scholarly journals Dietary Patterns and Breast Cancer Recurrence and Survival Among Women With Early-Stage Breast Cancer

2009 ◽  
Vol 27 (6) ◽  
pp. 919-926 ◽  
Author(s):  
Marilyn L. Kwan ◽  
Erin Weltzien ◽  
Lawrence H. Kushi ◽  
Adrienne Castillo ◽  
Martha L. Slattery ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Breast Cancer Survivors ◽  
Proportional Hazards ◽  
Early Stage ◽  
Cancer Recurrence ◽  
Cox Proportional Hazards ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Recurrence

Purpose To determine the association of dietary patterns with cancer recurrence and mortality of early-stage breast cancer survivors. Patients and Methods Patients included 1,901 Life After Cancer Epidemiology Study participants diagnosed with early-stage breast cancer between 1997 and 2000 and recruited primarily from the Kaiser Permanente Northern California Cancer Registry. Diet was assessed at cohort entry using a food frequency questionnaire. Two dietary patterns were identified: prudent (high intakes of fruits, vegetables, whole grains, and poultry) and Western (high intakes of red and processed meats and refined grains). Two hundred sixty-eight breast cancer recurrences and 226 all-cause deaths (128 attributable to breast cancer) were ascertained. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs. Results Increasing adherence to a prudent dietary pattern was associated with a statistically significant decreasing risk of overall death (P trend = .02; HR for highest quartile = 0.57; 95% CI, 0.36 to 0.90) and death from non–breast cancer causes (P trend = .003; HR for highest quartile = 0.35; 95% CI, 0.17 to 0.73). In contrast, increasing consumption of a Western dietary pattern was related to an increasing risk of overall death (P trend = .05) and death from non–breast cancer causes (P = .02). Neither dietary pattern was associated with risk of breast cancer recurrence or death from breast cancer. These observations were generally not modified by physical activity, being overweight, or smoking. Conclusion Women diagnosed with early-stage breast cancer might improve overall prognosis and survival by adopting more healthful dietary patterns.

Effect of Obesity on Prognosis After Early-Stage Breast Cancer

2011 ◽  
Vol 29 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Marianne Ewertz ◽  
Maj-Britt Jensen ◽  
Katrín Á. Gunnarsdóttir ◽  
Inger Højris ◽  
Erik H. Jakobsen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Adjuvant Treatment ◽  
Proportional Hazards ◽  
Early Stage ◽  
Cancer Recurrence ◽  
Distant Metastases ◽  
Cox Proportional Hazards ◽  
Early Stage Breast Cancer ◽  
The Impact

Purpose This study was performed to characterize the impact of obesity on the risk of breast cancer recurrence and death as a result of breast cancer or other causes in relation to adjuvant treatment. Patients and Methods Information on body mass index (BMI) at diagnosis was available for 18,967 (35%) of 53,816 women treated for early-stage breast cancer in Denmark between 1977 and 2006 with complete follow-up for first events (locoregional recurrences and distant metastases) up to 10 years and for death up to 30 years. Information was available on prognostic factors and adjuvant treatment for all patients. Univariate analyses were used to compare the associations of known prognostic factors and risks of recurrence or death according to BMI categories. Cox proportional hazards regression models were used to assess the influence of BMI after adjusting for other factors. Results Patients with a BMI of 30 kg/m2 or more were older and had more advanced disease at diagnosis compared with patients with a BMI below 25 kg/m2 (P < .001). When data were adjusted for disease characteristics, the risk of developing distant metastases after 10 years was significantly increased by 46%, and the risk of dying as a result of breast cancer after 30 years was significantly increased by 38% for patients with a BMI of 30 kg/m2 or more. BMI had no influence on the risk of locoregional recurrences. Both chemotherapy and endocrine therapy seemed to be less effective after 10 or more years for patients with BMIs greater than 30 kg/m2. Conclusion Obesity is an independent prognostic factor for developing distant metastases and for death as a result of breast cancer; the effects of adjuvant therapy seem to be lost more rapidly in patients with breast cancer and obesity.

scholarly journals Post-diagnosis weight gain and breast cancer recurrence in women with early stage breast cancer

2006 ◽  
Vol 99 (1) ◽  
pp. 47-57 ◽  
Author(s):  
Bette J. Caan ◽  
Jennifer A. Emond ◽  
Loki Natarajan ◽  
Adrienne Castillo ◽  
Erica P. Gunderson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Early Stage ◽  
Cancer Recurrence ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Recurrence

