scholarly journals Plant-Based Dietary Patterns and Breast Cancer Recurrence and Survival in the Pathways Study

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3374
Author(s):  
Ijeamaka C. Anyene ◽  
Isaac J. Ergas ◽  
Marilyn L. Kwan ◽  
Janise M. Roh ◽  
Christine B. Ambrosone ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Dietary Patterns ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Cancer Recurrence ◽  
Cox Proportional Hazards ◽  
Breast Cancer Recurrence ◽  
Breast Cancer Patients ◽  
Dietary Recommendations

Plant-based diets are recommended for cancer survivors, but their relationship with breast cancer outcomes has not been examined. We evaluated whether long-term concordance with plant-based diets reduced the risk of recurrence and mortality among a prospective cohort of 3646 women diagnosed with breast cancer from 2005 to 2013. Participants completed food frequency questionnaires at diagnosis and 6-, 25-, and 72-month follow-up, from which we derived plant-based diet indices, including overall (PDI), healthful (hPDI), and unhealthful (uPDI). We observed 461 recurrences and 653 deaths over a median follow-up of 9.51 years. Using multivariable-adjusted Cox proportional hazards models, we estimated hazard ratios (HR) and 95% confidence intervals for breast cancer recurrence and all-cause, breast-cancer-specific, and non-breast-cancer mortality. Increased concordance with hPDI was associated with a reduced hazard of all-cause (HR 0.93, 95% CI: 0.83–1.05) and non-breast-cancer mortality (HR 0.83, 95% CI: 0.71–0.98), whereas increased concordance with uPDI was associated with increased hazards (HR 1.07, 95% CI: 0.96–1.2 and HR 1.20, 95% CI: 1.02–1.41, respectively). No associations with recurrence or breast-cancer-specific mortality were observed. In conclusion, healthful vs. unhealthful plant-based dietary patterns had differing associations with mortality. To enhance overall survival, dietary recommendations for breast cancer patients should emphasize healthful plant foods.

SP8.1.5 Breast cancer follow up; Is routine mammography indicated?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Petr Polak ◽  
Declan Beattie ◽  
Colin McIlmunn ◽  
Stephen Kirk
Keyword(s):  
Breast Cancer ◽  
Open Access ◽  
Cost Benefit Analysis ◽  
Cancer Recurrence ◽  
Cost Benefit ◽  
Breast Cancer Recurrence ◽  
Breast Cancer Patients ◽  
Radiological Investigation ◽  
Patient Request

Abstract Aim This paper aims to review the outcome from yearly mammography in detecting breast cancer recurrence and new primary tumours in patients with a history of breast cancer. Methods From 2014, following treatment for breast cancer, patients were enrolled in a program of self-directed aftercare (SDA). They were given open access to the Breast service. Regular planned appointments were not offered. All patients underwent annual mammography for 5 years. Retrospective analysis of the SDA database from 2014 to 2016 was undertaken, time to and mechanism of detection of breast cancer recurrence in this population was determined. Results 352 patient records were analysed (1760 mammograms), 29 recurrences were identified. 12 locoregional, 12 systemic, 5 locoregional and systemic. Median time to diagnosis of recurrence was 30 months. Locoregional recurrence was detected by surveillance mammography (4 patients), clinical examination following patient request (7 patients), non-breast radiological investigation (5), by non-breast cancer care Doctors (1). No contralateral cancers were detected in patients who had mastectomy or WLE. Conclusion Despite limited evidence for regular clinical assessment post breast cancer treatment, the practice remains recommended. In this study regular clinical review was replaced by open access. Annual mammography was retained. Mammographic value out-with detection of malignancy (new/recurrent) was not assessed. The number of tumours detected (4 out of 1760 mammograms) would suggest that non-stratified routine mammography is of limited value for most patients. Further study is required to determine the risk or value and the cost/benefit analysis of mammographic follow up of breast cancer.

