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Teng YT, Wang YA, Dong YH, Liu JJ. Five-year survival prognosis of young, middle-aged, and elderly adult female invasive breast cancer patients by clinical and lifestyle characteristics. Breast Cancer Res Treat 2024; 205:619-631. [PMID: 38526687 PMCID: PMC11101574 DOI: 10.1007/s10549-024-07280-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/07/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE Early-onset breast cancer incidence has been increasing globally and in Taiwan. However, previous studies have not comprehensively examined how clinical and lifestyle characteristics influence the 5-year survival of breast cancer diagnosed at different stages of adulthood. METHODS We analyzed the Taiwan National Cancer Registry and Cause of Death datasets to understand how clinical factors (including tumor and treatment characteristics) and lifestyle factors (including body mass index, cigarette smoking, and alcohol consumption) were associated with the 5-year survival of 8471 young, 57,695 middle-aged, and 14,074 elderly female adult invasive breast cancer patients respectively diagnosed at age 20-39, 40-64, and ≥ 65 years between 2002 and 2015, with mortality follow-up to 2020. Poisson regression was used for obtaining the crude and adjusted 5-year survival risk ratios. RESULTS Clinical and lifestyle characteristics were distributed differently but had mostly similar direction of association with 5-year survival for the three age groups. Receiving any treatment was associated with better survival, especially for elderly patients. Being underweight at initial cancer treatment was associated with worse survival than having normal weight, especially for elderly patients. Current smokers had worse survival than never smokers for middle-aged and elderly patients. The 5-year breast cancer-specific survival was not significantly higher for those of age 45-49 years than 40-44 years, despite the recommended starting screening age is 45 years in Taiwan. CONCLUSION Our findings contribute to the understanding of early-onset and later-onset female breast cancer characteristics and prognosis, which may inform surveillance and treatment strategies to achieve better breast cancer prognosis.
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Affiliation(s)
- Yu-Tung Teng
- Institute of Public Health, National Yang Ming Chiao Tung University, No.155, Sec. 2, Linong St., Beitou District, Taipei, 112, Taiwan
| | - Yong Alison Wang
- Koo Foundation Sun-Yat Sen Cancer Center, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yaa-Hui Dong
- Institute of Public Health, National Yang Ming Chiao Tung University, No.155, Sec. 2, Linong St., Beitou District, Taipei, 112, Taiwan
- Department of Pharmacy, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jason J Liu
- Institute of Public Health, National Yang Ming Chiao Tung University, No.155, Sec. 2, Linong St., Beitou District, Taipei, 112, Taiwan.
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2
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Fabi A, Rossi A, Mocini E, Cardinali L, Bonavolontà V, Cenci C, Magno S, Barberi V, Moretti A, Besharat ZM, Iolascon G, Baldari C, Ferretti E, Botticelli A, Paris I, Scambia G, Migliaccio S. An Integrated Care Approach to Improve Well-Being in Breast Cancer Patients. Curr Oncol Rep 2024; 26:346-358. [PMID: 38400984 PMCID: PMC11021235 DOI: 10.1007/s11912-024-01500-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Breast cancer (BC) treatment has recently been revolutionized by the introduction of newer targeted agents, that helped tailoring therapies around the single patient. Along with increased survival rates, a careful evaluation of diet, lifestyle habits, physical activity, emotional and psychological experiences linked to the treatment journey, is now mandatory. However, a true proposal for an omnicomprehensive and "integrative" approach is still lacking in literature. METHODS A scientific board of internationally recognized specialists throughout different disciplines designed a shared proposal of holistic approach for BC patients. RESULTS A narrative review, containing information on BC treatment, endocrinological and diet aspects, physical activity, rehabilitation, integrative medicine, and digital narrative medicine, was developed. CONCLUSIONS In the context of a patient-centered care, BC treatment cannot be separated from a patient's long-term follow-up and care, and an organized interdisciplinary collaboration is the future in this disease's cure, to make sure that our patients will live longer and better. TRIAL REGISTRATION NCT05893368: New Model for Integrating Person-based Care (PbC) in the Treatment of Advanced HER2-negative Breast Cancer (PERGIQUAL). Registration date: 29th May 2023.
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Affiliation(s)
- Alessandra Fabi
- Precision Medicine Unit in Senology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
| | - Alessandro Rossi
- Precision Medicine Unit in Senology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
- Department of Movement, Human and Health Sciences, University Foro Italico of Rome, Rome, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
| | - Ludovica Cardinali
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
- Bone Metabolic Diseases Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Valerio Bonavolontà
- Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy
| | | | - Stefano Magno
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vittoria Barberi
- Medical Oncology 1, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Antimo Moretti
- Multidisciplinary Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Giovanni Iolascon
- Multidisciplinary Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Carlo Baldari
- Department of Theoretical and Applied Sciences, eCampus University, Rome, Italy
| | - Elisabetta Ferretti
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
| | - Andrea Botticelli
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Ida Paris
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Scambia
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, University Foro Italico of Rome, Rome, Italy
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
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3
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Moral R, Kapravelou G, Cubedo M, Solanas M, Escrich E. Body weight gain and control: beneficial effect of extra virgin olive oil versus corn oil in an experimental model of mammary cancer. J Nutr Biochem 2024; 125:109549. [PMID: 38104866 DOI: 10.1016/j.jnutbio.2023.109549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/02/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023]
Abstract
Obesity is a known risk factor for breast cancer, the most common malignancy among women worldwide. We have previously described different effects of high-fat diets on mammary experimental carcinogenesis. In this work, we analyzed the animal growth data obtained in six experimental assays, in healthy and carcinogen-induced rats undergoing different dietary interventions. The animals were fed with three experimental diets administered at different periods of development: a control low-fat diet, and two isocaloric high-fat diets (rich in corn oil or in extravirgin olive oil -EVOO-). Weekly weight throughout the development of 818 animals have been compiled and reanalyzed using adjusted mathematical models. Molecular mechanisms have been investigated: ethanolamides in small intestine, neuropeptides controlling satiety in hypothalamus, and proteins controlling lipid metabolism in adipose and mammary tissues. The results indicated that the effect of diets depended on type of lipid, timing of intervention and health status. The high corn oil diet, but not the high EVOO diet, increased body weight and mass, especially if administered from weaning, in healthy animals and in those that received a moderate dose of carcinogen. The potential protective effect of EVOO on weight maintenance may be related to anorexigenic neuropeptides such as oxytocin and lipolysis/deposition balance in adipose tissue (increasing phospho-PKA, HSL, MGL and decreasing FAS). In animals with cancer, body weight gain was related to the severity of the disease. Taken together, our results suggest that EVOO has a beneficial effect on body weight maintenance in both health and cancer.
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Affiliation(s)
- Raquel Moral
- Department of Cell Biology, Physiology and Immunology, Physiology Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.
| | - Garyfallia Kapravelou
- Department of Cell Biology, Physiology and Immunology, Physiology Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Marta Cubedo
- Department of Statistics, Universitat de Barcelona, Barcelona, Spain
| | - Montserrat Solanas
- Department of Cell Biology, Physiology and Immunology, Physiology Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Eduard Escrich
- Department of Cell Biology, Physiology and Immunology, Physiology Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.
