Posts Tagged ‘breast cancer’

New Mammography Guidelines

mammogramAlthough the American Cancer Society (ACS) confirms that mammography saves lives, the organization issued new breast cancer screening guidelines on Oct. 20 that recommend women at average risk for breast cancer start getting annual mammograms at age 45. The previous recommendation was to start at age 40, and I will continue to recommend that women get yearly screening mammograms starting at age 40.

Evidence shows that the most lives are saved when screening starts at age 40. Although breast cancer is a little less common in women aged 40 to 44, this group receives the same life-saving benefit from screening mammography that older women do. As a radiologist specializing in breast cancer detection and diagnosis, I see this first-hand. My colleagues in the American College of Radiology agree and are also continuing to recommend that yearly screenings begin at age 40.

The new ACS guidelines note that the “harms” associated with screening may outweigh the benefits in women age 40-44. It is vital that women compare the magnitude and implication of the harms versus benefits associated with screening mammography. The harms they identify are about getting false positive readings from mammograms that can result in women being called back in for more imaging or an ultrasound. About 10% of women are recalled for these additional tests and the vast majority are cleared at that point. About 1 – 2% of patients who are recalled receive a needle biopsy using local anesthetic.

The benefits include saving lives and finding cancers smaller and earlier so that less aggressive treatment is required. I believe most women will agree that the drawbacks pale in comparison to the benefits of screening, and will choose to proceed with yearly screening. In fact, the ACS declares that yearly screening is beneficial and something that the majority of women would want, as long as they are healthy and have a 10 year or longer life expectancy. It is vital that we preserve a woman’s access to this life-saving technology so that she may choose to screen.


About Dr. Newell

Newell_MaryMary S. Newell, MD, began practicing with Emory Healthcare in 2001 where she is a board certified radiologist specializing in breast cancer imaging and diagnosis. Dr. Newell has interests in emerging imaging technologies, teaching, and healthcare policy.

Dr. Newell chairs the American Board of Radiology Maintenance of Certification (MOC) Breast Committee and the American College of Radiology Joint Practice Guidelines and Technical Standards and Appropriateness Committee on Criteria. She is Head of Curriculum Assessment for the Society of Breast Imaging and Special Consulting Editor for CME for the American Journal of Roentgenology. She also serves as the treasurer for the Georgia Radiologicial Society, is a councilor to the American college of radiology representing the state of Georgia, and serves on numerous committees institutionally and nationally.

Dr. Newell earned her medical degree from the University of Michigan Medical School. She then completed her residency in diagnostic radiology and fellowship in body imaging at the St. Francis Hospital in Illinois. Dr. Newell’s research focuses on discovery and evaluation of new imaging modalities for future use in breast cancer screening and detection.

Life After Breast Cancer

supportive-friendsBreast cancer is the most frequently diagnosed cancer in women according to the American Cancer Society. This year alone, more than 234,000 cases of invasive breast cancer will be diagnosed in the United States. Most women with breast cancer do quite well and have long lives after completing treatment. One of the hardest things for survivors is living with the worry that the cancer may come back. We recommend scheduling regular follow-up appointments with an oncologist and following the screening and/or prevention guidelines that your provider recommends. I also tell my patients to try, as best as they can, not to worry.

It is easy to see how breast surgery, radiation, and some of the side effects from systemic therapy (which, depending on treatment, can include hair loss, nausea, fatigue, weight gain, hot flashes, joint aches, or other unpleasant symptoms) can wreak havoc on a woman’s self esteem. In addition, many women are used to serving as a support system for their spouse, children, parents, or other loved ones; and to being responsible for important matters at work and at home. Learning to accept help and support rather than giving it can be very challenging. I always recommend honest conversations with family and loved ones, and involving a social worker, psychologist, or psychiatrist if patients are interested and willing to pursue this. Sometimes it can be helpful to talk with someone outside of one’s immediate network of family and friends to try to sort through some of the feelings surrounding the diagnosis and treatment of breast cancer. Support groups can also be helpful; hearing from others who are going through the same thing (perhaps at similar points in life and/or stages of the disease), can help normalize the experience.

Physical changes to the breast – scars from lumpectomy or mastectomy, getting used to the look and feel of reconstructed breasts (if this approach is chosen), and radiation-related changes – can make women less comfortable with their bodies and therefore less comfortable being intimate. These changes can also make them worry about whether a partner will still find them attractive. In addition, some of the systemic treatments used in breast cancer, such as chemotherapy or anti-estrogen therapy, can change hormone levels and decrease interest in intimacy. I always recommend sharing these concerns with your doctor or health care team. Talking with a social worker, psychologist, or even sex therapist can be helpful in dealing with some of the complicated feelings surrounding the look and feel of the breasts after treatment for breast cancer. There are also a number of options for managing symptoms like vaginal dryness, which can be a result of chemotherapy or anti-estrogen therapy and can make intimacy uncomfortable. Finally, open communication with significant others is critical, as they too may be struggling to find the best way to show affection in this new situation. I have actually seen many situations where the diagnosis of breast cancer actually brings couples closer together, as they navigate the path from diagnosis to treatment and finally to recovery together.

About Dr. Meisel

jane lowe meiselJane Lowe Meisel, MD, joined the Glenn Family Breast Center at Winship Cancer Institute as a practicing physician in January 2015. Prior to her arrival, she was Chief Fellow at Memorial Sloan Kettering Cancer Center in New York. Dr. Meisel is a medical oncologist with a special interest in women’s health and in cancers that affect women, including breast, cervical, endometrial, and ovarian cancers. Her goal is to provide exceptional, state-of-the-art individualized care to patients fighting these diseases and to conduct research that improves treatment options for these patients.


Exercise, Diet and Breast Cancer
Take-Aways from Breast Cancer Chat with Heather Pinkerton, BSN
Advancements in Imaging for Early Breast Cancer Detection
Latest in Breast Cancer Research
Breast cancer care at Winship
Social services at Winship
Support groups at Winship

Exercise, Diet and Breast Cancer

trio-exercisingDiet and exercise can help women who have completed treatment for breast cancer to live longer and feel better. They may even help lower the chance of the cancer coming back (recurrence). The Women’s Intervention Nutrition Study (WINS) was a randomized study of a low fat diet in women who had completed treatment for early stage breast cancer. At five years, the women on the low fat diet lost weight about six pounds on average (the control group didn’t lose weight) and had a lower risk of the cancer coming back or getting a new breast cancer than the control group. After longer follow up, the risk of recurrence evened out between the two groups, but the women in the low fat diet group had better survival. Observational studies have also found that women who exercised more had lower risks of the cancer coming back. These kinds of studies have also found that women who gain weight after diagnosis have a higher risk of the cancer coming back. Diet and exercise are key to preventing weight gain.

Women who are obese have an increased risk of post-menopausal breast cancer compared with women who maintain a healthy weight, which means that those who maintain a healthy weight have a lower risk (of getting breast cancer after menopause) than those who do not. Studies have shown that moderate to vigorous exercise is linked to a lower risk of breast cancer. This may be in part due to effects on body composition, as well as hormone levels. Exercise can improve fatigue and other symptoms in women with breast cancer in active treatment, as well as maintain their physical function and prevent changes in body composition (like weight gain) that can result from treatment. Women in treatment may have to cut back on their exercise routine for a time (exercise at a lower intensity or for shorter periods) due to side effects of treatment, but it is helpful for them to try to stay active.

So how much exercise is enough? The American Cancer Society recommends that healthy adults engage in at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week. Moderate activities may include walking, dancing, leisurely bicycling, and yoga, while vigorous activities may include jogging or running, fast bicycling, circuit weight training, swimming, jumping rope, aerobic dance, and martial arts.

About Dr. Kramer:

jkramerJoan Kramer, MD, is an assistant professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine. Dr. Kramer graduated cum laude receiving her Medical Degree from Saint Louis University in Saint Louis, Missouri. She completed her postdoctoral training with a residency in internal medicine at Saint Louis University Hospital and a fellowship in hematology and medical oncology at University of Texas Health Science Center at San Antonio in San Antonio, Texas. Dr. Kramer served as Medical Editor for the American Cancer Society until May 2015. She is published in a number of peer-reviewed journals.


Take-Aways from Breast Cancer Chat with Heather Pinkerton, BSN
Advancements in Imaging for Early Breast Cancer Detection
Latest in Breast Cancer Research
Breast cancer care at Winship
Social services at Winship
Support groups at Winship

Takeaways from Dr. Cohen’s “Advancements in Breast Imaging” Live Chat

Thank you to everyone who joined us for last week’s live web chat on “Advancements in Imaging for Early Breast Cancer Detection.” Dr. Michael Cohen, director, Division of Breast Imaging for Emory’s Department of Radiology, discussed the latest in breast imaging screening and technology.

Questions varied from ,“What are the current breast screening guidelines?” to “What is tomosynthesis and when is it the right choice for screening?” Below are just a few of the questions and answers from the chat. Make sure to view the chat transcript for the whole discussion.

Question: What are the current breast cancer screening guidelines?

Michael Cohen, MDAnswer:
Women aged 40 and younger should have a clinical breast exam at least every 3 years. All women aged 40 and over should get a yearly screening mammogram, clinical breast exam and perform a monthly breast self-examination.


When is breast tomosynthesis the right choice for screening? And how does tomosynthesis compare to an MRI in diagnosing cancer?

Michael Cohen, MDAnswer:
Digital Tomosynthesis (3D mammography) is an improvement on traditional 2D mammography. Rather than the traditional single view of a breast in 2D mammography, 3D mammography obtains a series of very thin 1 mm sections of the breast. This allows us to look at the breast as if we were viewing pages of a book and gives a much more accurate look inside. If tomosynthesis is available at your breast imaging facility, it is an excellent way to screen.

Studies have shown that 3D mammography permits detections of more cancers, while at the same time reducing the number of unnecessary call-backs to evaluate lesions that are not cancer. This is a win-win for the patient. MRI screening is reserved for a limited number of patients at high risk.

What about the radiation exposure for these types of test [tomosynthesis]; is it different from traditional mammograms?

Michael Cohen, MDAnswer:
With current technology, a patient receives both a 2D and a 3D mammogram at the same time. The addition of 3D about doubles the radiation exposure compared to 2D alone, but is still within FDA guidelines for mammography.

Also, some very exciting technology is on the horizon that will permit us to create a 2D mammogram from a 3D mammogram using sophisticated computers. When that becomes available, we will only need to do a 3D mammogram, thereby reducing the radiation exposure to the original level.

If you missed this informative chat with Dr. Cohen, be sure to check out the full list of questions and answers on the web transcript.

If you have any questions for Dr. Cohen, don’t hesitate to leave a comment in our comments area below!

Latest in Breast Cancer Research

According to the National Breast Cancer Foundation, 10%-20% of diagnosed breast cancers are determined to be triple negative breast cancer. It tends to primarily affect younger, premenopausal women and is more aggressive than other types of breast cancer. Studies show that African-American and Hispanic women are more likely to be diagnosed with triple negative breast cancer than white women. Triple negative breast cancers don’t have the three types of receptors that most commonly fuel breast cancer growth — estrogen, progesterone and the HER2 gene — so they don’t respond to hormonal therapies and treatments that target those receptors. Chemotherapy is typically used for treatment, but there is an urgent need to find more precise therapies.

LaTonia Taliaferro-Smith, PhD, is one of the Winship Cancer Institute of Emory University’s scientists who have taken up the challenge to develop more targeted therapies. In her lab research, Taliaferro-Smith searches for alternative targets in the triple negative breast cancer cell. She works closely with Winship physician-researchers toward the goal of developing drugs that will benefit patients with this disease.

“I’m very hopeful about the research we’re doing here and what Winship is offering to triple negative breast cancer patients,” says Taliaferro-Smith. “Oftentimes when patients hear a triple negative diagnosis, they think there are no options and ultimately their endpoint is death. But we’re very encouraged here at Winship because we do have active research that is trying to find alternative therapies for these particular patients, so we can let them know that you will have treatment options available hopefully in the near future.”

Check out the video below as Dr. Taliaferro- Smith discusses the continuous work research teams at Winship are doing to develop more precise treatment therapies for triple negative breast cancer:

Related Resources

Learn more about breast cancer care at Winship at Emory. October is Breast Cancer Awareness Month and our breast care teams want you to know that early detection is key to survival. Have questions about the role of screening in early breast cancer detection? Join us for a live web chat with a breast imaging expert on October 21, 204.

Advancements in Imaging for Early Breast Cancer Detection

Advancements in Breast Imaging ChatBreast cancer is the most common cancer among American women, according to the Centers for Disease Control and Prevention (CDC). October is Breast Cancer Awareness month and the breast care specialists across Emory Healthcare want you to know the importance of screening and early detection.

The American Cancer Society recommends that women (without breast cancer symptoms), age 40 and older should have a mammogram every year as long as they are in good health. Getting yearly screening mammograms increases the chance of detecting cancers in the early stages, before they start to cause symptoms. By detecting cancer early, screening exams also help increase the chance of survival and lower the risk of mortality.

At Emory Healthcare, we are proud to offer patients with leading breast screening techniques, including the latest in breast imaging technology, called tomosynthesis, or 3D mammography.

Learn more about breast screening guidelines and advancements in breast imaging by joining us on Tuesday, October 21 at 12:00 pm EST for a live web chat on “Advancements in Imaging for Early Breast Cancer Detection.” Dr. Michael Cohen, Director, Division of Breast Imaging for Emory’s Department of Radiology, will be available to answer questions such as: what is the latest in breast imaging technology? When should I start getting screened? To register for the chat, click here.

Also, during October, the Emory Breast Imaging Centers are offering extended and weekend hours for women needing a screening mammogram. Dates and details are below:

Extended Hours: Thursday, October 9, Tuesday, October 21, Thrusday October 23; 7:30 a.m – 7:00 p.m. at the Emory Breast Imaging Center on Clifton Road.

Saturday Hours: October 18, 8 a.m. – 2 p.m. at Emory University Hospital Midtown.

Registration: To schedule an appointment, call 404-778-PINK (7465). Standard rates apply.

Chat Details:

Date: Tuesday, October 21, 2014
Time: 12:00- 1:00 pm EST
Chat Leader: Dr. Michael Cohen
Chat Topic: Advancements in Imaging for Early Breast Cancer Detection

Chat Sign Up

Survivor Story: Debbie Church’s Battle with Breast Cancer

Debbie Church

Debbie Church is Coordinator of the Cancer Survivors’ Network and Patient Navigator at Saint Joseph’s Hospital and a 5-year breast cancer survivor. Debbie has shared her story through the journey of survivorship below. We’re lucky to have Debbie and Saint Joseph’s Hospital as part of the Emory Healthcare family and we thank her for sharing her story. We hope our readers and community members are as inspired by her story as we are!

“Dick and I fell in love over 32 years ago and have never quite gotten over it! We have had some interesting moments, but we have made it through each challenge. Love always finds a way. Unexpectedly, our lives changed in an instant when I was diagnosed with breast cancer in December of 2008. We knew life would never be the same. Life is like that box of chocolates – you never know what you’re going to get.”

Read more of Debbie’s story on the Saint Joseph’s Hospital blog >>

About Debbie Church, BA
Debbie Church, BA in Psychology and History, Salem College, and a M.Div. from Southeastern Seminary Wake Forest and a Certified Cancer Services Navigator has worked in oncology for over 20 years. She is currently employed at St. Joseph’s Hospital of Atlanta as Coordinator of the Cancer Survivors’ Network and Patient Navigator. She has worked also as Director of Support Services and Chaplain at Northwest Georgia Oncology Centers, Atlanta Medical Center and various hospitals in the Southeast. She has spoken at many cancer events including GASCO Conferences here in Atlanta and other hospice and oncology centers in the southeast. She was a contributing author for Thomas Nelson’s Women’s Study Bible as well as publishing a book in 2010 with her husband, Don’t’ Ever Look Down; Surviving Cancer Together.

Chronic Pain Lingers For Some Postoperative Breast Cancer Patients

Chronic Neuropathic Pain Postoperative Breast Cancer

Different surgical procedures come with varying levels of risk for post-surgical pain during the healing process. Regardless of the surgery type, postoperative pain is not uncommon. For women who undergo surgery to treat breast cancer, however, postoperative pain and/or numbness can greatly affect a patient’s quality of life. This pain, which can be encountered after a mastectomy, is characterized by a constant, achy, stinging, burning sensation around the surgical area near the chest or underarms.

 Before having surgery to remove cancerous breast tumors, women typically undergo what’s called a sentinel lymph node biopsy. Sentinel lymph nodes, as described by the National Cancer Institute are, “the first lymph node(s) to which cancer cells are most likely to spread from a primary tumor.” Chronic underarm pain after surgery (as opposed to chest pain) is more common among women who have had their lymph nodes removed rather than a sentinel lymph node biopsy alone.

Often, chronic pain among breast cancer patients is related to nerve damage that occurs via surgical and/or radiation treatment. Although the painful side effects from surgery typically subside in 3 months for most women, some women experience pain for months or even years after treatment.

To ease the recovery process after surgery, physicians often treat patients with postoperative pain with a multi-modal approach including physical therapy, anti-inflammatory medications, neuropathic pain medications, and sometimes narcotics. Alternative techniques such as massage and acupuncture can also help reduce pain and tenderness for some patients.

Interventional Pain Physicians can also help to reduce this pain via injections, including thoracic epidurals and intercostal nerve blocks. Both of these involve placing local anesthetic and steroid around the nerves, which stabilizes cell membranes and decreases inflammation and swelling. Doing so helps to decrease ectopic neural discharge and thus provide pain relief.

About Josephine Clingan MD, Physician Pain Specialists at Saint Joseph’s Hospital:
After attending MCG Medical School, Dr. Clingan completed  both her residency in Anesthesiology, and her fellowship in Interventional Pain Management at St. Lukes-Roosevelt Hospital in New York City.
She joined Physician Pain Specialists, at Saint Joseph’s Hospital, in 2011 and loves her patients!

Related Resources:

We Are Winship – Survive and Thrive

Shawn Ware felt a small lump in her breast while in the shower on January 2nd, 2009, and on that day, the journey on the fight against breast cancer began for Shawn, her husband Albert, daughter Demitria, son Jalen, and mother Eva Freeman. As part of her treatment plan, Shawn underwent a lumpectomy and additional treatment with radiation therapy and chemotherapy.

Shawn Ware, breast cancer survivor

Shawn Ware

“You know those side effects that you see in fine print? I had all those and more,” she says, somehow able to laugh about them now. “I didn’t know that your eyelashes act as windshield wipers, and when I lost mine, I had to wear glasses just to keep things from getting in my eyes.”

Shawn triumphed. “I was ready to conquer the world after my last round of radiation,” she says. And three years later, she is considered a survivor and a reason for celebration.

“Cancer, it stinks,” says Shawn, the general manager of Blomeyer Health Fitness Center at Emory. “But you do change. You certainly learn to appreciate the good and not let the little things bother you any more.”

Like millions of other Americans, Shawn is part of a growing trend—more people than ever are surviving cancer. In just six years, the number of cancer survivors has jumped by almost 20 percent, according to the Centers for Disease Control and Prevention and the National Cancer Institute—11.7 million in 2007, up from 9.8 million in 2001, the most recent years available.

The good news comes with some challenges, however. As cancer treatment has become more successful, survivors —and their caregivers and providers—have learned that there is a cost to surviving.

“Long-term survivorship starts on the day treatment ends,” says nurse practitioner Joan Giblin, the director of Winship’s new Survivorship Program. “You’re actively doing something during treatment, but when treatment ends, many patients tell us they feel like they have been set adrift without a clear course. Our survivorship program is trying to bridge that gap and provide survivors with tools for these difficult times.”

Giblin says that some survivors respond by isolating themselves. Still others “jump right back into their old lives or try to adjust to a new life by adapting to any after-effects they may still be experiencing.”

Survivors of all types of cancer can face myriad physical issues. Treatment itself can be so hard on the body that survivors sometimes suffer chronic pain, heart problems, depression, sexual dysfunction, and a mental fogginess dubbed “chemo brain.” They also are at heightened risk for recurrence and secondary cancers.

Physical problems arise within individual cancer groups. For example, head and neck cancer patients often have trouble swallowing and lose their sense of taste. Breast cancer patients must deal with the changes that come as a result of a lumpectomy or mastectomy and reconstruction.

In addition, family and relationship problems may arise as all in a survivor’s relationship network struggle to adjust to cancer and life after cancer.  Emotional challenges abound, from sadness, fear, and anger to serious depression. Fatigue is common.

Winship Cancer Institute is helping survivors deal not only with the late physical effects of cancer but also with the psychological and social issues that are part of surviving.

“We are now defining a ‘new normal’ for these patients,” says Giblin. “There can be long-term after-effects when treated for cancer, and we are finding ways to improve their quality of life while providing guidance on strategies for dealing with these after-effects.”

The Winship Survivorship Program officially started in November, 2011. Already more than 10 Winship survivorship “clinics” are being offered, focusing on survivors of 10 different cancer categories. The program holds workshops on such vital topics as nutrition, preventing lymphedema, how to talk to children about cancer, spirituality and pet therapy. Workshops have been held on sexuality and also on fatigue. In May, Winship announced its collaboration with the YMCA of Metro Atlanta for a special exercise program for cancer survivors. A unique collaboration, Winship at the Y was Giblin’s brainchild. She is at the hub of a very extensive interdisciplinary wheel that involves specialists from a wide range of treatment areas, including nutrition, pain management, and psychiatry to help survivors thrive.

“We have to change how we look at cancer patients,” Giblin says. “Many cancers are not curable in a conventional sense, but the improvement in the quality and quantity of life needs to be our priority. Much as we view diabetes as a chronic condition, we must look at many cancers in the same way.”

Head and neck cancer survivor Barry Elson, 70, had difficulty swallowing after his treatment. Barry, who was first diagnosed in 2003, had an esophageal dilation last year to improve his ability to swallow.

“I think in the press of your day-to-day survivorship, you forget to ask what (the treatment) might do to your long-term quality of life,” Barry says.

Shawn found that exercise has not only helped her gain physical strength but also has helped her mental outlook. Shawn was able to exercise throughout most of her treatment, even as ill as she was. Now, her worst worry is fatigue. But that doesn’t slow her down. In her job as fitness manager at Blomeyer, she conducts “boot camp” training sessions and teaches other classes.

Winship is also helping survivors thrive by providing support services to help survivors cope with employment and insurance issues that arise as a result of their cancer.

“After treatment,” Giblin says, “patients tend to not be able to work as long, and they don’t have the stamina they used to have.” In addition, there can be stigma in the workplace against a cancer survivor, which in times of layoffs, can result in their loss of employment and consequently, loss of benefits.

“It’s the people who can’t afford to lose their jobs who do,” she says.

And even in cases where survivors keep their insurance benefits, they might find a lack of integrated care as they celebrate more birthdays.

Paper records are lost through the years, hospitals and oncology offices change and primary care physicians—who don’t have experience in oncology —aren’t prepared or educated to provide the ongoing care cancer survivors need.

Barry says he fared well—a result, in part, of diligent Winship physicians Amy Chen and Dong Moon Shin, and the nursing staff—including Giblin.

Despite the side effects she faced during treatment, Shawn says she has grown from her cancer experience.

It makes her a stronger survivor, she says, and also more hopeful, optimistic, and motivated.
“It’s almost motivated me to do more,” she says. “It really helps me to live day by day. You make every day everlasting.”

Original Article Source: Winship Magazine

Related Resources:

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.


Related Resources