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.

scholarly journals Reduced risk of metastatic breast cancer recurrence after bone fractures

2020 ◽  
Author(s):  
Nadia Obi ◽  
Stefan Werner ◽  
Frank Thelen ◽  
Klaus Pantel
Keyword(s):  
Breast Cancer ◽  
Bone Metastasis ◽  
Cancer Patients ◽  
Bone Fractures ◽  
Cancer Recurrence ◽  
Breast Cancer Recurrence ◽  
Insurance Fund ◽  
Breast Cancer Patients ◽  
Positive Effects

Abstract Recent experimental studies indicate that bone fractures result in the release of cytokines and cells that promote metastasis. Obtaining observational data on bone fractures after breast cancer diagnosis related to distant breast cancer recurrence risk could help determine whether fall prevention strategies can contribute to reduce breast cancer mortality. We used data from the largest German statutory health insurance fund (Techniker Krankenkasse) in a population-based cohort study of breast cancer patients diagnosed between January 2015 and November 2019. ICD-10 codes were documented monthly to quarterly. Fractures diagnosed simultaneous or after the initial breast cancer and metastases diagnosed initially from half a year later on served as exposure and outcome, respectively. The risk of regional, distant non-bone or bone metastasis related to a fracture was modelled by adjusted conditional logistic regression analysis. Of 154,000 breast cancer patients, 82,039 had a follow-up time of more than half a year. During follow-up, fractures were diagnosed in 11,900 (14.5%) patients and regional or distant metastases occurred in 7,011 (8.5%). The risk for a metastasis was reduced in patients, who had a fracture (OR 0.57, 95% CI 0.53, 0.62) compared to patients without, particularly for lymph node metastasis and moderately less pronounced in bone-metastasis (OR 0.69, 95% CI 0.61, 0.79). In view of the positive effects of sports on health of cancer survivors, the present results will decrease the anxiety of breast cancer patients that risking bone fractures might have a negative impact on their disease-specific outcome.

scholarly journals Prevalence of Breast Cancer and Its Associated Factors for Recurrence in Hospital Tengku Ampuan Afzan 2008 – 2012

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Azhani Chik
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Proportional Hazards ◽  
Univariate Analysis ◽  
Cancer Recurrence ◽  
Distant Recurrence ◽  
Cox Proportional Hazards ◽  
Breast Cancer Recurrence ◽  
Local Data

Introduction: Breast cancer is the commonest malignancy in Malaysian women. Cancer recurrence has been a detrimental factor towards survival with peak of recurrence recorded in first 2 years of diagnoses. Identifying the prognostic factors towards recurrence is important to management and prolonging survival. Materials and method: We have retrospectively analyzed 179 patients women with breast cancer based on 5 years single centre database with minimum follow up of 2 years. The demographic and clinicopathological characteristics were determined using descriptive statistics. Survival were calculated based on Kaplan- Meier method and multivariate analysis by Cox proportional hazards was performed to evaluate the potential factors affecting breast cancer recurrence. Results: Mean follow up was 42 months, with mean age 52 years and 60.9% presented in Stage II disease. Overall recurrence was 41.9% with local recurrence 2.1%, regional recurrence 12.3% and distant recurrence 27.4%. 50% of our patients developed recurrence at 25 months. In univariate analysis, time to first presentation was significantly correlated with recurrence. However, in multivariate analysis; tumor size, lymph node positivity  and lymphovascular invasion were independently associated with recurrence. Conclusion: Even though local data on breast cancer recurrence is sparse, it does correlate with the international data. Thus, optimizing our care in breast cancer.

