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Liu W, An J, Jiao C, Zhi L, Guo J, Sun L. The Association Between Physical Activity and risk for breast cancer in US female adults: A cross-sectional study based on NHANES 2011-2020. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108647. [PMID: 39217765 DOI: 10.1016/j.ejso.2024.108647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/27/2024] [Accepted: 08/27/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Breast cancer poses a significant threat to women's health worldwide. This study aimed to evaluate the association between various levels of physical activity and the incidence of breast cancer. METHODS The data for this study were obtained from the National Health and Nutrition Examination Survey (NHANES), spanning 2011 to 2020. The study included female participants aged 20 years or older, who provided detailed data on breast cancer incidence, physical activity levels, and other pertinent variables. Adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using multivariate logistic regression analyses, alongside subgroup and sensitivity analyses. RESULTS After adjusting for potential confounders, multivariate logistic regression analyses indicated that compared to individuals with low physical activity (<600 METs min/week), light physical activity (600 to < 1800 METs min/week), moderate physical activity (1800 to < 3000 METs min/week) and high physical activity (≥3000 METs min/week) were associated with breast cancer with adjusted ORs of 0.95 (95 % CI 0.68-1.34, P = 0.787), 0.92 (95 % CI 0.57-1.49, P = 0.747), and 0.56 (95 % CI 0.37-0.86, P = 0.009) respectively. These results were consistent across sensitivity and subgroup analyses. CONCLUSION High-intensity physical activity may decrease the risk of breast cancer, highlighting the importance of proactively implementing healthy lifestyle interventions to protect the health of adult women.
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Affiliation(s)
- Wei Liu
- Department of General Surgery, Bethune International Peace Hospital, No. 398 Zhongshan West Road, Qiaoxi District, Shijiazhuang, Hebei, China.
| | - Jie An
- Department of Pathology, Bethune International Peace Hospital, No. 398 Zhongshan West Road, Qiaoxi District, Shijiazhuang, Hebei, China.
| | - Cheng Jiao
- Department of General Surgery, Bethune International Peace Hospital, No. 398 Zhongshan West Road, Qiaoxi District, Shijiazhuang, Hebei, China.
| | - Lianghui Zhi
- Department of General Surgery, Bethune International Peace Hospital, No. 398 Zhongshan West Road, Qiaoxi District, Shijiazhuang, Hebei, China.
| | - Jun Guo
- Department of General Surgery, Bethune International Peace Hospital, No. 398 Zhongshan West Road, Qiaoxi District, Shijiazhuang, Hebei, China.
| | - Li Sun
- Department of Gynecology and Obstetrics, Bethune International Peace Hospital, No. 398 Zhongshan West Road, Qiaoxi District, Shijiazhuang, Hebei, China.
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Lin D, Thompson CL, Demalis A, Derbes R, Al-Shaar L, Spielfogel ES, Sturgeon KM. Association between pre-diagnosis recreational physical activity and risk of breast cancer recurrence: the California Teachers Study. Cancer Causes Control 2024; 35:1089-1100. [PMID: 38613744 DOI: 10.1007/s10552-024-01870-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/10/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE Studies have reported inverse associations of pre-diagnosis recreational physical activity (RPA) level with all-cause and breast cancer (BCa)-specific mortality among BCa patients. However, the association between pre-diagnosis RPA level and BCa recurrence is unclear. We investigated the association between pre-diagnosis RPA level and risk of BCa recurrence in the California Teachers Study (CTS). METHODS Stage I-IIIb BCa survivors (n = 6,479) were followed with median of 7.4 years, and 474 BCa recurrence cases were identified. Long-term (from high school to age at baseline questionnaire, or, age 55 years, whichever was younger) and baseline (past 3 years reported at baseline questionnaire) pre-diagnosis RPA levels were converted to metabolic equivalent of task-hours per week (MET-hrs/wk). Multivariable Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of BCa recurrence overall and by estrogen receptor (ER)/progesterone receptor (PR) status. RESULTS Long-term RPA was not associated with BCa recurrence risk (ptrend = 0.99). The inverse association between baseline pre-diagnosis RPA level and BCa recurrence risk was marginally significant (≥26.0 vs. <3.4 MET-hrs/wk: HR = 0.79, 95% CI = 0.60-1.03; ptrend = 0.07). However, the association became non-significant after adjusting for post-diagnosis RPA (ptrend = 0.65). An inverse association between baseline pre-diagnosis RPA level and BCa recurrence risk was observed in ER-PR- cases (≥26.0 vs. <3.4 MET-hrs/wk: HR = 0.31, 95% CI = 0.13-0.72; ptrend = 0.04), but not in ER+ or PR+ cases (ptrend = 0.97). CONCLUSIONS Our data indicates that the benefit of baseline RPA on BCa recurrence may differ by tumor characteristics. This information may be particularly important for populations at higher risk of ER-PR- BCa.
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Affiliation(s)
- Dan Lin
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Penn State Cancer Institute, CH69, 500 University Drive, Hershey, PA, 17033, USA
| | - Cheryl L Thompson
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Penn State Cancer Institute, CH69, 500 University Drive, Hershey, PA, 17033, USA
| | - Alaina Demalis
- Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA
| | - Rebecca Derbes
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Penn State Cancer Institute, CH69, 500 University Drive, Hershey, PA, 17033, USA
| | - Laila Al-Shaar
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Penn State Cancer Institute, CH69, 500 University Drive, Hershey, PA, 17033, USA
| | - Emma S Spielfogel
- Department of Computational and Quantitative Medicine, City of Hope, Duarte, CA, 91010, USA
| | - Kathleen M Sturgeon
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Penn State Cancer Institute, CH69, 500 University Drive, Hershey, PA, 17033, USA.
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Wilkerson AD, Gentle CK, Ortega C, Al-Hilli Z. Disparities in Breast Cancer Care-How Factors Related to Prevention, Diagnosis, and Treatment Drive Inequity. Healthcare (Basel) 2024; 12:462. [PMID: 38391837 PMCID: PMC10887556 DOI: 10.3390/healthcare12040462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
Breast cancer survival has increased significantly over the last few decades due to more effective strategies for prevention and risk modification, advancements in imaging detection, screening, and multimodal treatment algorithms. However, many have observed disparities in benefits derived from such improvements across populations and demographic groups. This review summarizes published works that contextualize modern disparities in breast cancer prevention, diagnosis, and treatment and presents potential strategies for reducing disparities. We conducted searches for studies that directly investigated and/or reported disparities in breast cancer prevention, detection, or treatment. Demographic factors, social determinants of health, and inequitable healthcare delivery may impede the ability of individuals and communities to employ risk-mitigating behaviors and prevention strategies. The disparate access to quality screening and timely diagnosis experienced by various groups poses significant hurdles to optimal care and survival. Finally, barriers to access and inequitable healthcare delivery patterns reinforce inequitable application of standards of care. Cumulatively, these disparities underlie notable differences in the incidence, severity, and survival of breast cancers. Efforts toward mitigation will require collaborative approaches and partnerships between communities, governments, and healthcare organizations, which must be considered equal stakeholders in the fight for equity in breast cancer care and outcomes.