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4
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Aiello Bowles EJ, Kroenke CH, Chubak J, Bhimani J, O'Connell K, Brandzel S, Valice E, Doud R, Theis MK, Roh JM, Heon N, Persaud S, Griggs JJ, Bandera EV, Kushi LH, Kantor ED. Evaluation of Algorithms Using Automated Health Plan Data to Identify Breast Cancer Recurrences. Cancer Epidemiol Biomarkers Prev 2024; 33:355-364. [PMID: 38088912 PMCID: PMC10922110 DOI: 10.1158/1055-9965.epi-23-0782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/20/2023] [Accepted: 12/11/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND We updated algorithms to identify breast cancer recurrences from administrative data, extending previously developed methods. METHODS In this validation study, we evaluated pairs of breast cancer recurrence algorithms (vs. individual algorithms) to identify recurrences. We generated algorithm combinations that categorized discordant algorithm results as no recurrence [High Specificity and PPV (positive predictive value) Combination] or recurrence (High Sensitivity Combination). We compared individual and combined algorithm results to manually abstracted recurrence outcomes from a sample of 600 people with incident stage I-IIIA breast cancer diagnosed between 2004 and 2015. We used Cox regression to evaluate risk factors associated with age- and stage-adjusted recurrence rates using different recurrence definitions, weighted by inverse sampling probabilities. RESULTS Among 600 people, we identified 117 recurrences using the High Specificity and PPV Combination, 505 using the High Sensitivity Combination, and 118 using manual abstraction. The High Specificity and PPV Combination had good specificity [98%, 95% confidence interval (CI): 97-99] and PPV (72%, 95% CI: 63-80) but modest sensitivity (64%, 95% CI: 44-80). The High Sensitivity Combination had good sensitivity (80%, 95% CI: 49-94) and specificity (83%, 95% CI: 80-86) but low PPV (29%, 95% CI: 25-34). Recurrence rates using combined algorithms were similar in magnitude for most risk factors. CONCLUSIONS By combining algorithms, we identified breast cancer recurrences with greater PPV than individual algorithms, without additional review of discordant records. IMPACT Researchers should consider tradeoffs between accuracy and manual chart abstraction resources when using previously developed algorithms. We provided guidance for future studies that use breast cancer recurrence algorithms with or without supplemental manual chart abstraction.
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Affiliation(s)
- Erin J Aiello Bowles
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, Washington
| | - Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Jessica Chubak
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, Washington
| | - Jenna Bhimani
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kelli O'Connell
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Susan Brandzel
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, Washington
| | - Emily Valice
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Rachael Doud
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, Washington
| | - Mary Kay Theis
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, Washington
| | - Janise M Roh
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Narre Heon
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
- Office of Faculty Professional Development, Diversity and Inclusion, Columbia University Irving Medical Center, New York, New York
| | - Sonia Persaud
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jennifer J Griggs
- Departments of Internal Medicine, Hematology and Oncology Division, and Health Management and Policy, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Elisa V Bandera
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, Rutgers, the State University of New Jersey, New Brunswick, New Jersey
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Elizabeth D Kantor
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
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5
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Li X, Li J, Hu Q, Zhang X, Chen F. Association of physical weight statuses defined by body mass index (BMI) with molecular subtypes of premenopausal breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat 2024; 203:429-447. [PMID: 37882920 DOI: 10.1007/s10549-023-07139-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/25/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND AND PURPOSE The association between overweight/obesity and postmenopausal breast cancer has been proven. However, uncertainty exists regarding the association between physical weight statuses and premenopausal breast cancer subtypes. This study aimed to explore the association of body weight statuses with molecular subtypes of premenopausal breast cancer. METHOD A systematic search of Medline, PubMed, Embase, and Web of Science was performed. The Newcastle-Ottawa Scale (NOS) and the Joanna Briggs Institute (JBI) Critical Appraisal tools were used to evaluate the quality of the literature. STATA and R software were used to analyze the extracted data. RESULT The meta-analysis included 35 observational studies with a total of 41,049 premenopausal breast cancer patients. The study showed that the proportion of underweight patients was 4.8% (95% CI = 3.9-5.8%, P = 0.01), overweight was 29% (95%CI = 27.1-30.9%, P < 0.01), obesity was 17.8% (95% CI = 14.9-21.2%, P < 0.0001), and normal weight was 51.6% (95% CI = 46.7-56.5%, P < 0.0001). The pooled results showed that in comparison to the normal weight group, being physically underweight is related to a 1.44-fold risk (OR = 1.44, 95%CI = 1.28-1.63, P < 0.0001) of HER2 + breast cancer. Overweight is related to a 1.16-fold risk (OR = 1.16, 95%CI = 1.06-1.26, P = 0.002) of TNBC and a 16% lower risk (OR = 0.84, 95%CI = 0.75-0.93, P = 0.001) of ER + breast cancer. When compared to underweight/normal weight populations, both overweight (OR = 0.74, 95%CI = 0.56-0.97, P = 0.032) and obesity (OR = 0.70, 95%CI = 0.50-0.98, P = 0.037) can reduce the risk of ER + PR + breast cancer. CONCLUSION In the premenopausal breast cancer population, the distribution of patients' numbers with different weight statuses was significantly distinct among the various breast cancer subtypes. Additionally, the associations between physical weight statuses and the risk of premenopausal breast cancer subtypes are divergent.
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Affiliation(s)
- Xuchu Li
- Department of Medical, Queen Mary School, Nanchang University, 461 Bayi Avenue, Donghu District, Nanchang City, 330006, Jiangxi Province, China
| | - Jinping Li
- Department of General Medical, People's Hospital of Fu City, Yan'an, 727505, Shaanxi Province, China
| | - Qirui Hu
- College of Food Science, Nanchang University, Nanchang, 330047, Jiangxi Province, China
| | - Xu Zhang
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330006, Jiangxi Province, China
| | - Fang Chen
- College of Food Science, Nanchang University, Nanchang, 330047, Jiangxi Province, China.
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang, 330006, Jiangxi Province, China.
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6
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Ng WH, Abu Zaid Z, Mohd Yusof BN, Amin Nordin S, Lim PY. Association between dietary inflammatory index and body fat percentage among newly diagnosed breast cancer patients. Ann Med 2024; 55:2303399. [PMID: 38242100 PMCID: PMC10802798 DOI: 10.1080/07853890.2024.2303399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/26/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Obesity, particularly excessive body fat, is an established risk factor and substantial prognostic determinant in breast cancer. Recent studies suggested that diet-related inflammation plays a key role in obesity. This study aimed to determine the association between energy-adjusted dietary inflammatory index (E-DII) and body composition, particularly body fat percentage, among patients with newly diagnosed breast cancer. MATERIALS AND METHODS This cross-sectional study was conducted on 124 breast cancer outpatients within the first year of diagnosis and yet to commence oncological treatment. Body composition parameters [body weight, body mass index (BMI), body fat percentage, fat mass over fat-free mass ratio (FM/FFM), muscle mass, and visceral fat] were obtained using a bioelectrical impedance analyzer. Body fat percentage was categorized into two groups which were normal (<35%) and high (≥35%). The E-DII was calculated from the validated 165-items Food Frequency Questionnaire (FFQ) and categorized into three groups or tertiles. Multiple logistic regression analysis was used to determine the association between the E-DII and body fat percentage. RESULTS Mean body weight, body fat percentage, FM/FFM, and visceral fat increased as E-DII increased from the lowest tertile (T1) to the most pro-inflammatory tertile (T3) (p for trend <0.05). E-DII was positively associated with body fat percentage (OR 2.952; 95% CI 1.154-7.556; p = 0.024) and remained significant after adjustment for cancer stage, age, physical activity, ethnicity, smoking history, and presence of comorbidities. Compared to T1, participants in T3 had a significantly lower consumption of fiber, vitamin A, beta-carotene, vitamin C, iron, thiamine, riboflavin, niacin, vitamin B6, folic acid, zinc, magnesium, and selenium, but a higher intake of total fat, saturated fat, and monounsaturated fatty acids. CONCLUSIONS A higher E-DII was associated with increased body fat percentage, suggesting the potential of advocating anti-inflammatory diet to combat obesity among newly diagnosed breast cancer patients.
