Skip to main content
Top
Published in: Current Breast Cancer Reports 3/2012

01-09-2012 | Risk, Prevention, and Screening (MC Liu, Section Editor)

Clinical Perspective: Influence of Modifiable Lifestyle Factors, Body Weight, Physical Activity, and Alcohol on Breast Cancer Outcome

Author: Rowan T. Chlebowski

Published in: Current Breast Cancer Reports | Issue 3/2012

Login to get access

Abstract

Observational studies associate obesity and physical inactivity with adverse breast cancer outcome. Whether weight loss/maintenance or increase in physical activity after diagnosis can improve breast cancer outcome is not established. While alcohol use increases breast cancer risk, the role of alcohol in altering breast cancer outcome is not established. Only two full-scale randomized clinical trials have evaluated lifestyle change in early-stage, resected breast cancer and they provide mixed results. Despite strong preclinical evidence and identified potential mediating factors, only one full-scale lifestyle intervention trial is currently ongoing, SUCCESS-C, which will evaluate a program of weight reduction and increased physical activity in an adjuvant setting. On the basisi of current evidence, weight loss/maintenance and physical activity increase/maintenance can reasonably be recommended for breast cancer patients with early-stage disease. However, the strength of the recommendation awaits definitive randomized clinical trial evidence.
Literature
1.
go back to reference • Protani M, Coory M, Martin JH, et al. Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Canc Res Treat. 2010;123:627–35. This meta-analyses of 45 observational studies examined the association between body mass index (BMI) at diagnosis to outcome of early-stage breast cancer. Obese patients (BMI > 30) were at greater risk for breast-cancer-related death and overall mortality.CrossRef • Protani M, Coory M, Martin JH, et al. Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Canc Res Treat. 2010;123:627–35. This meta-analyses of 45 observational studies examined the association between body mass index (BMI) at diagnosis to outcome of early-stage breast cancer. Obese patients (BMI > 30) were at greater risk for breast-cancer-related death and overall mortality.CrossRef
2.
go back to reference Lahmann PH, Hoffmann K, Allen N, et al. Body size and breast cancer risk: findings from the European Prospectives Investigation into Cancer and Nutrition (EPIC). Int J Cancer. 2004;111:762–71.PubMedCrossRef Lahmann PH, Hoffmann K, Allen N, et al. Body size and breast cancer risk: findings from the European Prospectives Investigation into Cancer and Nutrition (EPIC). Int J Cancer. 2004;111:762–71.PubMedCrossRef
3.
go back to reference • Ewertz M, Jensen MB, Gunnarsdottir KA, et al. Effect of obesity on prognosis after early stage breast cancer. J Clin Oncol. 2010;29:25–31. A study of 18,967 women treated in Denmark for early-stage breast cancer confirmed a substantially worse survival in obese versus nonobese patients. The obesity influence was mainly on distant metastases.PubMedCrossRef • Ewertz M, Jensen MB, Gunnarsdottir KA, et al. Effect of obesity on prognosis after early stage breast cancer. J Clin Oncol. 2010;29:25–31. A study of 18,967 women treated in Denmark for early-stage breast cancer confirmed a substantially worse survival in obese versus nonobese patients. The obesity influence was mainly on distant metastases.PubMedCrossRef
4.
go back to reference Sparano J, Wang M, Martino S, et al. Obesity at diagnosis is associated with inferior outcomes in hormone receptor positive breast cancer [abstract S2-1]. Paper presented at: The CTRC-AACR San Antonio Breast Cancer Symposium; 2010 December 6–10; San Antonio, Texas. Sparano J, Wang M, Martino S, et al. Obesity at diagnosis is associated with inferior outcomes in hormone receptor positive breast cancer [abstract S2-1]. Paper presented at: The CTRC-AACR San Antonio Breast Cancer Symposium; 2010 December 6–10; San Antonio, Texas.
5.
go back to reference Ademuyiwa FO, Groman A, O’Connor T, et al. Impact of body mass index on clinical outcomes in triple negative breast cancer. Cancer. 2011;117:4132–40.PubMedCrossRef Ademuyiwa FO, Groman A, O’Connor T, et al. Impact of body mass index on clinical outcomes in triple negative breast cancer. Cancer. 2011;117:4132–40.PubMedCrossRef
6.
go back to reference de Azambuja E, McCaskill-Stevens W, Francis P, et al. The effect of body mass index on overall and disease-free survival in node-positive breast cancer patients treated with docetaxel and doxorubicin-containing adjuvant chemotherapy: the experience of the BIG 02-98 trial. Breast Canc Res Treat. 2010;119:145–53.CrossRef de Azambuja E, McCaskill-Stevens W, Francis P, et al. The effect of body mass index on overall and disease-free survival in node-positive breast cancer patients treated with docetaxel and doxorubicin-containing adjuvant chemotherapy: the experience of the BIG 02-98 trial. Breast Canc Res Treat. 2010;119:145–53.CrossRef
7.
