Posts Tagged ‘breast cancer risk’

Breast Cancer – Understanding Risk Factors & Preventing Recurrence

Joan Giblin, Winship Cancer Institute

Joan Giblin, Survivorship Program Director, Winship Cancer Institute

Author: Joan Giblin, NP, Director of Survivorship, Winship Cancer Institute of Emory University.

Substantial research conducted over the last few decades demonstrates that being overweight at the time of a breast cancer diagnosis may result in less favorable outcomes. This information—coupled with the fact that many women are indeed overweight at the time of their breast cancer diagnosis and additional weight gain during treatment is frequently reported—means that for a woman diagnosed with breast cancer, achieving or maintaining a desirable weight may be one of the most important lifestyle pursuits they can make in the interest of their overall health and wellness.

Much of the research around breast cancer has supported the theory that excess weight at the time of diagnosis can lead to a worse prognosis. Recently, analyses conducted on a group of nonsmoking breast cancer survivors corroborated these findings. According to the study’s findings, women who increased their body mass index (BMI) by 0.5 to 2 units were found to have a 40% greater chance of breast cancer recurrence, and those who gained more than 2 BMI units had a 53% greater chance of recurrence. Data suggests that being overweight or obese adversely influences not only cancer-specific outcomes, but also overall health and quality of life. As a result, weight management is now considered a priority standard of care for overweight women diagnosed with early stage breast cancer.

Research around breast cancer also suggests that the weight gain experienced by women who have undergone chemotherapy or hormone treatments seems to be the result of increased tissue mass, with no change or a decrease in lean body mass. This unfavorable shift in body composition suggests that steps should be taken to not only curb weight gain during treatment, but also to preserve or rebuild muscle mass. Moderate physical activity (especially resistance training) during and after breast cancer treatment may help survivors maintain lean muscle mass while avoiding the accumulation of excess body fat.

Additional research is currently under way to evaluate the effects of dietary patterns on cancer-specific outcomes, as well as overall health. One observational study found that dietary pattern was important for overall survival among breast cancer patients, with those who ate a Western diet having poorer overall survival and those who ate a dietary pattern characterized by high amounts of fruits, vegetables, and whole grains having better survival rates overall. Furthermore, this theory is supported by data on breast cancer survivors participating in the Nurses’ Health Study. Participants were followed for nearly 10 years post-diagnosis, and study findings suggest that those who consume a healthy diet, with higher intakes of fruits, vegetables, and whole grains and lower intakes of added sugar, refined grains, and animal products, may not have had significantly lower rates of recurrence or cancer-specific mortality.

A topic of controversy as it relates to breast cancer risk and prognosis is alcohol consumption. Alcohol is an unusual factor, as it presents both risks and benefits to those with breast cancer. In the general population, clear and consistent evidence links moderate alcohol intake (1-2 drinks per day) with a lower risk of cardiovascular disease. For breast cancer survivors, however, the decision to drink alcoholic beverages at moderate levels is complex because they must consider their levels of risk for recurrent or second primary breast cancer as well as cardiovascular disease. See our post on the relationship between alcohol and breast cancer for more information.

It is important to remember that lifestyle, nutrition and physical activity recommendations to reduce the risks of a second primary breast cancer and heart disease are especially important for breast cancer survivors. Diet for those at high risk for breast cancer or with a breast cancer diagnosis should emphasize vegetables and fruits, have low amounts of saturated fats, and include sufficient dietary fiber. Most importantly, breast cancer patients and survivors should strive to achieve and maintain a healthy weight through eating a well-balanced diet and regular exercise. In addition, regular physical activity should be maintained regardless of any weight-related concerns.

Table 1. American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention and Cancer Survivorship.
Achieve and maintain a healthy weight.
• If overweight or obese, limit consumption of high-calorie foods and beverages and increase physical activity to promote weight loss. Engage in regular physical activity.
Engage in regular physical activity.
• Avoid inactivity and return to normal daily activities as soon as possible following diagnosis.
• Aim to exercise at least 150 minutes per week.
• Include strength training exercises at least 2 days per week.
Achieve a dietary pattern that is high in vegetables, fruits, and whole grains.
• Follow the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention.