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Affiliation(s)
- Wai Han Ng
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Department of Dietetics and Food Service, National Cancer Institute, Ministry of Health, Putrajaya, Malaysia
| | - Zalina Abu Zaid
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Department of Dietetics, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, Selangor, Malaysia
| | - Barakatun Nisak Mohd Yusof
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
- Department of Dietetics, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, Selangor, Malaysia
| | - Syafinaz Amin Nordin
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Crispo A, Augustin LSA, Luongo A, Calderaio C, Breda J, Coluccia S, Calabrese A, Marrazzo V, Giannatiempo R, Trasacco P, Palumbo E, Vitale S, Porciello G, Di Gennaro P, Caputo R, Buono G, Vernieri C, Schettini F, Grimaldi M, Nocerino F, Celentano E, Amore A, Giuliano M, De Placido P, De Angelis C, Bianco R, De Laurentiis M, La Vecchia C, Arpino G. Central obesity, body mass index, metabolic syndrome and mortality in Mediterranean breast cancer patients. Sci Rep 2023; 13:21208. [PMID: 38040773 PMCID: PMC10692221 DOI: 10.1038/s41598-023-45439-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/19/2023] [Indexed: 12/03/2023] Open
Abstract
Obesity and metabolic disorders have been associated with poor outcomes in non-Mediterranean breast cancer (BC) patients. The purpose of this study was to investigate the prognostic potential of anthropometric variables in patients with early BC living in Southern Mediterranean region of Italy. We enrolled 955 consecutive early BC patients treated in hospitals in Naples between 2009 and 2013 (median follow-up 11.8-year ending 15/09/2022). Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and metabolic syndrome (MetS) were collected. All-cause and BC-specific mortality were calculated. At the last day of contact 208 (22%) patients had died, 131 (14%) from BC. High WC (≥ 88 cm) or WHR (> 0.85) and the MetS were significantly associated with moderately increased risk of all-cause mortality (HR=1.39, 1.62, 1.61, respectively). A significant increased risk of BC-specific mortality was found in obese patients, in those with high WC, high WHR and those with MetS (HR=1.72, 1.71, 1.80, 1.81, respectively). Central obesity significantly increased total and BC-specific mortality particularly in pre-menopausal women and in luminal subtypes, while in post-menopause MetS was a stronger risk factor. Obesity and MetS may impair the effectiveness of BC therapies hence active lifestyle interventions are encouraged.
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Affiliation(s)
- Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Livia S A Augustin
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Assunta Luongo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Claudia Calderaio
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Campania, Italy
| | - Joao Breda
- WHO Athens Quality of Care Office, Athens, Greece
| | - Sergio Coluccia
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Alessandra Calabrese
- Department of Senology, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, NA, Italy
| | - Vittorio Marrazzo
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Campania, Italy
| | | | - Paola Trasacco
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Campania, Italy
| | - Elvira Palumbo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Sara Vitale
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Giuseppe Porciello
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Piergiacomo Di Gennaro
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Roberta Caputo
- Department of Senology, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, NA, Italy
| | - Giuseppe Buono
- Department of Senology, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, NA, Italy
| | - Claudio Vernieri
- IFOM ETS, the AIRC Institute of Molecular Oncology, Milan, Italy
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Francesco Schettini
- Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
- Medical Oncology Department, Hospital Clinic of Barcelona, Barcelona, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Maria Grimaldi
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Flavia Nocerino
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Egidio Celentano
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Alfonso Amore
- Division of Surgery of Melanoma and Skin Cancer, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Mario Giuliano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Campania, Italy.
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA.
| | - Pietro De Placido
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Campania, Italy
| | - Carmine De Angelis
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Campania, Italy
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA
| | - Roberto Bianco
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Campania, Italy
| | - Michelino De Laurentiis
- Department of Senology, Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale", Naples, NA, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Grazia Arpino
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Campania, Italy
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8
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Capuozzo M, Celotto V, Landi L, Ferrara F, Sabbatino F, Perri F, Cascella M, Granata V, Santorsola M, Ottaiano A. Beyond Body Size: Adiponectin as a Key Player in Obesity-Driven Cancers. Nutr Cancer 2023; 75:1848-1862. [PMID: 37873648 DOI: 10.1080/01635581.2023.2272343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 08/23/2023] [Indexed: 10/25/2023]
Abstract
Obesity, a complex and multifactorial disease influenced by genetic, environmental, and psychological factors, has reached epidemic proportions globally, posing a significant health challenge. In addition to its established association with cardiovascular disease and type II diabetes, obesity has been implicated as a risk factor for various cancers. However, the precise biological mechanisms linking obesity and cancer remain largely understood. Adipose tissue, an active endocrine organ, produces numerous hormones and bioactive molecules known as adipokines, which play a crucial role in metabolism, immune responses, and systemic inflammation. Notably, adiponectin (APN), the principal adipocyte secretory protein, exhibits reduced expression levels in obesity. In this scoping review, we explore and discuss the role of APN in influencing cancer in common malignancies, including lung, breast, colorectal, prostate, gastric, and endometrial cancers. Our review aims to emphasize the critical significance of investigating this field, as it holds great potential for the development of innovative treatment strategies that specifically target obesity-related malignancies. Furthermore, the implementation of more rigorous and comprehensive prevention and treatment policies for obesity is imperative in order to effectively mitigate the risk of associated diseases, such as cancer.
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Affiliation(s)
| | | | | | | | - Francesco Sabbatino
- Oncology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
| | - Francesco Perri
- Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Naples, Italy
| | - Marco Cascella
- Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Naples, Italy
| | - Vincenza Granata
- Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Naples, Italy
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9
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Kim YJ, Park S, Kim WT, Bae YJ, Kim Y, Kang HT. Weight maintenance and gain were significantly associated with lower risk of all-cause and cancer-related mortality in Korean adults who were newly diagnosed with cancer based on the Korean NHIS-HEALS cohort. Medicine (Baltimore) 2023; 102:e36184. [PMID: 38013342 PMCID: PMC10681573 DOI: 10.1097/md.0000000000036184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/27/2023] [Indexed: 11/29/2023] Open
Abstract
The burden of malignant neoplasms is increasing worldwide. Healthy lifestyles such as maintaining a healthy body weight are important to improve survival rate in cancer patients. This study was aimed to test the hypothesis that weight change affects mortality in patients newly diagnosed with cancer. This study was retrospectively designed based on the National Health Insurance Service-National Health Screening Cohort. A total of 1856 subjects aged at least 40 years who received a national health checkup within 6 months before cancer diagnosis was included. Study subjects were classified into 3 categories based on weight change before and after cancer diagnosis: weight loss, maintenance, and gain. Cox proportional hazards regression models were adopted to examine the association between weight change and mortality after adjusting for confounders. Compared to those experiencing weight loss, the adjusted hazards ratios (HRs) (95% confidence intervals [CIs]) for those experiencing weight maintenance were 0.327 (0.189-0.568) for all-cause mortality and 0.431 (0.215-0.867) for cancer-related mortality. The adjusted HRs (95% CIs) for those experiencing weight gain were 0.149 (0.044-0.505) for all-cause mortality and 0.289 (0.080-1.045) for cancer-related mortality. After stratifying according to baseline body mass index (BMI), weight maintenance and gain were negatively associated with all-cause mortality (0.286 [0.138-0.592] for weight maintenance and 0.119 [0.027-0.533] for weight gain) among those with a BMI < 25 kg/m2. Weight maintenance and gain reduced the risk of all-cause mortality in patients newly diagnosed with any cancer. In addition, weight maintenance was significantly related to cancer-related mortality.