go back to reference Majed B, Moreau T, Senouci K, et al. Is obesity an independent prognosis factor in woman breast cancer? Breast Canc Res Treat. 2008;111:329–42.CrossRef Majed B, Moreau T, Senouci K, et al. Is obesity an independent prognosis factor in woman breast cancer? Breast Canc Res Treat. 2008;111:329–42.CrossRef
8.
go back to reference Eley JW, Hill HA, Chen VW, et al. Racial differences in survival from breast cancer: results of the National Cancer Institute Black/White Cancer Survival Study. JAMA. 1994;272:947–54.PubMedCrossRef Eley JW, Hill HA, Chen VW, et al. Racial differences in survival from breast cancer: results of the National Cancer Institute Black/White Cancer Survival Study. JAMA. 1994;272:947–54.PubMedCrossRef
9.
go back to reference McCullough ML, Feigelson HS, Diver WR, et al. Risk factors for fatal breast cancer in African-American women and White women in a large US prospective cohort. Am J Epidemiol. 2005;162:734–42.PubMedCrossRef McCullough ML, Feigelson HS, Diver WR, et al. Risk factors for fatal breast cancer in African-American women and White women in a large US prospective cohort. Am J Epidemiol. 2005;162:734–42.PubMedCrossRef
10.
go back to reference Chlebowski RT, Chen Z, Anderson GI, et al. Ethnicity and breast cancer: factors influencing differences in incidence and outcome. J Natl Canc Inst. 2005;97:439–48.CrossRef Chlebowski RT, Chen Z, Anderson GI, et al. Ethnicity and breast cancer: factors influencing differences in incidence and outcome. J Natl Canc Inst. 2005;97:439–48.CrossRef
11.
go back to reference Lu Y, Ma H, Malone KE, et al. Obesity and survival among Black women and White women 35 to 64 years of age at diagnosis with invasive breast cancer. J Clin Oncol. 2011;29:3358–65.PubMedCrossRef Lu Y, Ma H, Malone KE, et al. Obesity and survival among Black women and White women 35 to 64 years of age at diagnosis with invasive breast cancer. J Clin Oncol. 2011;29:3358–65.PubMedCrossRef
12.
13.
go back to reference Bonomi P, Bunting N, Fishman D. Weight gain during adjuvant chemotherapy or hormono-chemotherapy for stage II breast cancer in relation to disease free survival [abstract]. Breast Canc Res Treat. 1984;4:339. Bonomi P, Bunting N, Fishman D. Weight gain during adjuvant chemotherapy or hormono-chemotherapy for stage II breast cancer in relation to disease free survival [abstract]. Breast Canc Res Treat. 1984;4:339.
14.
go back to reference Chlebowski RT, Weiner J, Reynolds R, et al. Long-term survival following relapse after 5-FU but not CMF adjuvant breast cancer therapy. Breast Canc Res Treat. 1986;7:23–30.CrossRef Chlebowski RT, Weiner J, Reynolds R, et al. Long-term survival following relapse after 5-FU but not CMF adjuvant breast cancer therapy. Breast Canc Res Treat. 1986;7:23–30.CrossRef
15.
go back to reference Levine E, Raczynski J, Carpenter J, et al. Weight gain with breast cancer adjuvant treatment. Cancer. 1991;67:1954–9.PubMedCrossRef Levine E, Raczynski J, Carpenter J, et al. Weight gain with breast cancer adjuvant treatment. Cancer. 1991;67:1954–9.PubMedCrossRef
16.
go back to reference Chlebowski RT, Aiello E, McTiernan A, et al. Weight loss in breast cancer management. J Clin Oncol. 2002;20:1128–43.PubMedCrossRef Chlebowski RT, Aiello E, McTiernan A, et al. Weight loss in breast cancer management. J Clin Oncol. 2002;20:1128–43.PubMedCrossRef
17.
go back to reference Chlebowski RT: Obesity and breast cancer outcome: Adding to the evidence. J Clin Oncol. 2011, Dec 12. [Epub ahead of print]. Chlebowski RT: Obesity and breast cancer outcome: Adding to the evidence. J Clin Oncol. 2011, Dec 12. [Epub ahead of print].
18.
go back to reference Kroenke C, Chen W, Rosner B, Holmes M. Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol. 2005;23:1370–8.PubMedCrossRef Kroenke C, Chen W, Rosner B, Holmes M. Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol. 2005;23:1370–8.PubMedCrossRef
19.
go back to reference Caan B, Emond J, Natarajan L, et al. Post-diagnosis weight gain and breast cancer recurrence in women with early stage breast cancer. Breast Canc Res Treat. 2006;99:47–57.CrossRef Caan B, Emond J, Natarajan L, et al. Post-diagnosis weight gain and breast cancer recurrence in women with early stage breast cancer. Breast Canc Res Treat. 2006;99:47–57.CrossRef
20.
go back to reference Chen X, Lu W, Gu K, et al. Weight change and its correlates among breast cancer survivors. Nutr Canc. 2011;63:538–48.CrossRef Chen X, Lu W, Gu K, et al. Weight change and its correlates among breast cancer survivors. Nutr Canc. 2011;63:538–48.CrossRef
21.
go back to reference • Chlebowski RT, Blackburn G, Thomson CA, et al. Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women’s Intervention Nutrition Study (WINS). J Natl Canc Inst. 2006;98:1767–76. This full scale adjuvant breast cancer randomized clinical trial evaluated a lifestyle intervention targeting dietary fat reduction. The intervention group participants significantly reduced fat, intake which was associated with a statistically significant weight loss and a statistically significant increase in relapse-free survival.CrossRef • Chlebowski RT, Blackburn G, Thomson CA, et al. Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women’s Intervention Nutrition Study (WINS). J Natl Canc Inst. 2006;98:1767–76. This full scale adjuvant breast cancer randomized clinical trial evaluated a lifestyle intervention targeting dietary fat reduction. The intervention group participants significantly reduced fat, intake which was associated with a statistically significant weight loss and a statistically significant increase in relapse-free survival.CrossRef