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Affiliation(s)
- Avia D Wilkerson
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Corey K Gentle
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Camila Ortega
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Zahraa Al-Hilli
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Breast Center, Integrated Surgical Institute, Cleveland Clinic, Cleveland, OH 44195, USA
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Garcia L, Pearce M, Abbas A, Mok A, Strain T, Ali S, Crippa A, Dempsey PC, Golubic R, Kelly P, Laird Y, McNamara E, Moore S, de Sa TH, Smith AD, Wijndaele K, Woodcock J, Brage S. Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose-response meta-analysis of large prospective studies. Br J Sports Med 2023; 57:979-989. [PMID: 36854652 PMCID: PMC10423495 DOI: 10.1136/bjsports-2022-105669] [Citation(s) in RCA: 41] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To estimate the dose-response associations between non-occupational physical activity and several chronic disease and mortality outcomes in the general adult population. DESIGN Systematic review and cohort-level dose-response meta-analysis. DATA SOURCES PubMed, Scopus, Web of Science and reference lists of published studies. ELIGIBILITY CRITERIA Prospective cohort studies with (1) general population samples >10 000 adults, (2) ≥3 physical activity categories, and (3) risk measures and CIs for all-cause mortality or incident total cardiovascular disease, coronary heart disease, stroke, heart failure, total cancer and site-specific cancers (head and neck, myeloid leukaemia, myeloma, gastric cardia, lung, liver, endometrium, colon, breast, bladder, rectum, oesophagus, prostate, kidney). RESULTS 196 articles were included, covering 94 cohorts with >30 million participants. The evidence base was largest for all-cause mortality (50 separate results; 163 415 543 person-years, 811 616 events), and incidence of cardiovascular disease (37 results; 28 884 209 person-years, 74 757 events) and cancer (31 results; 35 500 867 person-years, 185 870 events). In general, higher activity levels were associated with lower risk of all outcomes. Differences in risk were greater between 0 and 8.75 marginal metabolic equivalent of task-hours per week (mMET-hours/week) (equivalent to the recommended 150 min/week of moderate-to-vigorous aerobic physical activity), with smaller marginal differences in risk above this level to 17.5 mMET-hours/week, beyond which additional differences were small and uncertain. Associations were stronger for all-cause (relative risk (RR) at 8.75 mMET-hours/week: 0.69, 95% CI 0.65 to 0.73) and cardiovascular disease (RR at 8.75 mMET-hours/week: 0.71, 95% CI 0.66 to 0.77) mortality than for cancer mortality (RR at 8.75 mMET-hours/week: 0.85, 95% CI 0.81 to 0.89). If all insufficiently active individuals had achieved 8.75 mMET-hours/week, 15.7% (95% CI 13.1 to 18.2) of all premature deaths would have been averted. CONCLUSIONS Inverse non-linear dose-response associations suggest substantial protection against a range of chronic disease outcomes from small increases in non-occupational physical activity in inactive adults. PROSPERO registration number CRD42018095481.
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Affiliation(s)
- Leandro Garcia
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Matthew Pearce
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Ali Abbas
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alexander Mok
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Tessa Strain
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Sara Ali
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alessio Crippa
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paddy C Dempsey
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rajna Golubic
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh Institute for Sport, Physical Education and Health Sciences, Edinburgh, UK
| | - Yvonne Laird
- Sydney School of Public Health, Prevention Research Collaboration, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Eoin McNamara
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Economic and Social Research Institute, Dublin, Ireland
| | - Samuel Moore
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Thiago Herick de Sa
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Andrea D Smith
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Department of Behavioural Science and Health, University College London, London, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - James Woodcock
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
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Matou-Nasri S, Aldawood M, Alanazi F, Khan AL. Updates on Triple-Negative Breast Cancer in Type 2 Diabetes Mellitus Patients: From Risk Factors to Diagnosis, Biomarkers and Therapy. Diagnostics (Basel) 2023; 13:2390. [PMID: 37510134 PMCID: PMC10378597 DOI: 10.3390/diagnostics13142390] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Triple-negative breast cancer (TNBC) is usually the most malignant and aggressive mammary epithelial tumor characterized by the lack of expression for estrogen receptors and progesterone receptors, and the absence of epidermal growth factor receptor (HER)2 amplification. Corresponding to 15-20% of all breast cancers and well-known by its poor clinical outcome, this negative receptor expression deprives TNBC from targeted therapy and makes its management therapeutically challenging. Type 2 diabetes mellitus (T2DM) is the most common ageing metabolic disorder due to insulin deficiency or resistance resulting in hyperglycemia, hyperinsulinemia, and hyperlipidemia. Due to metabolic and hormonal imbalances, there are many interplays between both chronic disorders leading to increased risk of breast cancer, especially TNBC, diagnosed in T2DM patients. The purpose of this review is to provide up-to-date information related to epidemiology and clinicopathological features, risk factors, diagnosis, biomarkers, and current therapy/clinical trials for TNBC patients with T2DM compared to non-diabetic counterparts. Thus, in-depth investigation of the diabetic complications on TNBC onset, development, and progression and the discovery of biomarkers would improve TNBC management through early diagnosis, tailoring therapy for a better outcome of T2DM patients diagnosed with TNBC.
