Protein intake and breast cancer incidence and mortality.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 1569-1569
Author(s):  
Kathy Pan ◽  
Joseph C Larson ◽  
Rowan T. Chlebowski ◽  
Joanne E. Mortimer ◽  
JoAnn E Manson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Incidence ◽  
Protein Intake ◽  
Lower Risk ◽  
Vegetable Protein ◽  
Linear Trend ◽  
Breast Cancer Incidence ◽  
Animal Protein ◽  
Breast Cancers ◽  
Incidence And Mortality

1569 Background: Associations between dietary protein intake and breast cancer are unclear, in part due to limitations of dietary self-report. Women’s Health Initiative (WHI) investigators compared the accuracy of food frequency questionnaire (FFQ) data on energy and protein intake with objective measures of dietary intake using biomarkers (doubly labeled water for energy and urinary nitrogen for protein [n=544]). Subsequently, regression equations incorporating participant characteristics were developed acknowledging differential reporting dietary data errors based on participant characteristics (Neuhouser Am J Epidemiol). FFQ findings were then used to determine biomarker- adjusted animal vs vegetable protein ratios. Methods: We examined associations of energy and protein intake with breast cancer incidence and mortality in Women’s Health Initiative (WHI) participants 50-79 years of age at entry between1993-1998, with breast cancers verified by medical record review and survival enhanced by serial National Death Index (NDI) searches through 2016. Associations between sources of protein intake (animal versus vegetable) quintiles and breast cancer incidence and mortality were estimated using multivariable Cox proportional hazards regression. Results: With 100,024 eligible participants, after 14 years follow-up, women with higher total protein intake had greater body mass index, were more likely White, menopausal hormone therapy users with higher total energy intake and fat intake. With 6,340 incident breast cancers, 764 deaths from breast cancer and 2,059 deaths after breast cancer, higher vegetable protein intake was associated with significantly lower breast cancer incidence (P for linear trend = 0.01) while higher animal protein intake was associated with significantly higher breast cancer incidence (P for linear trend = 0.03). Higher vegetable protein intake was also associated with significantly lower risk of death after breast cancer (P <0.001) but not with lower risk of deaths from breast cancer (breast cancer followed by death attributed to breast cancer). Animal protein intake was not associated with deaths from breast cancer or deaths after breast cancer. Conclusions: Based on findings from biomarker-calibrated determination of protein intake by source, higher vegetable protein intake was associated with significantly lower risk of breast cancer incidence and of death after breast cancer while higher animal protein intake was associated with significantly higher risk of breast cancer incidence, but not mortality.

scholarly journals Protein Intake by Source and Breast Cancer Incidence and Mortality: The Women’s Health Initiative

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Kathy Pan ◽  
Joseph C Larson ◽  
Ross L Prentice ◽  
Joanne E Mortimer ◽  
Marian L Neuhouser ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Incidence ◽  
Total Protein ◽  
Protein Intake ◽  
Vegetable Protein ◽  
Breast Cancer Incidence ◽  
Animal Protein ◽  
Breast Cancers ◽  
Risk Of Death ◽  
Total Protein Intake

Abstract Background Prior studies of dietary protein intake and breast cancer have been mixed and were limited by dietary self-report measurement error. Methods Biomarker-calibrated total protein intake and estimated vegetable protein and animal protein intake were determined from baseline food frequency questionnaires in 100 024 Women’s Health Initiative participants. Associations between total, animal, and vegetable protein intake and breast cancer incidence, deaths from breast cancer, and deaths after breast cancer were estimated using Cox proportional hazards regression. Breast cancers were verified by medical record review and survival outcomes enhanced by National Death Index queries. All statistical tests were 2-sided. Results After 14 years of follow-up, there were 6340 incident breast cancers, 764 deaths from breast cancer, and 2059 deaths after breast cancer. In multivariable analyses, higher calibrated total protein intake was not associated with breast cancer incidence or deaths from or after breast cancer. Vegetable protein intake was associated with statistically significantly lower breast cancer incidence (hazard ratio [HR] = 0.98, 95% confidence interval [CI] = 0.96 to 0.99, Ptrend = .006) and statistically significantly lower risk of death after breast cancer (HR = 0.93, 95% CI = 0.91 to 0.97, Ptrend &lt; .001) but not with deaths from breast cancer. In contrast, higher animal protein intake was associated with statistically significantly higher breast cancer incidence (HR = 1.03, 95% CI = 1.01 to 1.06, Ptrend = .02) but not with deaths from or after breast cancer. Conclusions Calibrated total protein intake was not associated with breast cancer incidence or mortality. Higher vegetable protein intake was associated with lower breast cancer incidence and lower risk of death after breast cancer. Higher animal protein intake was associated with higher breast cancer incidence.

Estrogen plus progestin (E+P) and breast cancer incidence and mortality.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1501-1501
Author(s):  
Rowan T. Chlebowski ◽  
Garnet L Anderson ◽  
Lewis H Kuller ◽  
Aaron K Aragaki ◽  
JoAnn E Manson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Cancer Incidence ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Breast Cancer Incidence ◽  
Cancer Prognosis ◽  
Breast Cancers ◽  
Incidence And Mortality ◽  
Mortality Table