22.
go back to reference Pierce JP, Natarajan L, Caan BL, et al. Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women’s Healthy Eating and Living (WHEL) randomized trial. JAMA. 2007;298:289–98.PubMedCrossRef Pierce JP, Natarajan L, Caan BL, et al. Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women’s Healthy Eating and Living (WHEL) randomized trial. JAMA. 2007;298:289–98.PubMedCrossRef
23.
go back to reference Abrahamson PE, Gammon MD, Lund MJ, et al. Recreational physical activity and survival among young women with breast cancer. Cancer. 2006;107:1777–85.PubMedCrossRef Abrahamson PE, Gammon MD, Lund MJ, et al. Recreational physical activity and survival among young women with breast cancer. Cancer. 2006;107:1777–85.PubMedCrossRef
24.
go back to reference Cleveland RJ, Eng SM, Stevens J, et al. Influence of prediagnostic recreational physical activity on survival from breast cancer. Eur J Canc Prev. 2012;21:46–54.CrossRef Cleveland RJ, Eng SM, Stevens J, et al. Influence of prediagnostic recreational physical activity on survival from breast cancer. Eur J Canc Prev. 2012;21:46–54.CrossRef
25.
go back to reference Holmes MD, Chen WY, Feskanich D, et al. Physical activity and survival after breast cancer diagnosis. JAMA. 2005;293:2479–86.PubMedCrossRef Holmes MD, Chen WY, Feskanich D, et al. Physical activity and survival after breast cancer diagnosis. JAMA. 2005;293:2479–86.PubMedCrossRef
26.
go back to reference Pierce J, Stefanick M, Flatt S, et al. Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. J Clin Oncol. 2007;17:2345–51.CrossRef Pierce J, Stefanick M, Flatt S, et al. Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. J Clin Oncol. 2007;17:2345–51.CrossRef
27.
go back to reference Holick C, Newcomb P, Trentham-Dietz A, et al. Physical activity and survival after diagnosis of invasive breast cancer. Canc Epidemiol Biomarkers Prev. 2008;17:379–86.CrossRef Holick C, Newcomb P, Trentham-Dietz A, et al. Physical activity and survival after diagnosis of invasive breast cancer. Canc Epidemiol Biomarkers Prev. 2008;17:379–86.CrossRef
28.
go back to reference Chen X, Lu W, Zheng W, et al. Exercise after diagnosis of breast cancer in association with survival. Canc Prev Res (Phila). 2011;4:1409–18.CrossRef Chen X, Lu W, Zheng W, et al. Exercise after diagnosis of breast cancer in association with survival. Canc Prev Res (Phila). 2011;4:1409–18.CrossRef
29.
go back to reference Irwin M, Smith A, McTiernan A, et al. Influence of pre and post diagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity and lifestyle study. J Clin Oncol. 2008;26:3958–64.PubMedCrossRef Irwin M, Smith A, McTiernan A, et al. Influence of pre and post diagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity and lifestyle study. J Clin Oncol. 2008;26:3958–64.PubMedCrossRef
30.
go back to reference Sternfeld B, Weltzien E, Quesenberry Jr CP, et al. Physical activity and risk of recurrence and moratliy in breast cancer survivors: findings from the LACE study. Canc Epidemiol Biomarkers Prev. 2009;18:87–95.CrossRef Sternfeld B, Weltzien E, Quesenberry Jr CP, et al. Physical activity and risk of recurrence and moratliy in breast cancer survivors: findings from the LACE study. Canc Epidemiol Biomarkers Prev. 2009;18:87–95.CrossRef
31.
go back to reference • Irwin ML, McTiernan A, Manson JE, et al. Physical activity and survival in postmenopausal women with breast cancer: results from the Women’s Health Initiative. Canc Prev Res. 2011;4:522–9. This study conducted in the Women’s Health Initiative cohort reported on both pre- and postdiagnosis physical activity in postmenopausal women with early-stage breast cancer. Women with active postdiagnosis physical activity status experienced fewer breast cancer deaths, even if they were inactive prediagnosis.CrossRef • Irwin ML, McTiernan A, Manson JE, et al. Physical activity and survival in postmenopausal women with breast cancer: results from the Women’s Health Initiative. Canc Prev Res. 2011;4:522–9. This study conducted in the Women’s Health Initiative cohort reported on both pre- and postdiagnosis physical activity in postmenopausal women with early-stage breast cancer. Women with active postdiagnosis physical activity status experienced fewer breast cancer deaths, even if they were inactive prediagnosis.CrossRef
32.
go back to reference Cadmus-Bertram LA, Stefanick ML, Saquib N, et al. Physical activity, additional breast cancer events, and mortality among early-stage breast cancer survivors: findings from the WHEL study. Canc Causes Contr. 2011;22:427–35.CrossRef Cadmus-Bertram LA, Stefanick ML, Saquib N, et al. Physical activity, additional breast cancer events, and mortality among early-stage breast cancer survivors: findings from the WHEL study. Canc Causes Contr. 2011;22:427–35.CrossRef
