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Energy-Related Indicators and Breast Cancer Risk among White and Black Women.

ABSTRACT: Energy-related indicators, including physical activity, energy intake, body mass index (BMI) and adult weight change, have been linked to breast cancer risk. Very few studies of these associations have been conducted among black women, therefore we used the Nashville Breast Health Study (NBHS) to determine whether similar effects were seen in black and white women. The NBHS is a population-based case-control study of breast cancer among women age 25 to 75 years conducted between 2001 and 2010 in and around the Nashville Metropolitan area. Telephone interviews and self-administered food frequency questionnaires were completed with 2,614 incident breast cancer cases ascertained through hospitals and the statewide cancer registry, and 2,306 controls selected using random digit dialing. Among premenopausal white and black women, there was little effect of adult exercise or other energy-related indicators on breast cancer risk, regardless of tumor estrogen receptor (ER) status. The beneficial effect of adult exercise on postmenopausal breast cancer appeared to be comparable between white and black women (highest tertile relative to none - white odds ratio [OR] 0.8, 95% confidence interval [CI] 0.6-1.0, p for trend=0.05; black OR 0.7, 95% CI 0.4-1.1, p for trend=0.07); however, among black women the reduction was limited to those with ER-positive disease. White and black women should be encouraged to engage in more physical activity to reduce their risk of postmenopausal breast cancer.

SUBMITTER: Sanderson M

PROVIDER: S-EPMC4416034 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Energy-Related Indicators and Breast Cancer Risk among White and Black Women.

Sanderson Maureen M Lipworth Loren L Shen-Miller David D Nechuta Sarah S Beeghly-Fadiel Alicia A Shrubsole Martha J MJ Zheng Wei W

PloS one 20150430 4

Energy-related indicators, including physical activity, energy intake, body mass index (BMI) and adult weight change, have been linked to breast cancer risk. Very few studies of these associations have been conducted among black women, therefore we used the Nashville Breast Health Study (NBHS) to determine whether similar effects were seen in black and white women. The NBHS is a population-based case-control study of breast cancer among women age 25 to 75 years conducted between 2001 and 2010 in ...[more]

PMID: 25927530

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Project description:INTRODUCTION:Although breast cancer incidence is higher among white women, black women are more likely to have aggressive tumors with less favorable histology, and to have a worse prognosis. Obesity and alcohol consumption have been identified as two modifiable risk factors for breast cancer, while physical activity may offer protection. Little however is known about the association of these factors with race on the severity of breast cancer. METHODS:Data collected as part of a large prospective study looking at insulin resistance and race among women with breast cancer was queried for patient characteristics, lifestyle factors and tumor characteristics. The association with Nottingham Prognostic Index (NPI) was assessed with different models using univariate and multivariate linear regression. RESULTS:Among 746 women in our cohort, 82% (n?=?615) were white and 18% (n?=?131) were black, mean age 58 years. Black patients were more likely to have high BMI (31.0 vs. 26.7, p?<?0.0001), comorbidities (69% vs 55%, p?=?0.01), self-reported poor diet (70% vs 42%, p?<?0.001), be sedentary (56% vs 46%, p?=?0.03) and were less likely to consume alcohol (8% vs 32%, p?<?0.0001) compared to white patients. Overall, 137 (18%) of the patients had poorer prognosis (NPI?>?4.4), which was significantly associated with younger age (55.6 vs 58.5 years, p?=?0.02), black race (27% vs 15%, p?=?0.001), triple negative cancer (15% vs 6%, p?=?0.003), and poor diet (54% vs 45%, p?=?0.046) compared to patients with better prognosis (NPI???4.4). On multivariate analysis, (model R2?=?0.12; p?<?0.001), age (??=?-0.011 per year, p?=?0.002), healthy diet (??=?-0.195, p?=?0.02), and exercise (??=?-0.004, p?=?0.02) were associated with better prognosis, while black race (??=?0.247, p?=?0.02) and triple negative cancer (??=?0.908, p?<?0.0001) were associated with poor prognosis. Neither alcohol use nor BMI was significantly associated with NPI. CONCLUSION:Among modifiable risk factors, diet and exercise are associated with NPI. Unmodifiable factors including race and biologic subtype remain the most important determinants of prognosis.

Project description:Lymphocyte and breast tissue samples from overweight woman at increased risk of breast cancer before and after 1 month of intermittant energy restriction Introduction Observational studies indicate that weight loss and energy restriction reduce breast cancer risk. Intermittent energy restriction (IER) reduces weight as well as, or more than continuous energy restriction (CER), but its effect on the breast and systemic metabolism as indicators of breast cancer risk are not known. Methods We assessed the effect of IER ( 2 days of 65% energy restriction) for one menstrual cycle on the breast (breast gene expression and fat cell size) and systemic metabolism (insulin resistance, lipids, serum and urine metabolites) in 23 overweight premenopausal women at high risk of breast cancer. Unsupervised hierarchical analysis selected 100 genes with the highest variance between pre and post IER biopsies in 20 subjects, whilst mass spectrometry was used to assess corresponding changes in serum (LCMS) and urine metabolites (GCMS) in 23 subjects in the restricted and unrestricted days of the IER. Results Women lost on average 4.8% (± 2.0) of body weight and 8.0% (± 5.0) of body fat. Insulin resistance (HOMA) was reduced by 29.8% (±17.8) on the restricted days and by 11%(±34) on the unrestricted days of the IER. Over 250 serum and urine metabolites significantly increased or decreased during the two restricted days and most returned to normal after the subsequent five day period . In the breast tissue, approximately half (In 11) of the subjects displayed down regulation of several metabolic pathways including lipid synthesis, growth factors and hormones, whilst epithelial genes including milk proteins, secretoglobulins and mucins were up-regulated and several metabolic pathways down-regulated including lipid synthesis, growth factors and hormones. In the other nine subjects there was no appreciable effect of IER on the breast. CorrespondingThe gene changes were not seen in peripheral blood lymphocytes, and there was no reduction in breast fat cell size. The two groups defined by change in gene expression or lack of it did not differ in the degree of weight or fat loss, other systemic metabolic markers, or histological assessment of the biopsies. Conclusion We conclude that breasts vary in response to short-term IER, the mechanism of which requires further investigation. Trial registration ISRCTN77916487

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Energy-Related Indicators and Breast Cancer Risk among White and Black Women.

Publications

Energy-Related Indicators and Breast Cancer Risk among White and Black Women.

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