses completed and ongoing randomized trials testing the impact of lifestyle change in primary and secondary breast cancer prevention, and reviews efforts to implement and disseminate lifestyle interventions in at-risk and breast cancer survivor populations.

scholarly journals Adherence to cancer prevention recommendations is associated with a lower breast cancer risk in black urban South African women

2021 ◽  
pp. 1-35
Author(s):  
Inarie Jacobs ◽  
Christine Taljaard-Krugell ◽  
Mariaan Wicks ◽  
Herbert Cubasch ◽  
Maureen Joffe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
South Africa ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Cancer Prevention ◽  
South African ◽  
Breast Cancer Prevention ◽  
Inverse Association ◽  
Obese Women ◽  
Cancer Subtypes

Abstract Breast cancer prevention is of great importance to reduce high incidence in South Africa. This study aimed to investigate adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations and the association with breast cancer risk in black urban women from Soweto, South Africa. A total of 396 breast cancer cases and 396 population-based controls from the South African Breast Cancer study (SABC) matched on age and demographic settings was included. Validated questionnaires were used to collect dietary and epidemiological data. To assess adherence to these recommendations, an 8-point adherence score was developed, using tertiles among controls for scoring each recommendation (0, 0.5 and 1) with zero indicating the lowest adherence to the recommendations. Odds ratios and 95% confidence intervals were estimated using multivariate logistic regression models to analyse associations between the WCRF/AICR score and breast cancer risk. Greater adherence (>4.5 vs <3.25) to the 2018 WCRF/AICR Cancer Prevention Recommendations was associated with a significant inverse association with breast cancer risk overall (OR=0.54, 95%CI:0.35-0.91) and specifically in postmenopausal women (OR=0.55, 95%CI:0.34-0.95), in cases with oestrogen positive (ER+) and progesterone positive (PR+) breast cancer subtypes (OR=0.54, 95%CI:0.39-0.89 and OR=0.68, 95%CI:0.43-0.89, respectively), and in obese women (OR=0.52, 95%CI:0.35-0.81). No significant association with breast cancer risk was observed in premenopausal women. Greater adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations may reduce breast cancer risk in this black urban population of Soweto. Adherence thereof should be encouraged and form part of cost-effective breast cancer prevention guidelines.

Sign in / Sign up

Export Citation Format

Share Document