33.
34.
go back to reference Chen WU, Rosner B, Hankinson SE, et al. Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk. JAMA. 2001;306:1920–1. Chen WU, Rosner B, Hankinson SE, et al. Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk. JAMA. 2001;306:1920–1.
35.
go back to reference Li CI, Chlebowski RT, Freiberg M, et al. Alcohol consumption and risk of postmenopausal breast cancer by subtype: the Women’s Health Initiative Observational Study. J Natl Canc Inst. 2010;102:1–10.CrossRef Li CI, Chlebowski RT, Freiberg M, et al. Alcohol consumption and risk of postmenopausal breast cancer by subtype: the Women’s Health Initiative Observational Study. J Natl Canc Inst. 2010;102:1–10.CrossRef
36.
go back to reference Saxe GA, Rock CL, Wicha MS, et al. Diet and risk of breast cancer recurrence and survival. Breast Canc Res Treat. 1999;53:241–53.CrossRef Saxe GA, Rock CL, Wicha MS, et al. Diet and risk of breast cancer recurrence and survival. Breast Canc Res Treat. 1999;53:241–53.CrossRef
37.
go back to reference Hebert JR, Hurley TG, Ma Y. The effect of dietary exposures on recurrence and mortality in early stage breast cancer. Breast Canc Res Treat. 1998;51:17–28.CrossRef Hebert JR, Hurley TG, Ma Y. The effect of dietary exposures on recurrence and mortality in early stage breast cancer. Breast Canc Res Treat. 1998;51:17–28.CrossRef
38.
go back to reference Flatt SW, Thomson CA, Gold EB, et al. Low to moderate alcohol intake is not associated with increased morality after breast cancer. Canc Epidemiol Biomarkers Prev. 2010;19:681–8.CrossRef Flatt SW, Thomson CA, Gold EB, et al. Low to moderate alcohol intake is not associated with increased morality after breast cancer. Canc Epidemiol Biomarkers Prev. 2010;19:681–8.CrossRef
39.
go back to reference • Kwan ML, Kushi LH, Weltzien E, et al. Alcohol consumption and breast cancer recurrence and survival among women with early-stage breast cancer: the life after cancer epidemiology study. J Clin Oncol. 2010;28:4410–6. The relationship between alcohol and breast cancer recurrence remains controversial. This recent report described a significant increase in recurrence risk and deaths due to breast cancer for alcohol use > 6 g/d, but the recurrence risk increase appeared limited to overweight and obese women.PubMedCrossRef • Kwan ML, Kushi LH, Weltzien E, et al. Alcohol consumption and breast cancer recurrence and survival among women with early-stage breast cancer: the life after cancer epidemiology study. J Clin Oncol. 2010;28:4410–6. The relationship between alcohol and breast cancer recurrence remains controversial. This recent report described a significant increase in recurrence risk and deaths due to breast cancer for alcohol use > 6 g/d, but the recurrence risk increase appeared limited to overweight and obese women.PubMedCrossRef
40.
go back to reference Holmes MD, Stampfer MJ, Colditz GA, et al. Dietary factors and the survival of women with breast carcinoma. Cancer. 1999;86:826–35.PubMedCrossRef Holmes MD, Stampfer MJ, Colditz GA, et al. Dietary factors and the survival of women with breast carcinoma. Cancer. 1999;86:826–35.PubMedCrossRef
41.
go back to reference Borugian MJ, Sheps SB, Kim-Sing C, et al. Insulin, macronutrient intake, and physical activity: are potential indicators of insulin resistance associated with mortality from breast cancer? Canc Epidemiol Biomarkers Prev. 2004;13:1163–72. Borugian MJ, Sheps SB, Kim-Sing C, et al. Insulin, macronutrient intake, and physical activity: are potential indicators of insulin resistance associated with mortality from breast cancer? Canc Epidemiol Biomarkers Prev. 2004;13:1163–72.
42.
go back to reference Franceschi S, Dal Maso L, Zucchetto A, Talamini R. Alcohol consumption and survival after breast cancer. Canc Epidemiol Biomarkers Prev. 2009;18:1011–2.CrossRef Franceschi S, Dal Maso L, Zucchetto A, Talamini R. Alcohol consumption and survival after breast cancer. Canc Epidemiol Biomarkers Prev. 2009;18:1011–2.CrossRef
43.
go back to reference Barnett GC, Shah M, Redman K, et al. Risk factors for the incidence of breast cancer: do they affect survival from the disease? J Clin Oncol. 2008;26:3310–6.PubMedCrossRef Barnett GC, Shah M, Redman K, et al. Risk factors for the incidence of breast cancer: do they affect survival from the disease? J Clin Oncol. 2008;26:3310–6.PubMedCrossRef
44.
go back to reference Reding KW, Daling JR, Doody DR, et al. Effect of prediagnostic alcohol consumption on survival after breast cancer in young women. Canc Epidemiol Biomarkers Prev. 2008;17:1988–96.CrossRef Reding KW, Daling JR, Doody DR, et al. Effect of prediagnostic alcohol consumption on survival after breast cancer in young women. Canc Epidemiol Biomarkers Prev. 2008;17:1988–96.CrossRef
45.
go back to reference Li CI, Daling JR, Porter PL, et al. Relationship between potentially modifiable lifestyle factors and risk of second primary contralateral breast cancer among women diagnosed with estrogen receptor-positive invasive breast cancer. J Clin Oncol. 2009;27:5312–8.PubMedCrossRef Li CI, Daling JR, Porter PL, et al. Relationship between potentially modifiable lifestyle factors and risk of second primary contralateral breast cancer among women diagnosed with estrogen receptor-positive invasive breast cancer. J Clin Oncol. 2009;27:5312–8.PubMedCrossRef