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Affiliation(s)
- Yong-June Kim
- Department of Urology, Chungbuk National University Hospital, Cheongju, Chungbuk, South Korea
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea
| | - Seung Park
- Department of Biomedical Engineering, Chungbuk National University Hospital, Cheongju, Chungbuk, South Korea
| | - Won Tae Kim
- Department of Urology, Chungbuk National University Hospital, Cheongju, Chungbuk, South Korea
- Department of Urology, Chungbuk National University College of Medicine, Cheongju, Chungbuk, South Korea
| | - Yoon-Jong Bae
- Department of Information & Statistics, Chungbuk National University College of Science, Cheongju, Chungbuk, South Korea
| | - Yonghwan Kim
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Chungbuk, South Korea
| | - Hee-Taik Kang
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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10
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Urzì AG, Tropea E, Gattuso G, Spoto G, Marsala G, Calina D, Libra M, Falzone L. Ketogenic Diet and Breast Cancer: Recent Findings and Therapeutic Approaches. Nutrients 2023; 15:4357. [PMID: 37892432 PMCID: PMC10609494 DOI: 10.3390/nu15204357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Breast cancer (BC), a complex disease with several influencing factors, is significantly impacted by dietary habits. The ketogenic diet (KD), characterized by high fat and low carbohydrate intake, has gained attention as a potential therapeutic approach, but its effects on BC remain unclear. This review seeks to summarize the current knowledge on the principles of the KD, its metabolic influence on BC cells, and the findings of recent clinical trials, in order to elucidate the potential therapeutic role of the KD in BC management. For these purposes, a comprehensive literature review was conducted selecting preclinical and clinical studies that investigate the relationship between the KD and BC. The selection criteria prioritized studies exploring the KD's metabolic effects on BC cells and current clinical trials involving the KD in BC management. The reviewed studies provide a diverse range of findings, with some suggesting potential benefits of the KD in inhibiting tumor growth and improving treatment response. However, robust clinical trials providing clear evidence of the KD's efficacy as a standalone therapeutic approach in BC are still lacking. There are also significant concerns regarding the safety and long-term effects of sustained ketosis in cancer patients. The therapeutic potential of the KD in BC remains an area of active research and debate. While preliminary findings are promising, definitive conclusions are hindered by inconsistent results and limited human trial data. Future research, specifically well-structured, large-scale clinical trials, is necessary to provide a comprehensive understanding of the role of the KD in BC treatment. Until then, caution should be exercised in its application, and patients should continue prioritizing evidence-based, standard-of-care treatments.
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Affiliation(s)
- Alfio Giuseppe Urzì
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (A.G.U.); (G.G.)
| | - Emanuela Tropea
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (A.G.U.); (G.G.)
| | - Giuseppe Gattuso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (A.G.U.); (G.G.)
| | - Graziana Spoto
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (A.G.U.); (G.G.)
| | - Gabriella Marsala
- Dipartimento del Farmaco, U.O.C. di Farmaceutica Convenzionata, 95100 Catania, Italy
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (A.G.U.); (G.G.)
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy
| | - Luca Falzone
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Naples, Italy;
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11
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Aburto TC, Romieu I, Stern MC, Barquera S, Corvalán C, Hallal PC, Reynales-Shigematsu LM, Barnoya J, Cavalcante TM, Canelo-Aybar C, Santero M, Feliu A, Espina C, Rivera JA. Latin American and the Caribbean Code Against Cancer 1st edition: Weight, physical activity, diet, breastfeeding, and cancer. Cancer Epidemiol 2023; 86 Suppl 1:102436. [PMID: 37852731 DOI: 10.1016/j.canep.2023.102436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 10/20/2023]
Abstract
In Latin America and the Caribbean a considerable proportion of the population have excess body weight, do not meet the recommendations of physical activity and healthy diet, and have suboptimal rates of breastfeeding. Excess body weight is associated with at least 15 cancer sites, physical activity protects against three cancers, with some evidence suggesting a protective effect for eight more cancer sites, and sedentary behavior probably increases the risk of five cancer sites. Fiber and wholegrains protect against colorectal cancer, high intake of fruits and vegetables could reduce the risk of aerodigestive cancers; processed and red meat increase the risk of colorectal cancer; and very hot beverages are associated with esophageal cancer. Moreover, sugar-sweetened beverages and ultra-processed foods are a convincing cause for excess body weight, increasing cancer risk through this pathway, with some emerging evidence suggesting also direct pathways. Breastfeeding protects against breast cancer, and could protect against ovarian cancer. Taking this evidence into account, the Latin America and the Caribbean Code Against Cancer recommends the general public to maintain a healthy body weight, be physically active and limit sedentary behavior, eat a healthy diet (eat plenty of vegetables, fruits, wholegrains and legumes; avoid sugar-sweetened beverages and processed meat; and limit ultra-processed foods, red meat and very hot beverages), and breastfeed. Moreover, the Latin America and the Caribbean Code Against Cancer also includes a set of public policy recommendations for cancer prevention to inform policy makers and civil society about the need of policies to shape healthy environments and create opportunities to facilitate the adoption of the recommendations directed to the public.
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Affiliation(s)
- Tania C Aburto
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Isabelle Romieu
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Mariana C Stern
- Department of Preventive Medicine and Urology, Keck School of Medicine of USC, 90033 Los Angeles, United States
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Pedro C Hallal
- Department of Kinesiology and Community Health, University of Illinois Champaign-Urbana, Illinois, United States
| | - Luz M Reynales-Shigematsu
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Joaquín Barnoya
- Research Department, Integra Cancer Institute, Guatemala City, Guatemala; Department of Environmental and Occupational Health, Colorado School of Public Health, CU Anschutz, United States
| | - Tania M Cavalcante
- Instituto Nacional de Câncer José de Alencar Gomes da Silva, Secretaria Executiva da Comissão Nacional para a Implementação da Convenção-Quadro para o Controle do Tabaco, Rio de Janeiro, RJ, Brasil
| | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Marilina Santero
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07 France
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07 France
| | - Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico.
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12
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Lin D, Sturgeon KM, Gordon BR, Brown JC, Sears DD, Sarwer DB, Schmitz KH. WISER Survivor Trial: Combined Effect of Exercise and Weight Loss Interventions on Adiponectin and Leptin Levels in Breast Cancer Survivors with Overweight or Obesity. Nutrients 2023; 15:3453. [PMID: 37571390 PMCID: PMC10421485 DOI: 10.3390/nu15153453] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
Adipocyte dysregulation is one mechanism linking overweight and breast cancer recurrence. Exercise and weight loss are associated with a decreased risk of breast cancer recurrence in breast cancer survivors with overweight or obesity, which may be mediated through reduced leptin levels, increased adiponectin levels, and an elevated adiponectin to leptin (A:L) ratio. The four-arm randomized controlled WISER Survivor trial examined the 12-month intervention effects of exercise, weight loss, and the combination of exercise and weight loss on adipokine levels among breast cancer survivors (n = 339) with overweight or obesity. Compared with Control, the Combination of Exercise and Weight Loss decreased leptin levels (-35.9%; 95% CI: -46.8%, -25.0%) and increased A:L ratio (11.6%; 95% CI: 5.6%, 17.6%) but did not change adiponectin levels (4.1%; 95% CI: -3.1%, 11.2%). Compared with Control, Weight Loss Alone decreased leptin levels (-35.6%; 95% CI: -46.6%, -24.5%) and increased A:L ratio (10.6%; 95% CI: 4.7%, 16.5%) but did not change adiponectin levels (0.9%; 95% CI: -6.0%, 7.9%). Compared with Control, Exercise Alone did not change leptin levels, adiponectin levels, or A:L ratio. In analyses that consolidated intervention groups, compared with Control, weight loss of ≥5% decreased leptin levels (p trend < 0.01) and increased A:L ratio (p trend < 0.01) but did not alter adiponectin levels (p trend = 0.53). Weight loss, with or without exercise, was associated with decreased leptin levels in breast cancer survivors with overweight or obesity. Improvements in the adipokine secretion profile (A:L ratio) were primarily driven by a weight loss-induced change in leptin levels.