Effect of Pregnancy on Overall Survival After the Diagnosis of Early-Stage Breast Cancer

2001 ◽  
Vol 19 (6) ◽  
pp. 1671-1675 ◽  
Author(s):  
Shari Gelber ◽  
Alan S. Coates ◽  
Aron Goldhirsch ◽  
Monica Castiglione-Gertsch ◽  
Gianluigi Marini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Proportional Hazards ◽  
Comparison Group ◽  
Early Stage ◽  
Pregnant Patient ◽  
Subsequent Pregnancy ◽  
Cox Proportional Hazards ◽  
Early Stage Breast Cancer ◽  
Study Group ◽  
The Impact

PURPOSE: To evaluate the impact of subsequent pregnancy on the prognosis of patients with early breast cancer. PATIENTS AND METHODS: One hundred eight patients who became pregnant after diagnosis of early-stage breast cancer were identified in institutions participating in International Breast Cancer Study Group (IBCSG) studies. Fourteen had relapse of breast cancer before their first subsequent pregnancy. The remaining 94 patients (including eight who relapsed during pregnancy) formed the study group reported here. A comparison group of 188 was obtained by randomly selecting two patients, matched for nodal status, tumor size, age, and year of diagnosis from the IBCSG database, who were free of relapse for at least as long as the time between breast cancer diagnosis and completion of pregnancy for each pregnant patient. Survival comparison used Cox proportional hazards regression models. RESULTS: Overall 5- and 10-year survival percentages (± SE) measured from the diagnosis of early-stage breast cancer among the 94 study group patients were 92% ± 3% and 86% ± 4%, respectively. For the matched comparison group survival was 85% ± 3% at 5 years and 74% ± 4% at 10 years (risk ratio, 0.44; 95% confidence interval, 0.21 to 0.96; P = .04). CONCLUSION: Subsequent pregnancy does not adversely affect the prognosis of early-stage breast cancer. The superior survival seen in this and other controlled series may merely reflect a healthy patient selection bias, but is also consistent with an antitumor effect of the pregnancy.

Weight, Weight Gain, and Survival After Breast Cancer Diagnosis

2005 ◽  
Vol 23 (7) ◽  
pp. 1370-1378 ◽  
Author(s):  
Candyce H. Kroenke ◽  
Wendy Y. Chen ◽  
Bernard Rosner ◽  
Michelle D. Holmes
Keyword(s):  
Breast Cancer ◽  
Weight Gain ◽  
Proportional Hazards ◽  
Linear Trend ◽  
Menopausal Status ◽  
Cancer Recurrence ◽  
Cox Proportional Hazards ◽  
Breast Cancer Recurrence ◽  
Health Study ◽  
Breast Cancer Death

Purpose To determine whether weight prior to diagnosis and weight gain after diagnosis are predictive of breast cancer survival. Methods Patients included 5,204 Nurses' Health Study participants diagnosed with incident, invasive, nonmetastatic breast cancer between 1976 and 2000; 860 total deaths, 533 breast cancer deaths, and 681 recurrences (defined as secondary lung, brain, bone, or liver cancer, and death from breast cancer) accrued to 2002. We computed the change in body mass index (BMI) from before to the first BMI reported ≥ 12 months after the date of diagnosis. Cox proportional hazards models were used to evaluate associations of categories of BMI before diagnosis and of BMI change with time to event. We stratified by smoking, menopausal status, and breast cancer–related variables. Results In multivariate-adjusted analyses, weight before diagnosis was positively associated with breast cancer recurrence and death, but this was apparent only in never smokers. Similarly, among never-smoking women, those who gained between 0.5 and 2.0 kg/m2 (median gain, 6.0 lb; relative risk [RR], 1.35; 95% CI, 0.93 to 1.95) or more than 2.0 kg/m2 (median gain, 17.0 lb; RR, 1.64; 95% CI, 1.07 to 2.51) after diagnosis had an elevated risk of breast cancer death during follow-up (median, 9 years), compared with women who maintained their weight (test for linear trend, P = .03). Associations with weight were stronger in premenopausal than in postmenopausal women. Similar findings were noted for breast cancer recurrence and all-cause mortality. Conclusion Weight and weight gain were related to higher rates of breast cancer recurrence and mortality, but associations were most apparent in never-smoking women.