1501 Background: In the WHI clinical trial, E+P increased both breast cancer incidence and breast cancer mortality (JAMA 2010;304:1684). In contrast, breast cancers associated with E+P use in most observational studies have a more favorable prognosis. To address differences, a cohort of WHI Observational Study participants with characteristics similar to the WHI clinical trial was identified to examine E+P association with invasive breast cancer incidence and outcome. Methods: 41,449 postmenopausal women with no prior hysterectomy and mammogram negative for breast cancer < 2 years before who either were not hormone users (25,328) or were using E+P (16,121) were identified. Breast cancers were verified by centralized medical record review. Adjusted Cox proportional hazard regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CI). Additional analyses adjusted for breast cancer screening, censoring participants for incidence analyses who had a > 2 year interval without a mammogram. Results: After a mean (SD) follow-up 11.3 (3.1) years, 2,236 breast cancers were diagnosed. Breast cancer incidence was higher in E+P users (0.60% vs 0.42%, annualized rate, respectively: HR 1.55, 95% CI 1.41-1.70, P<0.001). Screening adjusted analyses had stronger breast cancer association (0.63% vs 0.39%, HR 1.72, 95% CI 1.54-1.93; P<0.001). Survival following breast cancer, measured from diagnosis date, was similar in E+P users and non-users (HR 0.95, 95% CI 0.74-1.23). Breast cancer mortality, analyzed from cohort entry date, are shown in the table. Conclusions: E+P use is associated with increased breast cancer incidence. As breast cancer prognosis following diagnosis on E+P is similar to that of nonusers, the higher incidence with E+P leads to increased breast cancer mortality. [Table: see text]

Breast Cancer

2018 ◽  
Author(s):  
Nancy E Davidson
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Cancer Incidence ◽  
Hormone Replacement ◽  
Breast Cancer Incidence ◽  
Stage Iv ◽  
The United States ◽  
Rate Of Increase ◽  
Stage Iv Breast Cancer ◽  
Incidence And Mortality

Invasive breast cancer, the most common nonskin cancer in women in the United States, will be diagnosed in 266,120 In 2018, along with 63,960 new cases of non-invasive (in situ) breast cancer. Incidence and mortality reached a plateau and appear to be dropping in both the United States and parts of western Europe. This decline has been attributed to several factors, such as early detection through the use of screening mammography and appropriate use of systemic adjuvant therapy, as well as decreased use of hormone replacement therapy. However, the global burden of breast cancer remains great, and global breast cancer incidence increased from 641,000 in 1980 to 1,643,000 in 2010, an annual rate of increase of 3.1%. This chapter examines the etiology, epidemiology, prevention, screening, staging, and prognosis of breast cancer. The diagnoses and treatments of the four stages of breast cancer are also included. Figures include algorithms used for the systemic treatment of stage IV breast cancer and hormone therapy for women with stage IV breast cancer. Tables describe selected outcomes from the National Surgical Adjuvant Breast and Bowel Project (NSABP) P-1 and P-2 chemoprevention trials, tamoxifen chemoprevention trials for breast cancer, the TNM staging system and stage groupings for breast cancer, some commonly used adjuvant chemotherapy regimens, an algorithm for suggested treatment for patients with operable breast cancer from the 2011 St. Gallen consensus conference, guidelines for surveillance of asymptomatic early breast cancer survivors from the American Society of Clinical Oncology, and newer agents for metastatic breast cancer commercially available in the United States. This review contains 2 highly rendered figures, 8 tables, and 108 references.

Insulin resistance and breast cancer incidence and mortality in postmenopausal women in the Women’s Health Initiative

Cancer ◽  
2020 ◽  
Vol 126 (16) ◽  
pp. 3638-3647
Author(s):  
Kathy Pan ◽  
Rowan T. Chlebowski ◽  
Joanne E. Mortimer ◽  
Marc J. Gunther ◽  
Thomas Rohan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Insulin Resistance ◽  
Women's Health ◽  
Postmenopausal Women ◽  
Cancer Incidence ◽  
Breast Cancer Incidence ◽  
Women's Health Initiative ◽  
Health Initiative ◽  
Incidence And Mortality ◽  
The Women’S Health Initiative

scholarly journals Global patterns and trends in the breast cancer incidence and mortality according to sociodemographic indices: an observational study based on the global burden of diseases

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e028461 ◽  
Author(s):  
Kaimin Hu ◽  
Peili Ding ◽  
Yinan Wu ◽  
Wei Tian ◽  
Tao Pan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Observational Study ◽  
Cancer Incidence ◽  
Disease Incidence ◽  
Breast Cancer Incidence ◽  
Global Burden ◽  
Incidence And Mortality ◽  
Global Burden Of Diseases ◽  
Concentration Indices ◽  
Burden Of Diseases

ObjectivesDisparities in the global burden of breast cancer have been identified. We aimed to investigate recent patterns and trends in the breast cancer incidence and associated mortality. We also assessed breast cancer-related health inequalities according to socioeconomic development factors.DesignAn observational study based on the Global Burden of Diseases.MethodsEstimates of breast cancer incidence and mortality during 1990–2016 were obtained from the Global Health Data Exchange database. Subsequently, data obtained in 2016 were described using the age-standardised and age-specific incidence, mortality and mortality-to-incidence (MI) ratios according to sociodemographic index (SDI) levels. Trends were assessed by measuring the annual percent change using the joinpoint regression. The Gini coefficients and concentration indices were used to identify between-country inequalities.ResultsCountries with higher SDI levels had worse disease incidence burdens in 2016, whereas inequalities in the breast cancer incidence had decreased since 1990. Opposite trends were observed in the mortality rates of high and low SDI countries. Moreover, the decreasing concentration indices, some of which became negative, among women aged 15–49 and 50–69 years suggested an increase in the mortality burdens in undeveloped regions. Conversely, inequality related to the MI ratio increased. In 2016, the MI ratios exhibited distinct gradients from high to low SDI regions across all age groups.ConclusionsThe patterns and trends in breast cancer incidence and mortality closely correlated with the SDI levels. Our findings highlighted the primary prevention of breast cancer in high SDI countries with a high disease incidence and the development of cost-effective diagnostic and treatment interventions for low SDI countries with poor MI ratios as the two pressing needs in the next decades.

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