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Affiliation(s)
- Dan Lin
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA; (D.L.); (B.R.G.); (K.H.S.)
| | - Kathleen M. Sturgeon
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA; (D.L.); (B.R.G.); (K.H.S.)
| | - Brett R. Gordon
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA; (D.L.); (B.R.G.); (K.H.S.)
| | - Justin C. Brown
- Cancer Metabolism Program, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA;
| | - Dorothy D. Sears
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA;
- Department of Medicine, UC San Diego, San Diego, CA 92093, USA
- Department of Family Medicine, UC San Diego, San Diego, CA 92093, USA
- Moores Cancer Center, US San Diego, San Diego, CA 92093, USA
| | - David B. Sarwer
- College of Public Health, Center for Obesity Research and Education, Temple University, Philadelphia, PA 19122, USA;
| | - Kathryn H. Schmitz
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA; (D.L.); (B.R.G.); (K.H.S.)
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
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13
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Uhelski ACR, Blackford AL, Sheng JY, Snyder C, Lehman J, Visvanathan K, Lim D, Stearns V, Smith KL. Factors associated with weight gain in pre- and post-menopausal women receiving adjuvant endocrine therapy for breast cancer. J Cancer Surviv 2023:10.1007/s11764-023-01408-y. [PMID: 37261654 DOI: 10.1007/s11764-023-01408-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 05/22/2023] [Indexed: 06/02/2023]
Abstract
PURPOSE Weight gain after breast cancer poses health risks. We aimed to identify factors associated with weight gain during adjuvant endocrine therapy (AET). METHODS Women initiating AET enrolled in a prospective cohort. Participants completed FACT-ES plus PROMIS pain interference, depression, anxiety, fatigue, sleep disturbance and physical function measures at baseline, 3, 6, 12, 24, 36, 48 and 60 months. Treatment-emergent symptoms were defined as changes in scores in the direction indicative of worsening symptoms that exceeded the minimal important difference at 3 and/or 6 months compared to baseline. We used logistic regression to evaluate associations of clinicodemographic features and treatment-emergent symptoms with clinically significant weight gain over 60 months (defined as ≥ 5% compared to baseline) in pre- and post-menopausal participants. RESULTS Of 309 participants, 99 (32%) were pre-menopausal. The 60 months cumulative incidence of clinically significant weight gain was greater in pre- than post-menopausal participants (67% vs 43%, p < 0.001). Among pre-menopausal participants, treatment-emergent pain interference (OR 2.49), aromatase inhibitor receipt (OR 2.8), mastectomy, (OR 2.06) and White race (OR 7.13) were associated with weight gain. Among post-menopausal participants, treatment-emergent endocrine symptoms (OR 2.86), higher stage (OR 2.25) and White race (OR 2.29) were associated with weight gain while treatment-emergent physical function decline (OR 0.30) was associated with lower likelihood of weight gain. CONCLUSIONS Weight gain during AET is common, especially for pre-menopausal women. Clinicodemographic features and early treatment-emergent symptoms may identify at risk individuals. IMPLICATIONS FOR CANCER SURVIVORS Patients at risk for weight gain can be identified early during AET. CLINICAL TRIALS GOV IDENTIFIER NCT01937052, registered September 3, 2013.
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Affiliation(s)
- Anna-Carson Rimer Uhelski
- Johns Hopkins Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Hematology/Oncology Fellowship Program, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amanda L Blackford
- Division of Biostatistics and Bioinformatics, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Jennifer Y Sheng
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Claire Snyder
- Johns Hopkins Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer Lehman
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kala Visvanathan
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Cancer Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David Lim
- Division of Biostatistics and Bioinformatics, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
- Division of Statistics, Collaborative Inc., WCG, Washington, DC, USA
| | - Vered Stearns
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Under Armour Breast Health Innovation Center, The Skip Viragh Outpatient Cancer, Building 201 North Broadway Viragh 10th floor, Room 10291, Baltimore, MD, 21287, USA.
| | - Karen Lisa Smith
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- AstraZeneca, Gaithersburg, MD, USA
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14
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de Borba Cecílio da Silva AP, Santos Jaques HD, Ferronato M, Mara Alves F, Iago Colleto M, Okamoto Ferreira M, Orrutéa JF, Mezzoni M, Soares da Silva RG, Rech D, Panis C. Excess body weight significantly affects systemic and tumor inflammatory status and correlates to poor prognosis parameters in patients with breast cancer. CURRENT RESEARCH IN IMMUNOLOGY 2023; 4:100059. [PMID: 37228483 PMCID: PMC10205449 DOI: 10.1016/j.crimmu.2023.100059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/20/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
Introduction Obesity is a pro-inflammatory disease critical for developing breast cancer (BC), which impacts the profiles of systemic inflammatory mediators and determinants of different disease clinical outcomes remains little explored. Methods A total of 195 patients diagnosed with breast cancer were included. Aiming to exclude chemotherapy interference on circulating mediators, samples were collected at diagnosis, out of the treatment period. Patients were classified as normal weight (BMI up to 24.9 kg/m2) or overweight (BMI ≥25.0 kg/m2). Serum levels of IL-4, IL-12, hydroperoxides, and nitric oxide metabolites (NOx) were measured. Also, tumor expression of inducible nitric oxide synthase (iNOS), TGF-β1, CD4+, and CD8+ lymphocytes were evaluated. Results IL-4 levels were significantly increased in the overweight BC group (p = 0.0329), including patients with luminal B subtype (p = 0.0443), presence of lymph node metastases (p = 0.0115) and age of diagnosis below 50 years, (p = 0.0488). IL-12 levels were significantly increased in overweight BC patients with lymph node metastases (p = 0.0115). Hydroperoxides were increased in overweight BC patients (p = 0.0437), including those with tumors smaller than 2 cm (p = 0.05). NOx levels were also increased in overweight BC patients, including those with luminal B disorders (p = 0.0443), high-grade tumors (p = 0.0351) and lymph node metastases (p = 0.0155). The expression of iNOS (p < 0.001) and TCD4+ lymphocytes (p = 0.0378) was significantly investigated in tumor biopsies from overweight BC women. Conclusions These data provide a picture of the influence of excess body weight on inflammatory mediators' systemic and tumoral profiles, especially in patients displaying poor outcome BC.
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15
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Akingbesote ND, Owusu D, Liu R, Cartmel B, Ferrucci LM, Zupa M, Lustberg MB, Sanft T, Blenman KRM, Irwin ML, Perry RJ. A review of the impact of energy balance on triple-negative breast cancer. J Natl Cancer Inst Monogr 2023; 2023:104-124. [PMID: 37139977 DOI: 10.1093/jncimonographs/lgad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 05/05/2023] Open
Abstract
Cancer cells cannot proliferate without sufficient energy to generate biomass for rapid cell division, as well as to fuel their functions at baseline. For this reason, many recent observational and interventional studies have focused on increasing energy expenditure and/or reducing energy intake during and after cancer treatment. The impact of variance in diet composition and in exercise on cancer outcomes has been detailed extensively elsewhere and is not the primary focus of this review. Instead, in this translational, narrative review we examine studies of how energy balance impacts anticancer immune activation and outcomes in triple-negative breast cancer (TNBC). We discuss preclinical, clinical observational, and the few clinical interventional studies on energy balance in TNBC. We advocate for the implementation of clinical studies to examine how optimizing energy balance-through changes in diet and/or exercise-may optimize the response to immunotherapy in people with TNBC. It is our conviction that by taking a holistic approach that includes energy balance as a key factor to be considered during and after treatment, cancer care may be optimized, and the detrimental effects of cancer treatment and recovery on overall health may be minimized.