scholarly journals 21-Gene Recurrence Assay Associated With Favorable Metabolic Profiles in HR-Positive, HER2-Negative Early-Stage Breast Cancer Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Yifei Zhu ◽  
Tiange Wang ◽  
Yiwei Tong ◽  
Xiaosong Chen ◽  
Kunwei Shen
Keyword(s):  
Breast Cancer ◽  
Insulin Resistance ◽  
Cancer Patients ◽  
Early Stage ◽  
Cancer Recurrence ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Recurrence ◽  
Metabolic Profiles ◽  
Breast Cancer Patients ◽  
C Peptide

BackgroundComprehensive investigations of the associations between 21-gene recurrence assay and metabolic profiles in Chinese breast cancer patients are limited.MethodsWe evaluated the relations of the 21-gene recurrence risk score (RS) and the expression of cancer-related genes with metabolic factors and biomarkers of insulin and the insulin-like growth factor (IGF) axis, and examined the interactions between the 21-gene RS and these metabolic profiles on breast cancer recurrence in Chinese women with HR-positive, HER2-negative early-stage breast cancer.ResultsThe 21-gene RS was inversely associated with body mass index ([BMI]β: −0.178 kg/m2; P=0.040), the homeostasis model assessment of insulin resistance index ([HOMA-IR] β: −0.031; P=0.042), insulin (β: −0.036 uIU/ml; P=0.009), and C-peptide (β: −0.021 ug/L; P=0.014) and was positively associated with high-density lipoprotein cholesterol (β: 0.025 mmol/L; P=0.004), which were driven by the relation patterns between specific cancer-related genes and these metabolic profiles. Each 10-unit increase in the 21-gene RS was associated with 28% (95% CI: 5–47%) higher risk of breast cancer recurrence; this association was also observed in patients with favorable metabolic profiles in relevant to an absence of obesity, insulin resistance, hyperglycemia, hypertension, or dyslipidemia (28–44% higher risk) and among women with a low level of insulin, C-peptide, or the IGF1/IGFBP3 ratio (41–155% higher risk).ConclusionsThe 21-gene RS was related to favorable metabolic profiles including lower BMI, HOMA-IR, insulin, and C-peptide, and higher HDL in Chinese breast cancer patients, and its prognostic impact on breast cancer recurrence was more likely to present among patients with relatively favorable metabolic profiles.

scholarly journals Adherence and Persistence to Adjuvant Hormonal Therapy in Early-Stage Breast Cancer Patients: A Population-Based Retrospective Cohort Study in Israel

Breast Care ◽  
2019 ◽  
Vol 15 (1) ◽  
pp. 45-54
Author(s):  
Tal Sella ◽  
Gabriel Chodick
Keyword(s):  
Breast Cancer ◽  
Hormonal Therapy ◽  
Breast Cancer Survivors ◽  
Proportional Hazards ◽  
Early Stage ◽  
Cox Proportional Hazards ◽  
Adjuvant Hormonal Therapy ◽  
Breast Cancer Patients ◽  
Early Discontinuation ◽  
Increased Risk

Background: Adjuvant hormonal therapy (HT) has been consistently proven to improve multiple outcomes in early breast cancer yet rates of adherence and persistence are variable. Methods: We retrospectively identified women diagnosed with nonmetastatic breast cancer and initiating HT between January 2000 and December 2007 in a large Israeli health provider. Prescription records including the drug name, date of purchase, and the quantity of pills dispensed were collected. We used Cox proportional hazards and binary logistic models to analyze factors associated with early discontinuation (<5 years) and nonadherence (proportion of days covered, PDC <80%) of HT, respectively. Results: A total of 4,178 women with breast cancer were identified with nearly 95% of patients treated with tamoxifen as the initial HT. Over the 5-year follow-up period, early discontinuation was identified in 955 (23%) patients. The mean PDC was 82.9% (SD 0.004). Younger age and low BMI were both associated with an increased risk of early discontinuation and nonadherence. A history of hypertension was associated with a higher likelihood of both outcomes. Conclusion: Adherence and persistence with HT among Israeli breast cancer survivors are comparable to those in international reports. Interventions are necessary to identify and prevent suboptimal HT adherence.

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