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Affiliation(s)
- Sabine Matou-Nasri
- Blood and Cancer Research Department, King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs (MNG-HA), Riyadh 11481, Saudi Arabia
- Biosciences Department, Faculty of the School for Systems Biology, George Mason University, Manassas, VA 22030, USA
| | - Maram Aldawood
- Blood and Cancer Research Department, King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs (MNG-HA), Riyadh 11481, Saudi Arabia
- Post Graduate and Zoology Department, King Saud University, Riyadh 12372, Saudi Arabia
| | - Fatimah Alanazi
- Blood and Cancer Research Department, King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard Health Affairs (MNG-HA), Riyadh 11481, Saudi Arabia
- Biosciences Department, Faculty of the School for Systems Biology, George Mason University, Manassas, VA 22030, USA
| | - Abdul Latif Khan
- Tissue Biobank, KAIMRC, MNG-HA, Riyadh 11481, Saudi Arabia
- Pathology and Clinical Laboratory Medicine, King Abdulaziz Medical City (KAMC), Riyadh 11564, Saudi Arabia
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Akingbesote ND, Owusu D, Liu R, Cartmel B, Ferrucci LM, Zupa M, Lustberg MB, Sanft T, Blenman KRM, Irwin ML, Perry RJ. A review of the impact of energy balance on triple-negative breast cancer. J Natl Cancer Inst Monogr 2023; 2023:104-124. [PMID: 37139977 DOI: 10.1093/jncimonographs/lgad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 05/05/2023] Open
Abstract
Cancer cells cannot proliferate without sufficient energy to generate biomass for rapid cell division, as well as to fuel their functions at baseline. For this reason, many recent observational and interventional studies have focused on increasing energy expenditure and/or reducing energy intake during and after cancer treatment. The impact of variance in diet composition and in exercise on cancer outcomes has been detailed extensively elsewhere and is not the primary focus of this review. Instead, in this translational, narrative review we examine studies of how energy balance impacts anticancer immune activation and outcomes in triple-negative breast cancer (TNBC). We discuss preclinical, clinical observational, and the few clinical interventional studies on energy balance in TNBC. We advocate for the implementation of clinical studies to examine how optimizing energy balance-through changes in diet and/or exercise-may optimize the response to immunotherapy in people with TNBC. It is our conviction that by taking a holistic approach that includes energy balance as a key factor to be considered during and after treatment, cancer care may be optimized, and the detrimental effects of cancer treatment and recovery on overall health may be minimized.
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Affiliation(s)
- Ngozi D Akingbesote
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Department of Cellular & Molecular Physiology, Yale University, New Haven, CT, USA
| | - Dennis Owusu
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Department of Cellular & Molecular Physiology, Yale University, New Haven, CT, USA
- Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti Region, Ghana
| | - Ryan Liu
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Department of Cellular & Molecular Physiology, Yale University, New Haven, CT, USA
- Cedar Park High School, Cedar Park, TX, USA
| | - Brenda Cartmel
- Yale School of Public Health, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
| | - Leah M Ferrucci
- Yale School of Public Health, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
| | | | - Maryam B Lustberg
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
| | - Tara Sanft
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
| | - Kim R M Blenman
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
- Department of Computer Science, Yale University, New Haven, CT, USA
| | - Melinda L Irwin
- Yale School of Public Health, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
| | - Rachel J Perry
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Department of Cellular & Molecular Physiology, Yale University, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
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Lin D, Liu Y, Tobias DK, Sturgeon K. Physical activity from menarche-to-first pregnancy and risk of breast cancer: the California teachers study. Cancer Causes Control 2022; 33:1343-1353. [PMID: 35987978 PMCID: PMC10440155 DOI: 10.1007/s10552-022-01617-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 08/01/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE A longer menarche-to-first pregnancy window of susceptibility (WOS) is associated with increased breast cancer risk. Whether physical activity, an established preventive risk factor, during the menarche-to-first pregnancy WOS offsets breast cancer risk overall or for specific molecular subtypes is unclear. METHODS We examined the prospective association between physical activity during the menarche-to-first pregnancy WOS and breast cancer risk in the California Teachers Study (N = 78,940). Recreational physical activity at multiple timepoints were recalled at cohort entry, and converted to metabolic equivalent of task hours per week (MET-hrs/wk). We used multivariable Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS We observed 5,157 invasive breast cancer cases over 21.6 years of follow-up. Longer menarche-to-first pregnancy WOS (≥ 20 vs. < 15 years) was associated with higher breast cancer risk (HR = 1.23, 95% CI = 1.13-1.34). Women with higher physical activity level during menarche-to-first pregnancy had lower risk of invasive breast cancer (≥ 40 vs. < 9 MET-hrs/wk: HR = 0.89, 95% CI = 0.83-0.97) and triple-negative subtype (≥ 40 vs. < 9 MET-hrs/wk: HR = 0.53, 95% CI = 0.32-0.87). No association was observed for luminal A-like and luminal B-like subtypes. Higher physical activity level was associated with lower breast cancer risk among women with moderate (15-19 years) menarche-to-first pregnancy intervals (≥ 40 vs. < 9 MET-hrs/wk: HR = 0.80, 95% CI = 0.69-0.92), but not with short (< 15 years) or long (≥ 20 years) intervals. CONCLUSION Physical activity during a WOS was associated with lower breast cancer risk in our cohort. Understanding timing of physical activity throughout the life course in relationship with breast cancer risk maybe important for cancer prevention strategies.
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Affiliation(s)
- Dan Lin
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA
| | - Ying Liu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Deirdre K Tobias
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Kathleen Sturgeon
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA.
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Bigman G, Adebamowo SN, Yawe KDT, Yilkudi M, Olaomi O, Badejo O, Famooto A, Ezeome E, Salu IK, Miner E, Anosike I, Achusi B, Adebamowo C. Leisure-time physical activity is associated with reduced risks of breast cancer and triple negative breast cancer in Nigerian women. Cancer Epidemiol 2022; 79:102195. [PMID: 35717688 PMCID: PMC9904209 DOI: 10.1016/j.canep.2022.102195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/26/2022] [Accepted: 06/01/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND Leisure-time physical activity(LTPA) is associated with a reduced risk of breast cancer, but this has less been investigated by cancer subtypes in Africans living in Sub-Saharan Africa(SSA). We examined the associations between LTPA and breast cancer including its subtypes in Nigerian women and explored the effect modification of body size on such associations. METHODS The sample included 508 newly diagnosed primary invasive breast cancer cases and 892 controls from the Nigerian Integrative Epidemiology of Breast Cancer(NIBBLE) Study. Immunohistochemical(IHC) analysis was available for 294 cases. Total metabolic equivalents(METs) per hour/week of LTPA were calculated and divided by quartiles(Q1 <3.75, Q2:3.75-6.69, Q3:6.70-14.74, Q4:14.75 ≤). We applied logistic regressions to estimate the adjusted Odds Ratios(ORs) between LTPA and breast cancer and by its molecular subtypes and whether age-adjusted associations are modified by BMI. RESULTS The mean age(Mean±SD) of cases vs. controls(45.5 ± 11.1vs.40.1 ± 9.0) was higher, and the mean total METs hour/week was higher in controls vs. cases(11.9 ± 14.9vs.8.3 ± 11.1,p-value<0.001). Overall, 43.2%(N = 127/294) were classified as HRP, and 41.8%(N = 123/294) as TNBC. Women in the higher LTPA quartiles(Q3-Q4) vs. Q1 had lower odds of having breast cancer(ORQ4vs.Q1=0.51,95%CI:0.35-0.74) and TNBC(ORQ4vs.Q1=0.51, 95%CI:0.27-0.96), but not HRP(ORQ4vs.Q1=0.61,95%CI:0.34-1.09) after adjusting for age, age at first menarche, body size, breastfeeding, menopausal, parity, contraceptives, demographics, alcohol, smoking, and physical activity at home and work. Lastly, LTPA and its age-adjusted association with breast cancer was more pronounced in women with BMI< 30 vs. BMI 30 + . CONCLUSIONS LTPA may reduce the risk of breast cancer, especially TNBC, which is the more aggressive and prevalent molecular subtype of breast cancer in SSA.