Safety and Efficacy Results of a Randomized Trial Comparing Adjuvant Toremifene and Tamoxifen in Postmenopausal Patients With Node-Positive Breast Cancer

2000 ◽  
Vol 18 (20) ◽  
pp. 3487-3494 ◽  
Author(s):  
Kaija Holli ◽  
Ritva Valavaara ◽  
Guillermo Blanco ◽  
Vesa Kataja ◽  
Päivi Hietanen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Side Effect ◽  
Cancer Recurrence ◽  
Breast Cancer Recurrence ◽  
Side Effect Profile ◽  
Treatment Groups ◽  
Node Positive ◽  
Er Positive ◽  
The Mean

PURPOSE: In this multicenter trial, toremifene 40 mg/d was compared with tamoxifen 20 mg/d, both given orally for 3 years to postmenopausal, axillary node–positive women after breast surgery. PATIENTS AND METHODS: The first 899 patients (toremifene, n = 459; tamoxifen, n = 440) of the total of 1,480 patients accrued to the trial were included in this scheduled safety analysis. The mean follow-up time was 3.4 years. RESULTS: The two treatment groups were well balanced with respect to patient and disease characteristics. The subjective side-effect profile was similar in both treatment groups. Slightly more vascular complications (deep vein thromboses, cerebrovascular events, and pulmonary embolisms) were seen among tamoxifen-treated patients (5.9%) as compared with toremifene-treated patients (3.5%) (P = .11), whereas bone fractures (P = .09) and vaginal leukorrhea (P = .05) were more common in the toremifene group. The number of subsequent second cancers was similar. The breast cancer recurrence rate was 23.1% (n = 106) in the toremifene group and 26.1% (n = 115) in the tamoxifen group (P = .31). When only patients with estrogen receptor (ER)–positive cancer were considered (n = 556), the risk for breast cancer recurrence was nonsignificantly lower among the toremifene-treated women, with a hazards ratio of 0.74 (90% confidence interval, 0.52 to 1.04; P = .14). The mean time to breast cancer recurrence and overall survival were similar in both groups. CONCLUSION: The side-effect profile of toremifene resembles that of tamoxifen. The efficacy of toremifene seems to be no less than that of tamoxifen. The trend for fewer breast cancer recurrences in the ER-positive subgroup is encouraging, but a longer follow-up is needed to confirm this.

Mammography Surveillance and Mortality in Older Breast Cancer Survivors

2007 ◽  
Vol 25 (21) ◽  
pp. 3001-3006 ◽  
Author(s):  
Timothy L. Lash ◽  
Matthew P. Fox ◽  
Diana S.M. Buist ◽  
Feifei Wei ◽  
Terry S. Field ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Mortality ◽  
Breast Cancer Survivors ◽  
Care Delivery ◽  
Breast Cancer Mortality ◽  
The United States ◽  
Stage I ◽  
Early Stage Disease

Purpose There are more than 2,000,000 breast cancer survivors in the United States today. While surveillance for asymptomatic recurrence and second primary is included in consensus recommendations, the effectiveness of this surveillance has not been well characterized. Our purpose is to estimate the effectiveness of surveillance mammography in a cohort of breast cancer survivors with complete ascertainment of surveillance mammograms and negligible losses to follow-up. Patients and Methods We enrolled 1,846 stage I and II breast cancer patients who were at least 65 years old at six integrated health care delivery systems. We used medical record review and existing databases to ascertain patient, tumor, and therapy characteristics, as well as receipt of surveillance mammograms. We linked personal identifiers to the National Death Index to ascertain date and cause of death. We matched four controls to each breast cancer decedent to estimate the association between receipt of surveillance mammogram and breast cancer mortality. Results One hundred seventy-eight women died of breast cancer during 5 years of follow-up. Each additional surveillance mammogram was associated with a 0.69-fold decrease in the odds of breast cancer mortality (95% CI, 0.52 to 0.92). The protective association was strongest among women with stage I disease, those who received mastectomy, and those in the oldest age group. Conclusion Given existing recommendations for post-therapy surveillance, trials to compare surveillance with no surveillance are unlikely. This large observational study provides support for the recommendations, suggesting that receipt of surveillance mammograms reduces the rate of breast cancer mortality in older patients diagnosed with early-stage disease.