46.
go back to reference Dorgan JF, Baer DJ, Albert PS, et al. Serum hormones and the alcohol breast cancer association in postmenopausal women. J Natl Canc Inst. 2001;93:710–5.CrossRef Dorgan JF, Baer DJ, Albert PS, et al. Serum hormones and the alcohol breast cancer association in postmenopausal women. J Natl Canc Inst. 2001;93:710–5.CrossRef
47.
go back to reference Dumitrescu RG, Shields PG. The etiology of alcohol-induced breast cancer. Alcohol. 2005;35:213–25.PubMedCrossRef Dumitrescu RG, Shields PG. The etiology of alcohol-induced breast cancer. Alcohol. 2005;35:213–25.PubMedCrossRef
48.
49.
go back to reference Chlebowski RT, Ligibel JA. Lifestyle issues in breast cancer survivors. In: Diseases of the Breast. Fourth Edition. Harris JR, Lippman ME, Morrow M, Osborne CK, editors. Diseases of the breast (4th ed.). Philadelphia, PA: Lippincott Williams & Wikins; 2010. p. 676–82. Chlebowski RT, Ligibel JA. Lifestyle issues in breast cancer survivors. In: Diseases of the Breast. Fourth Edition. Harris JR, Lippman ME, Morrow M, Osborne CK, editors. Diseases of the breast (4th ed.). Philadelphia, PA: Lippincott Williams & Wikins; 2010. p. 676–82.
50.
go back to reference Prentice RL, Caan B, Chlebowski RT, et al. Low-fat dietary pattern and risk of invasive breast cancer: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006;295:629–42.PubMedCrossRef Prentice RL, Caan B, Chlebowski RT, et al. Low-fat dietary pattern and risk of invasive breast cancer: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006;295:629–42.PubMedCrossRef
51.
go back to reference Martin LJ, Li Q, Melnichouk O, et al. A randomized trial of dietary intervention for breast cancer prevention. Cancer Res. 2011;7:123–33.CrossRef Martin LJ, Li Q, Melnichouk O, et al. A randomized trial of dietary intervention for breast cancer prevention. Cancer Res. 2011;7:123–33.CrossRef
52.
go back to reference Davies NJ, Batehup L, Thomas R. The role of diet and physical activity in breast, colorectal, and prostate cancer survivorship: a review of the literature. Br J Canc. 2011;105:S52–73.CrossRef Davies NJ, Batehup L, Thomas R. The role of diet and physical activity in breast, colorectal, and prostate cancer survivorship: a review of the literature. Br J Canc. 2011;105:S52–73.CrossRef
53.
go back to reference Kendall A, Folkerd EJ, Dowsett M. Influences on circulating oestrogens in postmenopausal women: relationships with breast cancer. J Steriod Biochem Mol Biol. 2007;103:99–109.CrossRef Kendall A, Folkerd EJ, Dowsett M. Influences on circulating oestrogens in postmenopausal women: relationships with breast cancer. J Steriod Biochem Mol Biol. 2007;103:99–109.CrossRef
54.
go back to reference Key TJ, Appleby PN, Reeves GK, et al. Circulating sex hormones and breast cancer risk factors in postmenopausal women: reanalysis of 13 studies. Br J Cancer. 2011;105:709–22.PubMedCrossRef Key TJ, Appleby PN, Reeves GK, et al. Circulating sex hormones and breast cancer risk factors in postmenopausal women: reanalysis of 13 studies. Br J Cancer. 2011;105:709–22.PubMedCrossRef
55.
go back to reference Farhat GN, Cummings SR, Chlebowski RT, et al. Sex hormone levels and risks of estrogen receptor-negative and estrogen receptor-positive breast cancers. J Natl Canc Inst. 2011;103:562–70.CrossRef Farhat GN, Cummings SR, Chlebowski RT, et al. Sex hormone levels and risks of estrogen receptor-negative and estrogen receptor-positive breast cancers. J Natl Canc Inst. 2011;103:562–70.CrossRef
56.
go back to reference Eliassen AH, Tworogner SS, Mantzoros CS, et al. Circulating insulin and C-peptide levels and risk of breast cancer among predominately premenopausal women. Canc Epidemiol Bio Prev. 2007;16:161.CrossRef Eliassen AH, Tworogner SS, Mantzoros CS, et al. Circulating insulin and C-peptide levels and risk of breast cancer among predominately premenopausal women. Canc Epidemiol Bio Prev. 2007;16:161.CrossRef
57.
go back to reference Kabat GC, Kim M, Caan BJ, et al. Repeated measures of serum glucose and insulin in relation to postmenopausal breast cancer. Int J Cancer. 2009;125:2704–10.PubMedCrossRef Kabat GC, Kim M, Caan BJ, et al. Repeated measures of serum glucose and insulin in relation to postmenopausal breast cancer. Int J Cancer. 2009;125:2704–10.PubMedCrossRef
58.
go back to reference Gunter MJ, Hoover DR, Yu H, et al. Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women. J Natl Canc Inst. 2009;101:48–60. Gunter MJ, Hoover DR, Yu H, et al. Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women. J Natl Canc Inst. 2009;101:48–60.
59.
go back to reference Maccio A, Madeddu C. Obesity, inflammation, and postmenopausal breast cancer: therapeutic implications. Sci World J. 2011;11:2020–36.CrossRef Maccio A, Madeddu C. Obesity, inflammation, and postmenopausal breast cancer: therapeutic implications. Sci World J. 2011;11:2020–36.CrossRef