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Affiliation(s)
- Galya Bigman
- Department of Epidemiology and Public Health, Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, United States,Correspondence to: 725 Lombard Street, Baltimore, MD 21201, United States. (G. Bigman), (C. Adebamowo)
| | - Sally N. Adebamowo
- Department of Epidemiology and Public Health, Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, United States
| | | | - Monday Yilkudi
- University of Abuja Teaching Hospital, Gwagwalada, Nigeria
| | | | | | - Ayo Famooto
- African Collaborative Center for Microbiome and Genomics Research(ACCME) Biorepository and Research Laboratory, Institute of Human Virology, Nigeria
| | | | | | | | | | | | - Clement Adebamowo
- Department of Epidemiology and Public Health, Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, United States,African Collaborative Center for Microbiome and Genomics Research(ACCME) Biorepository and Research Laboratory, Institute of Human Virology, Nigeria,Correspondence to: 725 Lombard Street, Baltimore, MD 21201, United States. (G. Bigman), (C. Adebamowo)
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9
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Mediation analysis of racial disparities in triple-negative breast cancer incidence among postmenopausal women. Breast Cancer Res Treat 2021; 188:283-293. [PMID: 33677722 DOI: 10.1007/s10549-021-06158-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/20/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) is disproportionately higher in Black women relative to White women. The objective of this study was to examine to what extent the association between race/ethnicity and risk of TNBC is mediated by potentially modifiable factors. METHODS A total of 128,623 Black and White women aged 50-79 years from the Women's Health Initiative were followed for a mean of 15.8 years. 643 incident TNBC cases (92 Black women and 551 White women) were confirmed by medical record review. Mediation analyses were conducted using an approach under a counterfactual framework. RESULTS Black women had approximately twofold higher risk of TNBC compared with white women (HR = 1.93, 95% CI 1.52-2.45). We observed that 48% of the racial disparity was mediated by metabolic dysfunction defined by having 3 or more cardiometabolic risk factors including elevated waist circumference, having history of diabetes, high cholesterol and hypertension. The racial disparity was not significantly mediated by other factors studied, including socioeconomic, lifestyle or reproductive factors. CONCLUSION Our study observed that approximately half of the racial disparity between postmenopausal Black and White women in TNBC incidence was driven by metabolic dysfunction.
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Sanchez-Bayona R, Gardeazabal I, Romanos-Nanclares A, Fernandez-Lazaro CI, Alvarez-Alvarez I, Ruiz-Canela M, Gea A, Martinez-Gonzalez MA, Santisteban M, Toledo E. Leisure-time physical activity, sedentary behavior, and risk of breast cancer: Results from the SUN ('Seguimiento Universidad De Navarra') project. Prev Med 2021; 148:106535. [PMID: 33798533 DOI: 10.1016/j.ypmed.2021.106535] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 02/01/2021] [Accepted: 03/28/2021] [Indexed: 12/20/2022]
Abstract
Evidence is still limited on the influence of sedentary lifestyles on breast cancer (BC) risk. Also, prospective information on the combined effects of both sedentariness and leisure-time physical activity (LTPA) is scarce. We aimed to assess the association of higher sedentary behavior and LTPA (separately and in combination) with the risk of BC in a middle-aged cohort of university graduates. The SUN Project is a follow-up study initiated in 1999 with recruitment permanently open. Baseline assessments included a validated questionnaire on LTPA and sedentary habits. Subsequently, participants completed biennial follow-up questionnaires. Multivariable adjusted Cox models were used to estimate the hazard ratios (HR) for incident BC according to LTPA, TV-watching, the joint classification of both, and a combined 8-item multidimensional active lifestyle score. We included 10,812 women, with 11.8 years of median follow-up of. Among 115,802 women-years of follow-up, we confirmed 101 incident cases of BC. Women in the highest category of LTPA (>16.5 MET-h/week) showed a significantly lower risk of BC (HR = 0.55; 95% CI: 0.34-0.90) compared to women in the lowest category (≤6 MET/h-week). Women watching >2 h/d of TV sh owed a higher risk (HR = 1.67; 95% CI:1.03-2.72) than those who watched TV <1 h/d. Women in the highest category (6-8 points) of the multidimensional combined 8-item score showed a lower BC risk (HR = 0.35; 95% CI: 0.15-0.79) than those in the lowest category (<2 points) group. There was no significant supra-multiplicative interaction between TV-watching and LTPA. Both low LTPA and TV-watching >2 h/d may substantially increase BC risk, independently of each other.
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Affiliation(s)
- R Sanchez-Bayona
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; Department of Clinical Oncology, Breast Cancer Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Department of Clinical Oncology, Clínica Universidad de Navarra, Pamplona, Spain
| | - I Gardeazabal
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; Department of Clinical Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - A Romanos-Nanclares
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - C I Fernandez-Lazaro
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - I Alvarez-Alvarez
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain
| | - M Ruiz-Canela
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain
| | - A Gea
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain
| | - M A Martinez-Gonzalez
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, USA
| | - M Santisteban
- Department of Clinical Oncology, Clínica Universidad de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - E Toledo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Madrid, Spain.
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11
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Lamkin DM, Bradshaw KP, Chang J, Epstein M, Gomberg J, Prajapati KP, Soliman VH, Sylviana T, Wong Y, Morizono K, Sloan EK, Cole SW. Physical activity modulates mononuclear phagocytes in mammary tissue and inhibits tumor growth in mice. PeerJ 2021; 9:e10725. [PMID: 33552733 PMCID: PMC7821756 DOI: 10.7717/peerj.10725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 12/16/2020] [Indexed: 12/29/2022] Open
Abstract
The risk for breast cancer is significantly reduced in persons who engage in greater amounts of physical activity, and greater physical activity before or after diagnosis associates with reduced disease-specific mortality. Previous mechanistic studies indicate that components of innate immunity can mediate an inhibitory effect of physical activity on several types of tumor. However, in breast cancer specifically, the myeloid compartment of innate immunity is thought to exhibit high propensity for an immunosuppressive role that obstructs anti-tumor immunity. Thus, we tested the notion that greater physical activity alters mononuclear phagocytes in mammary tissue when inhibiting nascent tumor in a murine model of breast cancer. To model greater physical activity, we placed an angled running wheel in each mouse's home cage for two weeks before tumor engraftment with EO771 mammary cancer cells that express luciferase for bioluminescent detection. Fully immunocompetent mice and mice with compromised adaptive immunity showed significantly less mammary tumor signal when given access to running wheels, although the effect size was smaller in this latter group. To investigate the role of the myeloid compartment, mononuclear phagocytes were ablated by systemic injection of clodronate liposomes at 24 h before tumor engraftment and again at the time of tumor engraftment, and this treatment reversed the inhibition in wheel running mice. However, clodronate also inhibited mammary tumor signal in sedentary mice, in conjunction with an expected decrease in gene and protein expression of the myeloid antigen, F4/80 (Adgre1), in mammary tissue. Whole transcriptome digital cytometry with CIBERSORTx was used to analyze myeloid cell populations in mammary tissue following voluntary wheel running and clodronate treatment, and this approach found significant changes in macrophage and monocyte populations. In exploratory analyses, whole transcriptome composite scores for monocytic myeloid-derived suppressor cell (M-MDSC), macrophage lactate timer, and inflammation resolution gene expression programs were significantly altered. Altogether, the results support the hypothesis that physical activity inhibits nascent mammary tumor growth by enhancing the anti-tumor potential of mononuclear phagocytes in mammary tissue.