scholarly journals Pathways to Breast Cancer Recurrence

ISRN Oncology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-16 ◽  
Author(s):  
Aamir Ahmad
Keyword(s):  
Breast Cancer ◽  
Epithelial Mesenchymal Transition ◽  
Recurrent Disease ◽  
Current Knowledge ◽  
Cancer Recurrence ◽  
Breast Cancer Recurrence ◽  
Breast Cancer Patients ◽  
Mesenchymal Transition ◽  
Number Of Factors ◽  
Prevention Of Breast Cancer

Breast cancer remains a deadly disease, even with all the recent technological advancements. Early intervention has made an impact, but an overwhelmingly large number of breast cancer patients still live under the fear of “recurrent” disease. Breast cancer recurrence is clinically a huge problem and one that is largely not well understood. Over the years, a number of factors have been studied with an overarching aim of being able to prognose recurrent disease. This paper attempts to provide an overview of our current knowledge of breast cancer recurrence and its associated challenges. Through a survey of the literature on cancer stem cells (CSCs), epithelial-mesenchymal transition (EMT), various signaling pathways such as Notch/Wnt/hedgehog, and microRNAs (miRNAs), we also examine the hypotheses that are currently under investigation for the prevention of breast cancer recurrence.

Mode of detection and breast cancer mortality by follow-up time and tumor characteristics among screened women in Cancer Prevention Study-II

2019 ◽  
Vol 177 (3) ◽  
pp. 679-689 ◽  
Author(s):  
Samantha Puvanesarajah ◽  
Susan M. Gapstur ◽  
Alpa V. Patel ◽  
Mark E. Sherman ◽  
W. Dana Flanders ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Prevention ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Tumor Characteristics ◽  
Prevention Study ◽  
Mode Of Detection

scholarly journals Hemoglobin A1c Levels Modify Associations between Dietary Acid Load and Breast Cancer Recurrence

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 578 ◽  
Author(s):  
Tianying Wu ◽  
Fang-Chi Hsu ◽  
Shunran Wang ◽  
David Luong ◽  
John P. Pierce
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Cancer Recurrence ◽  
Breast Cancer Recurrence ◽  
Dietary Acid Load ◽  
Dietary Acid ◽  
Acid Load ◽  
Hba1c Levels

Background: Metabolic acidosis promotes cancer metastasis. No prospective studies have examined the association between dietary acid load and breast cancer recurrence among breast cancer survivors, who are susceptible to metabolic acidosis. Hyperglycemia promotes cancer progression and acid formation; however, researchers have not examined whether hyperglycemia can modify the association between dietary acid load and breast cancer recurrence. Methods: We studied 3081 early-stage breast cancer survivors enrolled in the Women’s Healthy Eating and Living study who provided dietary information through 24-h recalls at baseline and during follow-up and had measurements of hemoglobin A1c (HbA1c) at baseline. We assessed dietary acid load using two common dietary acid load scores, potential renal acid load (PRAL) score and net endogenous acid production (NEAP) score. Results: After an average of 7.3 years of follow-up, dietary acid load was positively associated with recurrence when baseline HbA1c levels were ≥ 5.6% (median level) and ≥5.7% (pre-diabetic cut-point). In the stratum with HbA1c ≥ 5.6%, comparing the highest to the lowest quartile of dietary acid load, the multivariable-adjusted hazard ratio was 2.15 (95% confidence interval [CI] 1.34-3.48) for PRAL and was 2.31 (95% CI 1.42-3.74) for NEAP. No associations were observed in the stratum with HbA1c levels were <5.6%. P-values for interactions were 0.01 for PRAL and 0.05 for NEAP. Conclusions: Our study demonstrated for the first time that even at or above normal to high HbA1c levels, dietary acid load was associated with increased risk of breast cancer recurrence among breast cancer survivors. Impacts: Our study provides strong evidence for developing specific dietary acid load guidelines based on HbA1c levels.

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