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Affiliation(s)
- Ngozi D Akingbesote
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Department of Cellular & Molecular Physiology, Yale University, New Haven, CT, USA
| | - Dennis Owusu
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Department of Cellular & Molecular Physiology, Yale University, New Haven, CT, USA
- Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti Region, Ghana
| | - Ryan Liu
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Department of Cellular & Molecular Physiology, Yale University, New Haven, CT, USA
- Cedar Park High School, Cedar Park, TX, USA
| | - Brenda Cartmel
- Yale School of Public Health, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
| | - Leah M Ferrucci
- Yale School of Public Health, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
| | | | - Maryam B Lustberg
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
| | - Tara Sanft
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
| | - Kim R M Blenman
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
- Department of Computer Science, Yale University, New Haven, CT, USA
| | - Melinda L Irwin
- Yale School of Public Health, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
| | - Rachel J Perry
- Department of Internal Medicine, Yale University, New Haven, CT, USA
- Department of Cellular & Molecular Physiology, Yale University, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
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16
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Chan DS, Vieira R, Abar L, Aune D, Balducci K, Cariolou M, Greenwood DC, Markozannes G, Nanu N, Becerra‐Tomás N, Giovannucci EL, Gunter MJ, Jackson AA, Kampman E, Lund V, Allen K, Brockton NT, Croker H, Katsikioti D, McGinley‐Gieser D, Mitrou P, Wiseman M, Cross AJ, Riboli E, Clinton SK, McTiernan A, Norat T, Tsilidis KK. Postdiagnosis body fatness, weight change and breast cancer prognosis: Global Cancer Update Program (CUP global) systematic literature review and meta-analysis. Int J Cancer 2023; 152:572-599. [PMID: 36279884 PMCID: PMC10092239 DOI: 10.1002/ijc.34322] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 07/29/2022] [Accepted: 09/05/2022] [Indexed: 02/01/2023]
Abstract
Previous evidence on postdiagnosis body fatness and mortality after breast cancer was graded as limited-suggestive. To evaluate the evidence on body mass index (BMI), waist circumference, waist-hip-ratio and weight change in relation to breast cancer prognosis, an updated systematic review was conducted. PubMed and Embase were searched for relevant studies published up to 31 October, 2021. Random-effects meta-analyses were conducted to estimate summary relative risks (RRs). The evidence was judged by an independent Expert Panel using pre-defined grading criteria. One randomized controlled trial and 225 observational studies were reviewed (220 publications). There was strong evidence (likelihood of causality: probable) that higher postdiagnosis BMI was associated with increased all-cause mortality (64 studies, 32 507 deaths), breast cancer-specific mortality (39 studies, 14 106 deaths) and second primary breast cancer (11 studies, 5248 events). The respective summary RRs and 95% confidence intervals per 5 kg/m2 BMI were 1.07 (1.05-1.10), 1.10 (1.06-1.14) and 1.14 (1.04-1.26), with high between-study heterogeneity (I2 = 56%, 60%, 66%), but generally consistent positive associations. Positive associations were also observed for waist circumference, waist-hip-ratio and all-cause and breast cancer-specific mortality. There was limited-suggestive evidence that postdiagnosis BMI was associated with higher risk of recurrence, nonbreast cancer deaths and cardiovascular deaths. The evidence for postdiagnosis (unexplained) weight or BMI change and all outcomes was graded as limited-no conclusion. The RCT showed potential beneficial effect of intentional weight loss on disease-free-survival, but more intervention trials and well-designed observational studies in diverse populations are needed to elucidate the impact of body composition and their changes on breast cancer outcomes.
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Affiliation(s)
- Doris S.M. Chan
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Rita Vieira
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Leila Abar
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Dagfinn Aune
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- Department of NutritionBjørknes University CollegeOsloNorway
- Department of Endocrinology, Morbid Obesity and Preventive MedicineOslo University HospitalOsloNorway
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska InstitutetStockholmSweden
| | - Katia Balducci
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Margarita Cariolou
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Darren C. Greenwood
- Leeds Institute for Data Analytics, Faculty of Medicine and HealthUniversity of LeedsLeedsUK
| | - Georgios Markozannes
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- Department of Hygiene and EpidemiologyUniversity of Ioannina Medical SchoolIoanninaGreece
| | - Neesha Nanu
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Nerea Becerra‐Tomás
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Edward L. Giovannucci
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
- Department of Nutrition, Harvard T. H. Chan School of Public HealthBostonMassachusettsUSA
| | - Marc J. Gunter
- Nutrition and Metabolism Section, International Agency for Research on CancerLyonFrance
| | - Alan A. Jackson
- Faculty of Medicine, School of Human Development and HealthUniversity of SouthamptonSouthamptonUK
- National Institute of Health Research Cancer and Nutrition CollaborationSouthamptonUK
| | - Ellen Kampman
- Division of Human Nutrition and HealthWageningen University & ResearchWageningenThe Netherlands
| | - Vivien Lund
- World Cancer Research Fund InternationalLondonUK
| | - Kate Allen
- World Cancer Research Fund InternationalLondonUK
| | | | - Helen Croker
- World Cancer Research Fund InternationalLondonUK
| | | | | | | | | | - Amanda J. Cross
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Elio Riboli
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - Steven K. Clinton
- Division of Medical Oncology, The Department of Internal MedicineCollege of Medicine and Ohio State University Comprehensive Cancer Center, Ohio State UniversityColumbusOhioUSA
| | - Anne McTiernan
- Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleWashingtonUSA
| | - Teresa Norat
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- World Cancer Research Fund InternationalLondonUK
| | - Konstantinos K. Tsilidis
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- Department of Hygiene and EpidemiologyUniversity of Ioannina Medical SchoolIoanninaGreece
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17
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Ozaki Y, Masuda J, Kataoka A, Kogawa T, Abe T, Morizono H, Inagaki L, Hara F, Takano T, Ueno T, Ohno S. The impact of obesity and endocrine therapy on the prognosis of premenopausal women with hormone receptor-positive breast cancer: A single-institute retrospective study. Cancer Rep (Hoboken) 2023; 6:e1695. [PMID: 36806718 PMCID: PMC9940008 DOI: 10.1002/cnr2.1695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 07/12/2022] [Accepted: 07/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Higher body mass index (BMI) is associated with worse prognosis in pre- and postmenopausal patients with breast cancer (BC). However, there is insufficient evidence regarding the optimal adjuvant endocrine therapy for obese premenopausal women with hormone receptor (HR)-positive BC. AIM To evaluate the impact of obesity and adjuvant endocrine therapy on prognosis in premenopausal patients with BC. METHODS AND RESULTS We retrospectively reviewed the medical record of premenopausal women who received curative surgery for clinical stage I-III HR-positive BC from 2007 to 2017. Patients were classified into five groups according to BMI: underweight (UW), normal weight (NW), obese 1 degree (OB1), obese 2 degree (OB2), and obese 3 degree (OB3) categories. The primary analysis was a comparison of BC-specific survival (BCSS) according to BMI (UW/NW vs. OB1-3) and adjuvant endocrine therapy (with or without ovarian function suppression [OFS]). Of 13 021 patients, the data of 3380 patients were analyzed. BCSS in OB1-3 patients was significantly worse than that in patients with UW/NW (hazard ratio [HR] 2.37; 95% confidence interval [CI], 1.40-4.02: p = .0009). In OB1-3 patients who received tamoxifen (TAM), BCSS was significantly worse than that in UW/NW patients (p = .0086); however, a significant difference was not shown in patients who received TAM and OFS (p = .0921). CONCLUSION High BMI was associated with worse prognosis in premenopausal patients with HR-positive BC who received adjuvant TAM. The role of OFS as adjuvant endocrine therapy remains unclear, and further studies are required to explore the adequate management of obese premenopausal patients.