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Affiliation(s)
- Donald M. Lamkin
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States of America
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, United States of America
| | - Karen P. Bradshaw
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
- Department of Neuroscience, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Janice Chang
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
| | - Ma’ayan Epstein
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
| | - Jack Gomberg
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
| | - Krupa P. Prajapati
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
| | - Veronica H. Soliman
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
| | - Thezia Sylviana
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
| | - Yinnie Wong
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
| | - Kouki Morizono
- Divison of Hematology-Oncology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, United States of America
- UCLA AIDS Institute, David Geffen School of Medicine, University of California, Los Angeles, CA, United States of America
| | - Erica K. Sloan
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, United States of America
- Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Division of Cancer Surgery, Peter MacCallum Cancer Centre-Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Austalia
| | - Steve W. Cole
- Norman Cousins Center for PNI, Semel Institute for Neuroscience, University of California, Los Angeles, CA, United States of America
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States of America
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, United States of America
- Divison of Hematology-Oncology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, United States of America
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12
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Zevallos A, Bravo L, Bretel D, Paez K, Infante U, Cárdenas N, Alvarado H, Posada AM, Pinto JA. The hispanic landscape of triple negative breast cancer. Crit Rev Oncol Hematol 2020; 155:103094. [PMID: 33027724 DOI: 10.1016/j.critrevonc.2020.103094] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 10/23/2022] Open
Abstract
Triple-negative breast cancer (TNBC) is a heterogeneous and complex disease characterized by the absence of immunohistochemical expression of estrogen receptor, progesterone receptor and HER2. These breast tumors present an aggressive biology and offer few opportunities to be treated with targeted therapy resulting in bad disease outcomes. The epidemiology of TNBC is intriguing where the understanding of its biology has progressed quickly. One of the peculiarities of this type of cancer is a high prevalence in Afrodescendants and Hispanic patients compared to Caucasian women. In this review we describe some features of TNBC, focusing in the Hispanic population, such as epidemiological, clinicopathological features and molecular features and the correlation between TNBC prevalence and the human development index.
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Affiliation(s)
- Alejandra Zevallos
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Leny Bravo
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Denisse Bretel
- Grupo de Estudios Clínicos Oncológicos Peruano, GECOPERU, Lima, Peru
| | - Kevin Paez
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Ulises Infante
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | - Nadezhda Cárdenas
- Escuela de Medicina Humana-Filial Ica, Universidad Privada San Juan Bautista, Ica, Peru
| | - Hober Alvarado
- Facultad de Ciencias Biológicas, Universidad Nacional San Luis Gonzaga de Ica, Ica, Peru
| | | | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud - AUNA, Lima, Peru.
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Impact of body mass index, smoking habit, alcohol consumption, physical activity and parity on disease course of women with triple-negative breast cancer. Arch Gynecol Obstet 2019; 301:603-609. [PMID: 31853714 DOI: 10.1007/s00404-019-05413-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 12/07/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate the potential impact of body mass index (BMI), smoking habit, alcohol consumption, physical activity and parity on disease course of women with triple-negative breast cancer (TNBC). MATERIAL AND METHODS This was a retrospective chart analysis of patients with TNBC. Primary target parameters were overall survival (OS) and disease-free survival (DFS) depending on BMI, smoking habit, alcohol consumption, physical activity and parity. Results were descriptively evaluated and plotted as Kaplan-Meier curves. The null hypothesis was tested using the non-parametric log-rank test. All patients were treated at the University Medical School of Saarland, Dept of Gynecology, Obstetrics and Reproductive Medicine. RESULTS A total of 197 patients were analyzed. More than 50% of women were 40-60 years old (mean 57 years) and had a normal BMI. More than 88% of patients had either a T1 or T2 tumor, 64% were N0 and 66.5% had a G3 cancer. Thirty-four of 84 patients (40.38%) on neo-adjuvant chemotherapy reached a pathology-confirmed complete remission. During the follow-up (median 41.43 months), 34 (17.3%) patients had recurrent disease and 51 (25.9%) suffered from metastases. A total of 51 (25.9%) finally deceased. OS and DFS were not significantly impacted by BMI (OS: p = 0.4720; DFS: p = 0.2272), smoking habit (p = 0.9892; p = 0.6040), alcohol consumption (p = 0.6515; p = 0.7460), physical activity (p = 0.3320; p = 0.5991) or parity (p = 0.5929; 0.1417). CONCLUSION BMI, smoking habit, alcohol consumption, physical activity and parity had no impact on OS or DFS in women with TNBC.
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14
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World Cancer Research Fund International: Continuous Update Project-systematic literature review and meta-analysis of observational cohort studies on physical activity, sedentary behavior, adiposity, and weight change and breast cancer risk. Cancer Causes Control 2019; 30:1183-1200. [PMID: 31471762 DOI: 10.1007/s10552-019-01223-w] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 08/16/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE The purpose of the present study was to systematically review the complex associations between energy balance-related factors and breast cancer risk, for which previous evidence has suggested different associations in the life course of women and by hormone receptor (HR) status of the tumor. METHODS Relevant publications on adulthood physical activity, sedentary behavior, body mass index (BMI), waist and hip circumferences, waist-to-hip ratio, and weight change and pre- and postmenopausal breast cancer risk were identified in PubMed up to 30 April 2017. Random-effects meta-analyses were conducted to summarize the relative risks across studies. RESULTS One hundred and twenty-six observational cohort studies comprising over 22,900 premenopausal and 103,000 postmenopausal breast cancer cases were meta-analyzed. Higher physical activity was inversely associated with both pre- and postmenopausal breast cancers, whereas increased sitting time was positively associated with postmenopausal breast cancer. Although higher early adult BMI (ages 18-30 years) was inversely associated with pre- and postmenopausal breast cancers, adult weight gain and greater body adiposity increased breast cancer risk in postmenopausal women, and the increased risk was evident for HR+ but not HR- breast cancers, and among never but not current users of postmenopausal hormones. The evidence was less consistent in premenopausal women. There were no associations with adult weight gain, inverse associations with adult BMI (study baseline) and hip circumference, and non-significant associations with waist circumference and waist-to-hip ratio that were reverted to positive associations on average in studies accounting for BMI. No significant associations were observed for HR-defined premenopausal breast cancers. CONCLUSION Better understanding on the impact of these factors on pre- and postmenopausal breast cancers and their subtypes along the life course is needed.