60.
go back to reference McTiernan A, Ulrich C, Kumai C, et al. Anthropometric and hormone effects of an eight week exercise diet intervention in breast cancer patients: results of a pilot study. Canc Epidemiol Biomarkers Prev. 1998;7:477–81. McTiernan A, Ulrich C, Kumai C, et al. Anthropometric and hormone effects of an eight week exercise diet intervention in breast cancer patients: results of a pilot study. Canc Epidemiol Biomarkers Prev. 1998;7:477–81.
61.
go back to reference Ligibel J, Campbell N, Partridge A, et al. Impact of a mixed strength and endurance exercise intervention on insulin levels in breast cancer survivors. J Clin Oncol. 2008;26:907–12.PubMedCrossRef Ligibel J, Campbell N, Partridge A, et al. Impact of a mixed strength and endurance exercise intervention on insulin levels in breast cancer survivors. J Clin Oncol. 2008;26:907–12.PubMedCrossRef
62.
go back to reference Irwin M, Varma K, Alvarez-Reeves M, et al. Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the Yale Exercise and Survivorship Study. Canc Epidemiol Biomarkers Prev. 2009;18:306–13.CrossRef Irwin M, Varma K, Alvarez-Reeves M, et al. Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the Yale Exercise and Survivorship Study. Canc Epidemiol Biomarkers Prev. 2009;18:306–13.CrossRef
63.
go back to reference Larsson SC, Mantzoros CS, Wolk A. Diabetes mellitus and risk of breast cancer: a meta-analysis. Int J Cancer. 2007;121:856–62.PubMedCrossRef Larsson SC, Mantzoros CS, Wolk A. Diabetes mellitus and risk of breast cancer: a meta-analysis. Int J Cancer. 2007;121:856–62.PubMedCrossRef
64.
go back to reference Del Giudice ME, Fantus IG, Ezzat S, et al. Insulin and related factors in premenopausal breast cancer risk. Breast Canc Res Treat. 1998;47:111–20.CrossRef Del Giudice ME, Fantus IG, Ezzat S, et al. Insulin and related factors in premenopausal breast cancer risk. Breast Canc Res Treat. 1998;47:111–20.CrossRef
65.
go back to reference Wolf I, Sadetzki S, Catane R, et al. Diabetes mellitus and breast cancer. Lancet Oncol. 2005;6:103–11.PubMedCrossRef Wolf I, Sadetzki S, Catane R, et al. Diabetes mellitus and breast cancer. Lancet Oncol. 2005;6:103–11.PubMedCrossRef
66.
go back to reference Michels KB, Hankinson SE, Solomon CG, et al. Type 2 diabetes and subsequent incidence of breast cancer in the Nurses' Health Study. Diabetes Care. 2003;26:1751–8.CrossRef Michels KB, Hankinson SE, Solomon CG, et al. Type 2 diabetes and subsequent incidence of breast cancer in the Nurses' Health Study. Diabetes Care. 2003;26:1751–8.CrossRef
67.
go back to reference Johnson JA, Bowker SL, Richardson K, Marra CA. Time-varying incidence of cancer after the onset of type 2 diabetes: evidence of potential detection bias. Diabetologia. 2011;54:2263–71.PubMedCrossRef Johnson JA, Bowker SL, Richardson K, Marra CA. Time-varying incidence of cancer after the onset of type 2 diabetes: evidence of potential detection bias. Diabetologia. 2011;54:2263–71.PubMedCrossRef
68.
go back to reference Bowker SL, Richardson K, Marra CA, Johnson JA. Risk of breast cancer after onset of type 2 diabetes: evidence of detection bias in postmenopausal women. Diabetes Care. 2012;34:2542–4.CrossRef Bowker SL, Richardson K, Marra CA, Johnson JA. Risk of breast cancer after onset of type 2 diabetes: evidence of detection bias in postmenopausal women. Diabetes Care. 2012;34:2542–4.CrossRef
69.
go back to reference Carstensen B, Witte DR, Friis S. Cancer occurrence in Danish diabetic patients: duration and insulin effects. Diabetologia. 2011 Nov 27. [Epub ahead of print]. Carstensen B, Witte DR, Friis S. Cancer occurrence in Danish diabetic patients: duration and insulin effects. Diabetologia. 2011 Nov 27. [Epub ahead of print].
70.
go back to reference Libby G, Donnelly LA, Donnan PT, et al. New users of metformin are at low risk of incident cancer. Diabetes Care. 2009;32:1620–5.PubMedCrossRef Libby G, Donnelly LA, Donnan PT, et al. New users of metformin are at low risk of incident cancer. Diabetes Care. 2009;32:1620–5.PubMedCrossRef
71.
go back to reference Evans JMM, Donnelly LA, Emslie-Smith AM, et al. Metformin and reduced risk of cancer in diabetic patients. BMJ. 2005;330:1304–5.PubMedCrossRef Evans JMM, Donnelly LA, Emslie-Smith AM, et al. Metformin and reduced risk of cancer in diabetic patients. BMJ. 2005;330:1304–5.PubMedCrossRef
72.
go back to reference DeCensi A, Puntoni M, Goodwin PJ, et al. Metformin and cancer risk in diabetic patients: a systematic review and meta-analysis. Canc Prev Res (Phila). 2010;3:1451–61.CrossRef DeCensi A, Puntoni M, Goodwin PJ, et al. Metformin and cancer risk in diabetic patients: a systematic review and meta-analysis. Canc Prev Res (Phila). 2010;3:1451–61.CrossRef
73.
go back to reference Chlebowski RT, McTiernan A, Aragaki AK, et al. Metformin and breast cancer incidence in postmenopausal diabetic women in the Women’s Health Initiative (WHI). J Clin Oncol. 2011;29(suppl; abstract 1503). Chlebowski RT, McTiernan A, Aragaki AK, et al. Metformin and breast cancer incidence in postmenopausal diabetic women in the Women’s Health Initiative (WHI). J Clin Oncol. 2011;29(suppl; abstract 1503).