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Affiliation(s)
- Yukinori Ozaki
- Breast Oncology CenterThe Cancer Institute Hospital of JFCRTokyoJapan
| | - Jun Masuda
- Breast Oncology CenterThe Cancer Institute Hospital of JFCRTokyoJapan
| | - Akemi Kataoka
- Breast Oncology CenterThe Cancer Institute Hospital of JFCRTokyoJapan
| | - Takahiro Kogawa
- Division of Early Clinical Development for Cancer, Advanced Medical Development CenterThe Cancer Institute Hospital of JFCRTokyoJapan
| | - Tomomi Abe
- Breast Oncology CenterThe Cancer Institute Hospital of JFCRTokyoJapan
| | - Hidetomo Morizono
- Breast Oncology CenterThe Cancer Institute Hospital of JFCRTokyoJapan
| | - Lina Inagaki
- Breast Oncology CenterThe Cancer Institute Hospital of JFCRTokyoJapan
| | - Fumikata Hara
- Breast Oncology CenterThe Cancer Institute Hospital of JFCRTokyoJapan
| | - Toshimi Takano
- Breast Oncology CenterThe Cancer Institute Hospital of JFCRTokyoJapan
| | - Takayuki Ueno
- Breast Oncology CenterThe Cancer Institute Hospital of JFCRTokyoJapan
| | - Shinji Ohno
- Breast Oncology CenterThe Cancer Institute Hospital of JFCRTokyoJapan
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18
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Su YH, Wu YZ, Ann DK, Chen JLY, Kuo CY. Obesity promotes radioresistance through SERPINE1-mediated aggressiveness and DNA repair of triple-negative breast cancer. Cell Death Dis 2023; 14:53. [PMID: 36681663 PMCID: PMC9867751 DOI: 10.1038/s41419-023-05576-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/08/2023] [Accepted: 01/09/2023] [Indexed: 01/22/2023]
Abstract
Obesity is a risk factor in various types of cancer, including breast cancer. The disturbance of adipose tissue in obesity highly correlates with cancer progression and resistance to standard treatments such as chemo- and radio-therapies. In this study, in a syngeneic mouse model of triple-negative breast cancer (TNBC), diet-induced obesity (DIO) not only promoted tumor growth, but also reduced tumor response to radiotherapy. Serpine1 (Pai-1) was elevated in the circulation of obese mice and was enriched within tumor microenvironment. In vitro co-culture of human white adipocytes-conditioned medium (hAd-CM) with TNBC cells potentiated the aggressive phenotypes and radioresistance of TNBC cells. Moreover, inhibition of both cancer cell autonomous and non-autonomous SERPINE1 by either genetic or pharmacological strategy markedly dampened the aggressive phenotypes and radioresistance of TNBC cells. Mechanistically, we uncovered a previously unrecognized role of SERPINE1 in DNA damage response. Ionizing radiation-induced DNA double-strand breaks (DSBs) increased the expression of SERPINE1 in cancer cells in an ATM/ATR-dependent manner, and promoted nuclear localization of SERPINE1 to facilitate DSB repair. By analyzing public clinical datasets, higher SERPINE1 expression in TNBC correlated with patients' BMI as well as poor outcomes. Elevated SERPINE1 expression and nuclear localization were also observed in radioresistant breast cancer cells. Collectively, we reveal a link between obesity and radioresistance in TNBC and identify SERPINE1 to be a crucial factor mediating obesity-associated tumor radioresistance.
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Affiliation(s)
- Yong-Han Su
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Zhen Wu
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - David K Ann
- Department of Diabetes Complications & Metabolism, City of Hope, Duarte, CA, USA
- Irell and Manella Graduate School of Biological Sciences, City of Hope, Duarte, CA, USA
| | - Jenny Ling-Yu Chen
- Department of Radiology, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Radiation Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Ching-Ying Kuo
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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19
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Marsh ML, Oliveira MN, Vieira-Potter VJ. Adipocyte Metabolism and Health after the Menopause: The Role of Exercise. Nutrients 2023; 15:444. [PMID: 36678314 PMCID: PMC9862030 DOI: 10.3390/nu15020444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/19/2023] Open
Abstract
Postmenopausal women represent an important target population in need of preventative cardiometabolic approaches. The loss of estrogen following the menopause eliminates protections against metabolic dysfunction, largely due to its role in the health and function of adipose tissue. In addition, some studies associate the menopause with reduced physical activity, which could potentially exacerbate the deleterious cardiometabolic risk profile accompanying the menopause. Meanwhile, exercise has adipocyte-specific effects that may alleviate the adverse impact of estrogen loss through the menopausal transition period and beyond. Exercise thus remains the best therapeutic agent available to mitigate menopause-associated metabolic dysfunction and represents a vital behavioral strategy to prevent and alleviate health decline in this population.
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20
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Henn M, Martin-Gorgojo V, Martin-Moreno JM. Vitamin D in Cancer Prevention: Gaps in Current Knowledge and Room for Hope. Nutrients 2022; 14:4512. [PMID: 36364774 PMCID: PMC9657468 DOI: 10.3390/nu14214512] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 08/03/2023] Open
Abstract
Intensive epigenome and transcriptome analyses have unveiled numerous biological mechanisms, including the regulation of cell differentiation, proliferation, and induced apoptosis in neoplastic cells, as well as the modulation of the antineoplastic action of the immune system, which plausibly explains the observed population-based relationship between low vitamin D status and increased cancer risk. However, large randomized clinical trials involving cholecalciferol supplementation have so far failed to show the potential of such interventions in cancer prevention. In this article, we attempt to reconcile the supposed contradiction of these findings by undertaking a thorough review of the literature, including an assessment of the limitations in the design, conduct, and analysis of the studies conducted thus far. We examine the long-standing dilemma of whether the beneficial effects of vitamin D levels increase significantly above a critical threshold or if the conjecture is valid that an increase in available cholecalciferol translates directly into an increase in calcitriol activity. In addition, we try to shed light on the high interindividual epigenetic and transcriptomic variability in response to cholecalciferol supplementation. Moreover, we critically review the standards of interpretation of the available study results and propose criteria that could allow us to reach sound conclusions in this field. Finally, we advocate for options tailored to individual vitamin D needs, combined with a comprehensive intervention that favors prevention through a healthy environment and responsible health behaviors.