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Godinho-Mota JCM, Gonçalves LV, Mota JF, Soares LR, Schincaglia RM, Martins KA, Freitas-Junior R. Sedentary Behavior and Alcohol Consumption Increase Breast Cancer Risk Regardless of Menopausal Status: A Case-Control Study. Nutrients 2019; 11:E1871. [PMID: 31408930 PMCID: PMC6723386 DOI: 10.3390/nu11081871] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/03/2019] [Accepted: 08/06/2019] [Indexed: 02/06/2023] Open
Abstract
Identification of modifiable risk factors for breast cancer is critical for primary prevention of the disease. The aim of this study was to evaluate how certain lifestyle variables modify the chances of developing breast cancer based on menopausal status. A case-control study was performed in a group of 542 women, 197 who were diagnosed with breast cancer and 344 control individuals. The groups were matched by age, body mass index, and menopausal status. Participants were evaluated for level of physical activity, alcohol consumption, smoking habit, weight, height, and waist circumference (WC). A multivariate logistic regression model was used to estimate odds ratios and 95% confidence intervals (95% CI). Regular consumption of alcoholic beverages (2.91, 95% CI 1.58-5.38 and 1.86, 95% CI 1.15-3.03) and sedentary behavior (2.08; 95% CI 1.12-3.85 and 1.81; 95% CI 1.12-2.94) were associated with breast cancer risk in pre- and postmenopausal women, respectively. High WC (3.31, 95% CI 1.45-7.55) was associated with an increased risk of developing breast cancer in premenopausal women. While in postmenopausal women, current smoking (2.43, 95% CI 1.01-5.83) or previous history of smoking (1.90; 95% CI 1.14-3.14) increased the chances of developing breast cancer. Sedentary behavior and current consumption of alcoholic beverages were more likely to increase the risk of developing breast cancer regardless of menopausal status.
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Affiliation(s)
- Jordana Carolina Marques Godinho-Mota
- Centro Avançado de Diagnóstico da Mama, Hospital das Clínicas, Federal University of Goiás, Goiania-GO 74.605-020, Brazil.
- Faculty of Nutrition, Federal University of Goiás, St. 227, Block 68, Goiania-GO 74.605-080, Brazil.
| | - Larissa Vaz Gonçalves
- Centro Avançado de Diagnóstico da Mama, Hospital das Clínicas, Federal University of Goiás, Goiania-GO 74.605-020, Brazil
- Faculty of Nutrition, Federal University of Goiás, St. 227, Block 68, Goiania-GO 74.605-080, Brazil
| | - Joao Felipe Mota
- Clinical and Sports Nutrition Research Laboratory (Labince), Faculty of Nutrition, Federal University of Goiás, St. 227, Block 68, Goiania-GO 74.605-080, Brazil
| | - Leonardo Ribeiro Soares
- Centro Avançado de Diagnóstico da Mama, Hospital das Clínicas, Federal University of Goiás, Goiania-GO 74.605-020, Brazil
| | | | - Karine Anusca Martins
- Faculty of Nutrition, Federal University of Goiás, St. 227, Block 68, Goiania-GO 74.605-080, Brazil
| | - Ruffo Freitas-Junior
- Centro Avançado de Diagnóstico da Mama, Hospital das Clínicas, Federal University of Goiás, Goiania-GO 74.605-020, Brazil
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Domain-specific patterns of physical activity and risk of breast cancer sub-types in the MCC-Spain study. Breast Cancer Res Treat 2019; 177:749-760. [DOI: 10.1007/s10549-019-05358-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/12/2019] [Indexed: 01/11/2023]
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McTiernan A, Friedenreich CM, Katzmarzyk PT, Powell KE, Macko R, Buchner D, Pescatello LS, Bloodgood B, Tennant B, Vaux-Bjerke A, George SM, Troiano RP, Piercy KL. Physical Activity in Cancer Prevention and Survival: A Systematic Review. Med Sci Sports Exerc 2019; 51:1252-1261. [PMID: 31095082 PMCID: PMC6527123 DOI: 10.1249/mss.0000000000001937] [Citation(s) in RCA: 458] [Impact Index Per Article: 91.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE This article reviews and updates the evidence on the associations between physical activity and risk for cancer, and for mortality in persons with cancer, as presented in the 2018 Physical Activity Guidelines Advisory Committee Scientific Report. METHODS Systematic reviews of meta-analyses, systematic reviews, and pooled analyses were conducted through December 2016. An updated systematic review of such reports plus original research through February 2018 was conducted. This article also identifies future research needs. RESULTS In reviewing 45 reports comprising hundreds of epidemiologic studies with several million study participants, the report found strong evidence for an association between highest versus lowest physical activity levels and reduced risks of bladder, breast, colon, endometrial, esophageal adenocarcinoma, renal, and gastric cancers. Relative risk reductions ranged from approximately 10% to 20%. Based on 18 systematic reviews and meta-analyses, the report also found moderate or limited associations between greater amounts of physical activity and decreased all-cause and cancer-specific mortality in individuals with a diagnosis of breast, colorectal, or prostate cancer, with relative risk reductions ranging almost up to 40% to 50%. The updated search, with five meta-analyses and 25 source articles reviewed, confirmed these findings. CONCLUSIONS Levels of physical activity recommended in the 2018 Guidelines are associated with reduced risk and improved survival for several cancers. More research is needed to determine the associations between physical activity and incidence for less common cancers and associations with survival for other cancers. Future studies of cancer incidence and mortality should consider these associations for population subgroups, to determine dose-response relationships between physical activity and cancer risk and prognosis, and to establish mechanisms to explain these associations.