74.
go back to reference Peairs KS, Barone BB, Snyder CF, et al. Diabetes mellitus and breast cancer outcomes: a systematic review and meta-analysis. J Clin Oncol. 2011;29:40–6.PubMedCrossRef Peairs KS, Barone BB, Snyder CF, et al. Diabetes mellitus and breast cancer outcomes: a systematic review and meta-analysis. J Clin Oncol. 2011;29:40–6.PubMedCrossRef
75.
go back to reference Erickson K, Patterson RE, Flatt SW, et al. Clinically defined Type 2 diabetes mellitus and prognosis in early stage breast cancer. J Clin Oncol. 2011;29:54–60.PubMedCrossRef Erickson K, Patterson RE, Flatt SW, et al. Clinically defined Type 2 diabetes mellitus and prognosis in early stage breast cancer. J Clin Oncol. 2011;29:54–60.PubMedCrossRef
76.
go back to reference Goodwin PJ, Ennis M, Pritchard KI, et al. Fasting insulin and outcome in early stage breast cancer: results of a prospective cohort study. J Clin Oncol. 2002;20:42–51.PubMedCrossRef Goodwin PJ, Ennis M, Pritchard KI, et al. Fasting insulin and outcome in early stage breast cancer: results of a prospective cohort study. J Clin Oncol. 2002;20:42–51.PubMedCrossRef
77.
go back to reference Goodwin PJ, Ennis M, Pritchard KI, et al. Insulin and obesity related variables in early stage breast cancer—correlations and time course of prognostic associations. J Clin Oncol. 2011 Dec 12. [Epub ahead of print]. Goodwin PJ, Ennis M, Pritchard KI, et al. Insulin and obesity related variables in early stage breast cancer—correlations and time course of prognostic associations. J Clin Oncol. 2011 Dec 12. [Epub ahead of print].
78.
go back to reference Duggan C, Irwin ML, Xiao L, et al. Associations of insulin resistance and adiponectin with mortality in women with breast cancer. J Clin Oncol. 2011;29:32–9.PubMedCrossRef Duggan C, Irwin ML, Xiao L, et al. Associations of insulin resistance and adiponectin with mortality in women with breast cancer. J Clin Oncol. 2011;29:32–9.PubMedCrossRef
79.
go back to reference Pollak MN, Chapman JW, Shepherd L, et al. Insulin resistance, estimated by serum C-peptide level, is associated with reduced event-free survival for postmenopausal women in NCIC CTG MA.14 adjuvant breast cancer trial. J Clin Oncol. 2006;25:9S (suppl; abstract 524). Pollak MN, Chapman JW, Shepherd L, et al. Insulin resistance, estimated by serum C-peptide level, is associated with reduced event-free survival for postmenopausal women in NCIC CTG MA.14 adjuvant breast cancer trial. J Clin Oncol. 2006;25:9S (suppl; abstract 524).
80.
go back to reference Jiralerspong S, Palla SL, Giordano SH, et al. Metformin and pathologic complete responses to neoadjuvant chemotherapy in diabetic patients with breast cancer. J Clin Oncol. 2009;27:3297–302.PubMedCrossRef Jiralerspong S, Palla SL, Giordano SH, et al. Metformin and pathologic complete responses to neoadjuvant chemotherapy in diabetic patients with breast cancer. J Clin Oncol. 2009;27:3297–302.PubMedCrossRef
81.
go back to reference Goodwin PJ, Pritchard KI, Ennis M, et al. Insulin lowering effects of metformin in women with early breast cancer. Clin Breast Canc. 2006;8:501–5.CrossRef Goodwin PJ, Pritchard KI, Ennis M, et al. Insulin lowering effects of metformin in women with early breast cancer. Clin Breast Canc. 2006;8:501–5.CrossRef
82.
go back to reference Goodwin PJ, Stombolic V, Lemieux J, et al. Evaluation of metformin in early breast cancer: a modification of the traditional paradigm for clinical testing of anti-cancer agents. Breast Canc Res Treat. 2011;126:215–20.CrossRef Goodwin PJ, Stombolic V, Lemieux J, et al. Evaluation of metformin in early breast cancer: a modification of the traditional paradigm for clinical testing of anti-cancer agents. Breast Canc Res Treat. 2011;126:215–20.CrossRef
83.
go back to reference Goodwin P, Esplen M, Butler K, et al. Multidisciplinary weight management in locoregional breast cancer: results of a phase II study. Breast Canc Res Treat. 1998;48:53–64.CrossRef Goodwin P, Esplen M, Butler K, et al. Multidisciplinary weight management in locoregional breast cancer: results of a phase II study. Breast Canc Res Treat. 1998;48:53–64.CrossRef
84.
go back to reference Shaw C, Mortimer P, Judd P. Randomized controlled trial comparing a low-fat diet with a weight reduction diet in breast cancer lymphedema. Cancer. 2007;109:1949–56.PubMedCrossRef Shaw C, Mortimer P, Judd P. Randomized controlled trial comparing a low-fat diet with a weight reduction diet in breast cancer lymphedema. Cancer. 2007;109:1949–56.PubMedCrossRef
85.
go back to reference Dujuric Z, DiLaura N, Jenkins I, et al. Combining weight loss counseling with the Weight Watchers plan for obese breast cancer survivors. Obes Res. 2002;10:657–65.CrossRef Dujuric Z, DiLaura N, Jenkins I, et al. Combining weight loss counseling with the Weight Watchers plan for obese breast cancer survivors. Obes Res. 2002;10:657–65.CrossRef
86.