 

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Dr. Styblo Follows Up with Answers to Breast Cancer Questions

We held a chat on the topic of breast cancer with Dr. Toncred Styblo in October. From that chat, we got lots of great questions and feedback and even a couple questions we couldn’t get to in the chat’s allotted time. Dr. Styblo has taken the time to answer those questions for this follow up blog post, mostly covering questions related to ductal carcinoma in situ (DCIS), a type of breast cancer typically found in the lining of the milk ducts that has not yet invaded nearby tissues.

Below are the questions Dr. Styblo has covered in this post:

  • How long does one continue to follow up with oncologist and surgeon after DCIS diagnosis and resultant mastectomy?
  • What is the risk of recurrence in other breast after DCIS and mastectomy?
  • Does that include blood work for Ca27-29, and how often?
  • I’m interested in risk of recurrence after DCIS diagnosis. If you continue to follow your patients for life (which Dr. Styblo mentioned in the chat that she does), that suggests a moderate risk for recurrence.]
  • What would you suggest in the case of multifocal DCIS?

Answers from Dr. Styblo:

Toncred Marya Styblo, M.D.DCIS, intraductal cancer and in situ ductal cancer are names for stage “0″ breast cancer. Stage 0 breast cancer is cured by removing it completely with surgery, but does not have any affect on the risk of developing a second breast cancer in that breast or the other breast.

The surgery to remove the cancer may be a lumpectomy or it might be a mastectomy.  This risk of a patient developing another breast cancer post-surgery is dependent on many factors and the risk is best assessed by your doctor.  The subsequent follow up and recommendations about screening and risk reduction will be dependent on additional factors including the pathologic features of the DCIS and the patient’s risk of developing a second breast cancer.

Because DCIS is stage 0 breast cancer, follow up is primarily to screen for another breast cancer rather than recurrence.  The screening includes breast imaging and clinical exam, there are no blood tests indicated.


Dr. Styblo also received a question on the topic of support in the chat: What role, in your opinion does emotional support play in achieving the best possible outcome after breast cancer? Where or how do you recommend patients find advocates? The Winship Cancer Institute has several programs for survivors and support, including the Peer Partner Program which “matches cancer survivors and caregivers with cancer patients and caregivers dealing with a similar diagnosis of cancer, pre-cancerous condition, or benign tumor.”

Breast Health & Breast Cancer Related Resources:

 

 

Breast Cancer Questions? Dr. Styblo Has Your Answers

Breast Cancer Doctor Chat

Breast cancer is the second most common cancer affecting women. In fact, 13% of all women will develop breast cancer in their lives. Many women are concerned about their risk for breast cancer, and are unsure what their next steps should be. Our doctors frequently get questions such as, Is getting yearly check-ups sufficient? At what age should I start scheduling regular mammograms? What symptoms should I look out for?

Are you concerned about breast cancer? If you have unanswered questions related to breast cancer, look no further. To kick off October as Breast Cancer Awareness Month, surgical oncologist and breast surgeon at the Winship Cancer Institute, Dr. Toncred Styblo will be hosting a live 1-hour web chat to answer all of your breast cancer questions.

Wonder if you’re at high risk for developing breast cancer and what you should do? Dr. Styblo will provide guidance on how to determine if you are high risk and steps you can take if you are. And as an expert in surgical oncology, Dr. Styblo will also be able to answer questions related to breast cancer treatment and surgical options.

Don’t forget, early detection is key to providing the best chance for cure. So take action and control of your health by scheduling your mammogram today and remind a friend to do the same! And, make sure to sign up for Dr. Styblo’s breast cancer chat and bring your questions with you. We’ll see you on October 4th for what’s sure to be a great discussion!