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Affiliation(s)
- Anne McTiernan
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
- Schools of Public Health and Medicine, Departments of Epidemiology and Medicine (Geriatrics), University of Washington, Seattle, WA
| | - Christine M. Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, CANADA
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CANADA
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CANADA
| | | | - Kenneth E. Powell
- Centers for Disease Control, Georgia Department of Public Health, Atlanta, GA
| | - Richard Macko
- Department of Neurology, University of Maryland School of Medicine; University Maryland Rehabilitation & Orthopedics Institute; Maryland Exercise & Robotics Center of Excellence, Veterans Affairs Maryland Health Care System; Geriatrics Research, Education, and Clinical Center, Veterans Affairs Medical Center, Baltimore, MD
| | - David Buchner
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Linda S. Pescatello
- Department of Kinesiology, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, CT
| | | | | | - Alison Vaux-Bjerke
- Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services, Rockville, MD
| | - Stephanie M. George
- Office of Disease Prevention, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD
| | - Richard P. Troiano
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD
| | - Katrina L. Piercy
- Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services, Rockville, MD
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Chen X, Wang Q, Zhang Y, Xie Q, Tan X. Physical Activity and Risk of Breast Cancer: A Meta-Analysis of 38 Cohort Studies in 45 Study Reports. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:104-128. [PMID: 30661625 DOI: 10.1016/j.jval.2018.06.020] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/22/2018] [Accepted: 06/28/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To evaluate and quantify the association between physical activity (PA) and risk of breast cancer. METHODS A systematic review meta-analysis was conducted. The literature was independently and manually searched by 2 reviewers through 3 English databases (PubMed, Embase, and ISI Web of Science) for data till October 2017. The quality of included studies was assessed by the Newcastle-Ottawa Quality Assessment Scale. Fixed-effects models were used to estimate the pooled relative risk and 95% confidence intervals (95% CI). Dose-response analysis was chosen for quantifying the association between PA and risk of breast cancer. The Begg test and the Egger test were used to estimate potential publication bias. Heterogeneity between studies was evaluated with I2 statistics. RESULTS The meta-analysis included 38 cohort studies published between 1994 and 2017, which included 68 416 breast cancer cases. The overall relative risk (ORR) for breast cancer was 0.87 (95% CI 0.84-0.90). The inverse association was consistent among all subgroup analyses. In subgroup analysis by menopausal status, the ORR of breast cancer was 0.83 (95% CI 0.79-0.87) for premenopausal status and 0.91 (95% CI 0.85-0.97) for postmenopausal status. In subgroup analysis by PA type, the ORR for total activity was 0.87 (95% CI 0.81-0.93), for recreational activity 0.88 (95% CI 0.85-0.91), for occupational activity 0.91 (95% CI 0.84-0.99), and for nonoccupational activity 0.87 (95% CI 0.83-0.92). The risk of breast cancer was significantly lower in people with exposure periods longer than 1 year and less than 5 years (ORR 0.62; 95% CI 0.46-0.78), followed by those with lifetime activity (ORR 0.81; 95% CI 0.69-0.93). The ORR for subjects with body mass index of less than 25 kg/m2 (0.88; 95% CI 0.83-0.93) was close to that for subjects with body mass index of more than 25 kg/m2 (0.87; 95% CI 0.77-0.97). A linear relationship was found between breast cancer risk and PA (recreational activity and total activity), and the ORR was reduced by 3% (95% CI 0.95-0.99) for every 10 metabolic equivalent of energy hours per week increment in recreational PA and by 2% (95% CI 0.97-0.99) for every 10 metabolic equivalent of energy hours per week increment in total PA. CONCLUSIONS PA is significantly associated with a decrease in the risk of breast cancer.
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Affiliation(s)
- Xuyu Chen
- School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Qiru Wang
- School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Yanan Zhang
- School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Qian Xie
- School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China
| | - Xiaodong Tan
- School of Health Science, Wuhan University, Wuhan, Hubei, People's Republic of China.
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Agostini D, Natalucci V, Baldelli G, De Santi M, Donati Zeppa S, Vallorani L, Annibalini G, Lucertini F, Federici A, Izzo R, Stocchi V, Barbieri E. New Insights into the Role of Exercise in Inhibiting mTOR Signaling in Triple-Negative Breast Cancer. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:5896786. [PMID: 30363988 PMCID: PMC6186337 DOI: 10.1155/2018/5896786] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/03/2018] [Accepted: 08/12/2018] [Indexed: 02/06/2023]
Abstract
Triple-negative breast cancer (TNBC) does not express estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 and is characterized by its aggressive nature, lack of targets for targeted therapies, and early peak of recurrence. Due to these specific characteristics, chemotherapy does not usually yield substantial improvements and new target therapies and alternative strategies are needed. The beneficial responses of TNBC survivors to regular exercise, including a reduction in the rate of tumor growth, are becoming increasingly apparent. Physiological adaptations to exercise occur in skeletal muscle but have an impact on the entire body through systemic control of energy homeostasis and metabolism, which in turn influence the TNBC tumor microenvironment. Gaining insights into the causal mechanisms of the therapeutic cancer control properties of regular exercise is important to improve the prescription and implementation of exercise and training in TNBC survivors. Here, we provide new evidence of the effects of exercise on TNBC prevention, control, and outcomes, based on the inhibition of the phosphatidylinositol-3-kinase (PI3K)/protein kinase B (PKB also known as Akt)/mammalian target of rapamycin (mTOR) (PI3K-Akt-mTOR) signaling. These findings have wide-ranging clinical implications for cancer treatment, including recurrence and case management.
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Affiliation(s)
- Deborah Agostini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Valentina Natalucci
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giulia Baldelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Mauro De Santi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Sabrina Donati Zeppa
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Luciana Vallorani
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Ario Federici
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Riccardo Izzo
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Vilberto Stocchi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Elena Barbieri
- Interuniversity Institute of Myology (IIM), University of Urbino Carlo Bo, 61029 Urbino, PU, Italy
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20
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Horakova D, Bouchalova K, Cwiertka K, Stepanek L, Vlckova J, Kollarova H. Risks and protective factors for triple negative breast cancer with a focus on micronutrients and infections. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2018; 162:83-89. [PMID: 29765171 DOI: 10.5507/bp.2018.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 03/27/2018] [Indexed: 12/21/2022] Open
Abstract
Triple negative breast cancer (TNBC) is an aggressive form of breast cancer (BC) with a poor prognosis. Second, patients cannot benefit from targeted therapy, except for those with BRCA1/2 mutations, for whom poly (ADP-ribose) polymerase (PARP) inhibition therapy using olaparib has recently been approved. As global priorities continue to be epidemiological analysis of BC risk factors and early diagnosis, this review focuses on the risks and protective factors associated with TNBC. A PubMed keyword search for new knowledge on the risks and protective factors for TNBC was carried out. We also found statistical information from current online databases concerning the estimated incidence, prevalence and mortality worldwide of this cancer. Traditional risk factors for BC and TNBC are those related to reproduction such as the age of menarche, age of first birth, parity, breastfeeding and age at menopause. Attention needs to be paid to familial BC, weight control, alcohol consumption and regular physical activity. Epidemiological studies on TNBC provide evidence for protective factors such as regular consumption of soya, seafood, green tea, folic acid and vitamin D. Potential risk factors may include night work and viral infectious agents like human papillomavirus (HPV) and Epstein-Barr virus (EBV). Droplet digital methylation-specific PCR (ddMSP) is a possible new screening method for detection of BC including TNBC. Further research is necessary to validate these new factors.
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Affiliation(s)
- Dagmar Horakova
- Department of Preventive Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Katerina Bouchalova
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.,Department of Pediatrics, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Karel Cwiertka
- Department of Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Ladislav Stepanek
- Department of Preventive Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Jana Vlckova
- Department of Preventive Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Helena Kollarova
- Department of Preventive Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
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21
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Ellingjord-Dale M, Vos L, Hjerkind KV, Hjartåker A, Russnes HG, Tretli S, Hofvind S, Dos-Santos-Silva I, Ursin G. Alcohol, Physical Activity, Smoking, and Breast Cancer Subtypes in a Large, Nested Case-Control Study from the Norwegian Breast Cancer Screening Program. Cancer Epidemiol Biomarkers Prev 2017; 26:1736-1744. [PMID: 28877889 DOI: 10.1158/1055-9965.epi-17-0611] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/23/2017] [Accepted: 08/31/2017] [Indexed: 11/16/2022] Open
Abstract
Background: To what extent alcohol, smoking, and physical activity are associated with the various subtypes of breast cancer is not clear. We took advantage of a large population-based screening cohort to determine whether these risk factors also increase the risk of the poor prognosis subtypes.Methods: We conducted a matched case-control study nested within the Norwegian Breast Cancer Screening Program during 2006-2014. A total of 4,402 breast cancer cases with risk factor and receptor data were identified. Five controls were matched to each case on year of birth and year of screening. Conditional logistic regression was used to estimate ORs of breast cancer subtypes adjusted for potential confounders.Results: There were 2,761 luminal A-like, 709 luminal B-like HER2-negative, 367 luminal B-like HER2-positive, 204 HER2-positive, and 361 triple-negative cancers. Current alcohol consumption was associated with breast cancer risk overall [OR 1.26; 95% confidence interval (CI), 1.09-1.45] comparing 6+ glasses a week to never drinkers. However, this risk increase was found only for luminal A-like breast cancer. Smoking 20+ cigarettes a day was associated with an OR of 1.41 (95% CI, 1.06-1.89) overall, with significant trends for luminal A-like and luminal B-like HER2-negative cancer. Current physical activity (4+ hours/week compared with none) was associated with 15% decreased risk of luminal A-like cancer, but not clearly with other subtypes.Conclusions: In this large study, alcohol, smoking, and physical activity were predominantly associated with luminal A-like breast cancer.Impact: Alcohol, smoking, and physical activity were associated with luminal A-like breast cancer subtype. Cancer Epidemiol Biomarkers Prev; 26(12); 1736-44. ©2017 AACR.
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Affiliation(s)
| | - Linda Vos
- Cancer Registry of Norway, Oslo, Norway
| | | | - Anette Hjartåker
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Hege G Russnes
- Laboratory of Molecular Pathology, Division of Pathology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,Department of Genetics, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,Institute for Clinical Medicine, University of Oslo, Norway.,Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
| | | | | | - Isabel Dos-Santos-Silva
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Giske Ursin
- Cancer Registry of Norway, Oslo, Norway.,Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.,University of Southern California, Los Angeles, California
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22
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Kerr J, Anderson C, Lippman SM. Physical activity, sedentary behaviour, diet, and cancer: an update and emerging new evidence. Lancet Oncol 2017; 18:e457-e471. [PMID: 28759385 PMCID: PMC10441558 DOI: 10.1016/s1470-2045(17)30411-4] [Citation(s) in RCA: 363] [Impact Index Per Article: 51.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/21/2017] [Accepted: 04/27/2017] [Indexed: 12/11/2022]
Abstract
The lifestyle factors of physical activity, sedentary behaviour, and diet are increasingly being studied for their associations with cancer. Physical activity is inversely associated with and sedentary behaviour is positively (and independently) associated with an increased risk of more than ten types of cancer, including colorectal cancer (and advanced adenomas), endometrial cancers, and breast cancer. The most consistent dietary risk factor for premalignant and invasive breast cancer is alcohol, whether consumed during early or late adult life, even at low levels. Epidemiological studies show that the inclusion of wholegrain, fibre, fruits, and vegetables within diets are associated with reduced cancer risk, with diet during early life (age <8 years) having the strongest apparent association with cancer incidence. However, randomised controlled trials of diet-related factors have not yet shown any conclusive associations between diet and cancer incidence. Obesity is a key contributory factor associated with cancer risk and mortality, including in dose-response associations in endometrial and post-menopausal breast cancer, and in degree and duration of fatty liver disease-related hepatocellular carcinoma. Obesity produces an inflammatory state, characterised by macrophages clustered around enlarged hypertrophied, dead, and dying adipocytes, forming crown-like structures. Increased concentrations of aromatase and interleukin 6 in inflamed breast tissue and an increased number of macrophages, compared with healthy tissue, are also observed in women with normal body mass index, suggesting a metabolic obesity state. Emerging randomised controlled trials of physical activity and dietary factors and mechanistic studies of immunity, inflammation, extracellular matrix mechanics, epigenetic or transcriptional regulation, protein translation, circadian disruption, and interactions of the multibiome with lifestyle factors will be crucial to advance this field.
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Affiliation(s)
- Jacqueline Kerr
- Moores Cancer Center, University of California, La Jolla, San Diego, CA, USA; Department of Family Medicine and Public Health, University of California, La Jolla, San Diego, CA, USA
| | - Cheryl Anderson
- Moores Cancer Center, University of California, La Jolla, San Diego, CA, USA; Department of Family Medicine and Public Health, University of California, La Jolla, San Diego, CA, USA
| | - Scott M Lippman
- Moores Cancer Center, University of California, La Jolla, San Diego, CA, USA; Department of Medicine, University of California, La Jolla, San Diego, CA, USA.
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23
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Shi J, Kobayashi LC, Grundy A, Richardson H, SenGupta SK, Lohrisch CA, Spinelli JJ, Aronson KJ. Lifetime moderate-to-vigorous physical activity and ER/PR/HER-defined post-menopausal breast cancer risk. Breast Cancer Res Treat 2017; 165:201-213. [DOI: 10.1007/s10549-017-4323-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 05/29/2017] [Indexed: 01/13/2023]
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