go back to reference Ligibel JA, Meyerhardt J, Pierce JP, et al. Impact of a telephone based physical activity intervention upon exercise behaviors and fitness in cancer survivors enrolled in a cooperative group setting. Breast Cancer Res Treat. 2011, Nov 4 [Epub ahead of print]. Ligibel JA, Meyerhardt J, Pierce JP, et al. Impact of a telephone based physical activity intervention upon exercise behaviors and fitness in cancer survivors enrolled in a cooperative group setting. Breast Cancer Res Treat. 2011, Nov 4 [Epub ahead of print].
87.
go back to reference Morey MC, Snyder DC, Sloane R, et al. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors. RENEW: a randomized controlled trial. JAMA. 2009;301:1883–91.PubMedCrossRef Morey MC, Snyder DC, Sloane R, et al. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors. RENEW: a randomized controlled trial. JAMA. 2009;301:1883–91.PubMedCrossRef
88.
go back to reference Parry BM, Milne JM, Yadegarfar G, Rainsbury RM. Dramatic dietary fat reduction is feasible for breast cancer patients: results of the randomized study, WINS (UK)—stage 2. Eur J Surg Oncol. 2011;37:848–55.PubMedCrossRef Parry BM, Milne JM, Yadegarfar G, Rainsbury RM. Dramatic dietary fat reduction is feasible for breast cancer patients: results of the randomized study, WINS (UK)—stage 2. Eur J Surg Oncol. 2011;37:848–55.PubMedCrossRef
89.
go back to reference Segal R, Pond G, Vallis M, et al. Randomized trial of a lifestyle intervention for women with early-stage breast cancer (BC) receiving adjuvant hormone therapy: Initial results. J Clin Oncol. 2011;29(abstract 512). Segal R, Pond G, Vallis M, et al. Randomized trial of a lifestyle intervention for women with early-stage breast cancer (BC) receiving adjuvant hormone therapy: Initial results. J Clin Oncol. 2011;29(abstract 512).
90.
go back to reference Early Breast Cancer Trialists Collaborative Group (EBCTCG). Comparisons between different polychemotherapy regimens for early breast cancer: meta-analysis of long-term outcome among 100,000 women in 123 randomized trials. Lancet. 2011, Dec 5 [Epub ahead of print]. Early Breast Cancer Trialists Collaborative Group (EBCTCG). Comparisons between different polychemotherapy regimens for early breast cancer: meta-analysis of long-term outcome among 100,000 women in 123 randomized trials. Lancet. 2011, Dec 5 [Epub ahead of print].
91.
go back to reference • Rack B, Andergassen U, Neugebauer J, et al. The German SUCCESS C Study: The first European lifestyle study on breast cancer. Breast Care. 2010;5:395–400. The German SUCCESS-C Study is the only full-scale, randomized clinical trial assessing a lifestyle intervention in early breast cancer. The intervention targets weight loss and increased physical activity in addition to standard systemic adjuvant therapy.PubMedCrossRef • Rack B, Andergassen U, Neugebauer J, et al. The German SUCCESS C Study: The first European lifestyle study on breast cancer. Breast Care. 2010;5:395–400. The German SUCCESS-C Study is the only full-scale, randomized clinical trial assessing a lifestyle intervention in early breast cancer. The intervention targets weight loss and increased physical activity in addition to standard systemic adjuvant therapy.PubMedCrossRef
92.
go back to reference Chlebowski RT, Blackburn GL, Elashoff RM, et al. Mature analysis from the women’s intervention nutrition study (WINS) evaluating dietary fat reduction and breast cancer outcome. SABCS Proc. 2008 (abstact 32). Chlebowski RT, Blackburn GL, Elashoff RM, et al. Mature analysis from the women’s intervention nutrition study (WINS) evaluating dietary fat reduction and breast cancer outcome. SABCS Proc. 2008 (abstact 32).
93.
go back to reference Chlebowski RT. Lifestyle change including dietary intervention and breast cancer outcome. J Nutr. 2007;137(1):233s–55.PubMed Chlebowski RT. Lifestyle change including dietary intervention and breast cancer outcome. J Nutr. 2007;137(1):233s–55.PubMed
94.
go back to reference Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention of metformin. N Engl J Med. 2002;346:393–406.CrossRef Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention of metformin. N Engl J Med. 2002;346:393–406.CrossRef
95.
go back to reference Lindstrom J, Ilanne-Parikka P, Peltonen M, et al. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet. 2006;368:1673–9.PubMedCrossRef Lindstrom J, Ilanne-Parikka P, Peltonen M, et al. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet. 2006;368:1673–9.PubMedCrossRef
Metadata
Title
Clinical Perspective: Influence of Modifiable Lifestyle Factors, Body Weight, Physical Activity, and Alcohol on Breast Cancer Outcome
Author
Rowan T. Chlebowski
Publication date
01-09-2012
Publisher
Current Science Inc.
Published in
Current Breast Cancer Reports / Issue 3/2012
Print ISSN: 1943-4588
Electronic ISSN: 1943-4596
DOI
https://doi.org/10.1007/s12609-012-0084-6

Other articles of this Issue 3/2012

Current Breast Cancer Reports 3/2012 Go to the issue

Invited Commentary

Is HER2 Through?

Risk, Prevention, and Screening (MC Liu, Section Editor)

Tamoxifen versus Raloxifene versus Exemestane for Chemoprevention

Risk, Prevention, and Screening (MC Liu, Section Editor)

Role of Mammography versus Magnetic Resonance Imaging for Breast Cancer Screening

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine