Physical activity, diet, adiposity and female breast cancer prognosis: A review of the epidemiologic literature

Patterson, Ruth E.; Cadmus, Lisa; Emond, Jennifer A.; Pierce, John P.

doi:10.1016/j.maturitas.2010.01.004

Cited by 220 publications

(233 citation statements)

References 66 publications

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“…Because there are increasing numbers of breast cancer survivors [1], high quality of life and hence high physical activity levels become more and more important [2]. In addition, high physical activity levels are associated with 30% decreased risk of mortality after breast cancer [3].…”

Section: Introductionmentioning

confidence: 99%

Physical activity levels after treatment for breast cancer: one-year follow-up

Devoogdt

Kampen

Geraerts

et al. 2010

Breast Cancer Res Treat

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Among patients with breast cancer, few studies have examined the pattern of change of physical activity levels over time or the predictive factors for this change. Particularly sparse are studies comparing pre-surgical physical activity levels with those 12 months post-surgery.Patients with a primary operable breast cancer (N=267) filled in the Physical Activity Computerised Questionnaire before breast surgery and one, three, six and twelve months postoperatively. Patient-, disease-and treatment-related factors were prospectively collected.Total physical activity level and occupational, sport and household activity levels were significantly decreased the first month postoperatively and did not recover during the first year after surgery. 'Being employed' was a predictive factor for a larger decrease of the total activity level, comparing the pre-operative and 12 months post-surgery stages. Having a spouse, a pN2-3 lesion and over 20 lymph nodes dissected predicted a decrease in occupational activity. Advanced age and smoking behaviour predicted a decrease in sport activities, and not having a spouse predicted a decrease in household activities.This study showed that one year after breast cancer surgery, preoperative physical activity levels were not recovered. Breast cancer patients, and in particular those at risk for a decreased physical activity level, should be identified, encouraged and guided to increase their activities.

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Section: Introductionmentioning

confidence: 99%

Physical activity levels after treatment for breast cancer: one-year follow-up

Devoogdt

Kampen

Geraerts

et al. 2010

Breast Cancer Res Treat

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“…3,33 One study involving 1893 women showed that high intake of high-fat dairy products (> 1 serving daily) was significantly more detrimental than an intake of less than 0.5 servings daily (HR 1.49, 95% CI 1.00-2.24). Low-fat dairy products were not associated with an increased risk of death related to breast cancer.…”

Section: Fatsmentioning

confidence: 99%

Lifestyle modifications for patients with breast cancer to improve prognosis and optimize overall health

Hamer

Warner

2017

CMAJ

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A lthough more than 90% of patients with breast cancer have early stage disease at diagnosis, about 25% will eventually die of distant metastasis.1 Many patients with breast cancer seek information from a variety of sources about behaviours that may reduce their risk of recurrence.2 Making positive lifestyle changes can also be psychologically beneficial to patients by empowering them, since the feeling of loss of control is one of biggest challenges of a cancer diagnosis.In this review, we identify which lifestyle changes can be recommended to patients as an adjunct to standard breast cancer treatments, to reduce their risk of distant recurrence and death. We review the role of lifestyle factors, particularly weight management, exercise, diet, smoking, alcohol intake and vitamin supplementation, on the prognosis of patients with breast cancer. Our literature search is summarized in Box 1.It is challenging to study lifestyle factors independently, because patients who are more physically active often are leaner, eat a healthier diet and are typically less likely to drink excessive amounts of alcohol or smoke; however, many studies try to adjust for these confounders.3 Another limitation is the potential impact of lifestyle factors before diagnosis. 4 Regrettably, but understandably, we found very few randomized trials. How does body weight influence the prognosis for breast cancer?Women who gain weight during or after treatment of breast cancer have been consistently shown to be at higher risk of breast cancer-related death.5-7 Also, women who are overweight or obese at the time of diagnosis have a poorer prognosis.8 Proposed mechanisms of how obesity might affect breast cancer mortality include a rise in circulating insulin-like growth factor, elevated circulating sex hormones and production of proinflammatory cytokines.9-12 Another possible mechanism is metabolic syndrome (presence of at least three of the following five components: abdominal obesity, hypertension, low level of highdensity lipoproteins, high plasma glucose level and high triglyceride levels). 13 In a recent study involving early stage breast cancer survivors, patients with metabolic syndrome were at significantly increased risk of distant metastasis (hazard ratio [HR] 2.45, 95% confidence interval [CI] 1.24-4.82) compared with those without the syndrome. 13Most patients with breast cancer gain weight both during and after active treatment, and much of the weight is never lost. The average reported weight gain is 2.5-5 kg, 5 but a gain of 10 kg or more is not uncommon.14 The reasons for weight gain are multifactorial and include "stress eating," reduced activity because of fatigue or other treatment-related adverse effects, lowered metabolic rate from chemotherapy, and use of pre-and post-chemotherapy medications such as dexamethasone.14 Weight gain is most common in women who experience treatment-related menopause and is often accompanied by relative fat gain and muscle loss. 15Several observational studies have shown that gaining weight dur...

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“…Patterson et al, basado en 2 estudios, el WINS (Women Intervention Nutrition Study) y el WHEL (Women's Healthy Eating and Living), concluye que la baja de peso, y no la dieta por sí sola, es la causante de la reducción en la incidencia de CM 54 . La pérdida de peso también está asociada con bajo riesgo de reflujo gastro-esofágico, un FR plausible para el desarrollo de adenocarcinoma del esófago 6 .…”

Section: Reducción De Peso Cáncer Y Obesidadunclassified