Healthy lifestyle impact on breast cancer-specific and all-cause mortality

Abstract

Purpose While several studies have evaluated the association of combined lifestyle factors on breast cancer-specific mortality, few have included Hispanic women. We constructed a “healthy behavior index” (HBI) and evaluated its associations with mortality in non-Hispanic White (NHW) and Hispanic women diagnosed with breast cancer from the southwestern U.S. Methods Diet and lifestyle questionnaires were analyzed for 837 women diagnosed with invasive breast cancer (1999–2004) in New Mexico as part of the 4-Corners Women’s Health Study. An HBI score ranging from 0 to 12 was based on dietary pattern, physical activity, smoking, alcohol consumption, and body size and shape, with increasing scores representing less healthy characteristics. Hazard ratios for mortality over 14 years of follow-up were estimated for HBI quartiles using Cox proportional hazards models adjusting for education and stratified by ethnicity and stage at diagnosis. Results A significant increasing trend was observed across HBI quartiles among all women, NHW women, and those diagnosed with localized or regional/distant stage of disease for all-cause (AC) mortality (p-trend = 0.006, 0.002, 0.03, respectively). AC mortality was increased >2-fold for all women and NHW women in HBI Q4 versus Q1 (HR = 2.18, 2.65, respectively). The association was stronger in women with regional/distant than localized stage of disease (HR = 2.62, 1.94, respectively). Associations for Hispanics or breast cancer-specific mortality were not significant. Conclusions These findings indicate the associations between the HBI and AC mortality, which appear to differ by ethnicity and stage at diagnosis. Interventions for breast cancer survivors should address the combination of lifestyle factors on prognosis.

Association between healthy lifestyle score and breast cancer

“…In the E3N cohort, adherence of postmenopausal women to a healthy lifestyle by following the recommendations for smoking, BMI, alcohol consumption, fruit and vegetable consumption, and PA, prevented BC by 6.3% [24]. However, an increased risk of breast cancer-specific mortality was found for individuals with healthy behavior index compared to those with a lower healthy lifestyle score, however, the results was not statistically significant [14]. Therefore, it seems that adherence to healthy lifestyle could be used as a good preventive measure to reduce BC.…”

“…Similarly, Sanchez-Zamorano et al concluded that healthy lifestyle was associated with a decreased risk of having BC [13]. However, some other studies failed to find any association [14]. It must be kept in mind that these studies were conducted in western countries and to our knowledge, no study was done in eastern countries, specifically Iran, investigating the healthy lifestyle factors in relation to risk of BC.…”

Impact of combined healthy lifestyle factors on survival in an adult general population and in high‐risk groups: prospective results from the Moli‐sani Study

“…All these previous cohort studies have estimated the contribution of a simultaneous adherence to healthy lifestyles in general population settings, with lack of further analysis among groups of individuals at different health risk, for which little evidence is available to date [6,13,14,[28][29][30].…”

High maternal milk intake in the postnatal life reduces the incidence of breast cancer during adulthood in rats

“…2 Dietary components contribute to the etiology of 30-50% of all breast cancers. 3,4 However, it is important to consider that in order to permanently modify breast cancer risk, the dietary exposures may need to take place at times when the mammary tissue is undergoing extensive modeling. Mammary glands begin to develop during the prenatal life, but continue their remodeling during postnatal life, puberty, pregnancy and lactation, becoming more susceptible to carcinogenesis and making the influence of nutrition more important during those stages.…”