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Affiliation(s)
- Matthias Henn
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA (Instituto de Investigación Sanitaria de Navarra), 31008 Pamplona, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Victor Martin-Gorgojo
- Biomedical Research Institute INCLIVA, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
- Orthopedic Surgery and Traumatology Department, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| | - Jose M. Martin-Moreno
- Biomedical Research Institute INCLIVA, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
- Department of Preventive Medicine and Public Health, Universitat de Valencia, 46010 Valencia, Spain
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21
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Abo Alrob O, Al-Horani RA, Altaany Z, Nusair MB. Synergistic Beneficial Effects of Resveratrol and Diet on High-Fat Diet-Induced Obesity. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58091301. [PMID: 36143977 PMCID: PMC9503422 DOI: 10.3390/medicina58091301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022]
Abstract
Introduction: Despite decades of research, obesity and its related medical complications remain a major health concern globally. Therefore, novel therapeutic strategies are needed to combat obesity and its numerous debilitating complications. Resveratrol (RES) has a potential therapeutic effect in obesity and diabetes by improving oxidative metabolism and insulin signaling. Background and Objectives: The aim of this study was to investigate the effect of RES treatment on weight loss and glucose and fatty acid metabolism. Methods: Obesity was induced in 24 mice by exposure to a high-fat diet (HFD) for 8 weeks. Mice were randomly assigned to one group of either: group 1: control, non-treated low-fat diet (LFD) for 12 weeks (n = 8), group 2: non-treated high-fat diet (HFD) for 12 weeks (n = 8), group 3: RES-treated HFD (HFD + RES) (n = 8), or group 4: RES-treated and switched to LFD (HFD-LFD + RES) (n = 8). HFD + RES mice were first fed an HFD for 8 weeks followed by 4 weeks of RES. The HFD-LFD + RES group was first fed an HFD for 8 weeks and then treated with RES and switched to an LFD for 4 weeks. Results: After 12 weeks, group 2 mice had significantly higher body weights compared to group 1 (23.71 ± 1.95 vs. 47.83 ± 2.27; p < 0.05). Group 4 had a significant decrease in body weight and improvement in glucose tolerance compared to mice in group 2 (71.3 ± 1.17 vs. 46.1 ± 1.82 and 40.9 ± 1.75, respectively; p < 0.05). Skeletal muscles expression of SIRT1, SIRT3, and PGC1α were induced in group 3 and 4 mice compared to group 2 (p < 0.01), with no changes in AMP-activated protein kinase expression levels. Furthermore, combination of RES and diet ameliorated skeletal muscle intermediate lipid accumulation and significantly improved insulin sensitivity and secretion. Conclusions: The results of this study suggest a synergistic beneficial effect of LFD and RES to lower body weight and enhance glucose and fatty acid metabolism.
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Affiliation(s)
- Osama Abo Alrob
- Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Yarmouk University, Irbid 211-63, Jordan or
- Correspondence:
| | - Ramzi A. Al-Horani
- Department of Exercise Science, Yarmouk University, Irbid 211-63, Jordan
| | - Zaid Altaany
- Department of Basic Sciences, Faculty of Medicine, Yarmouk University, Irbid 211-63, Jordan
| | - Mohammad B. Nusair
- Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Yarmouk University, Irbid 211-63, Jordan or
- Department of Sociobehavioral and Administrative Pharmacy, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
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22
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Kehm RD, Llanos AAM, McDonald JA, Tehranifar P, Terry MB. Evidence-Based Interventions for Reducing Breast Cancer Disparities: What Works and Where the Gaps Are? Cancers (Basel) 2022; 14:cancers14174122. [PMID: 36077659 PMCID: PMC9455068 DOI: 10.3390/cancers14174122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 01/26/2023] Open
Abstract
The National Cancer Institute (NCI) has established an online repository of evidence-based cancer control programs (EBCCP) and increasingly calls for the usage of these EBCCPs to reduce the cancer burden. To inventory existing EBCCPs and identify remaining gaps, we summarized NCI's EBCCPs relevant to reducing breast cancer risk with an eye towards interventions that address multiple levels of influence in populations facing breast cancer disparities. For each program, the NCI EBCCP repository provides the following expert panel determined summary metrics: (a) program ratings (1-5 scale, 5 best) of research integrity, intervention impact, and dissemination capability, and (b) RE-AIM framework assessment (0-100%) of program reach, effectiveness, adoption, and implementation. We quantified the number of EBCCPs that met the quality criteria of receiving a score of ≥3 for research integrity, intervention impact, and dissemination capability, and receiving a score of ≥50% for available RE-AIM reach, effectiveness, adoption, and implementation. For breast cancer risk reduction, we assessed the presence and quality of EBCCPs related to physical activity (PA), obesity, alcohol, tobacco control in early life, breastfeeding, and environmental chemical exposures. Our review revealed several major gaps in EBCCPs for reducing the breast cancer burden: (1) there are no EBCCPs for key breast cancer risk factors including alcohol, breastfeeding, and environmental chemical exposures; (2) among the EBCPPs that exist for PA, obesity, and tobacco control in early life, only a small fraction (24%, 17% and 31%, respectively) met all the quality criteria (≥3 EBCCP scores and ≥50% RE-AIM scores) and; (3) of those that met the quality criteria, only two PA interventions, one obesity, and no tobacco control interventions addressed multiple levels of influence and were developed in populations facing breast cancer disparities. Thus, developing, evaluating, and disseminating interventions to address important risk factors and reduce breast cancer disparities are needed.
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Affiliation(s)
- Rebecca D. Kehm
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, 1130 St Nicholas Ave, New York, NY 10033, USA
| | - Adana A. M. Llanos
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, 1130 St Nicholas Ave, New York, NY 10033, USA
| | - Jasmine A. McDonald
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, 1130 St Nicholas Ave, New York, NY 10033, USA
| | - Parisa Tehranifar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, 1130 St Nicholas Ave, New York, NY 10033, USA
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, 1130 St Nicholas Ave, New York, NY 10033, USA
- Correspondence: ; Tel.: +1-212-305-4915
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23
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Ee C, MacMillan F, Boyages J, McBride K. Barriers and enablers of weight management after breast cancer: a thematic analysis of free text survey responses using the COM-B model. BMC Public Health 2022; 22:1587. [PMID: 35987564 PMCID: PMC9392910 DOI: 10.1186/s12889-022-13980-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 08/03/2022] [Indexed: 12/24/2022] Open
Abstract
Background Weight gain is common after breast cancer. The aim of this study was to identify and describe the barriers to and enablers of successful weight management for women with breast cancer. Methods This was a combined inductive and deductive framework analysis of free text responses to an anonymous cross-sectional survey on weight after breast cancer. Women were recruited mainly through the Breast Cancer Network Australia Review and Survey Group. We applied deductive thematic analysis to free text responses to questions on barriers, enablers, research priorities, and one open-ended question at the end of the survey using the Capability, Opportunity, Motivation and Behaviour (COM-B) model as a framework. Subthemes that arose from the inductive analysis were mapped onto the COM-B model framework. Findings were used to identify behaviour change intervention functions. Results One hundred thirty-three women provided free text responses. Most women were of Caucasian origin and had been diagnosed with non-metastatic breast cancer, with a mean age of 59.1 years. Women's physical capability to adopt and sustain healthy lifestyle habits was significantly affected by treatment effects and physical illness, and some lacked psychological capability to self-regulate the face of stress and other triggers. Limited time and finances, and the social impact of undergoing cancer treatment affected the ability to control their diet. Frustration and futility around weight management were prominent. However, some women were confident in their abilities to self-regulate and self-monitor lifestyle behaviours, described support from friends and health professionals as enablers, and welcomed the physical and psychological benefits of being active in the context of embracing transformation and self-care after cancer. Conclusion Women need specific advice and support from peers, friends and families and health professionals. There is a substantial gap in provision of supportive care to enable women to adopt and sustain healthy lifestyles. Environmental restructuring (including financial support), incentivization (creating an expectation of looking and feeling better), persuasion and coercion (aiming to prevent recurrence), and equipping women with specific knowledge and skills, would also facilitate optimal lifestyle behaviours and weight management. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13980-6.
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