Diet and Prognosis in Women with Breast Cancer

Diet Matters in Breast Cancer Prognosis: Clinical Trial Evidence and Questions

Diet and weight matter in breast cancer prognosis. The DIANA-5 randomized controlled trial found no effect of a Mediterranean macrobiotic diet on 5-year breast cancer recurrence, but high adherence was associated with a 41% lower risk of recurrence versus controls. The effects of substantial weight loss on prognosis remain unknown. See related article by Berrino et al., p. 965.

Obesity Associated with Prediabetes Increases the Risk of Breast Cancer Development and Progression-A Study on an Obese Rat Model with Impaired Glucose Tolerance

Patients with comorbidities of obesity and diabetes are recognized to be at high risk of breast cancer development and face worse breast cancer outcomes. Though several reports showed the reinforced link between obesity, diabetes, and prediabetes with breast cancer, the underlying molecular mechanisms are still unknown. The present study aimed to investigate the underlying molecular link between increased risks of breast cancer due to coincident diabetes or obesity using a spontaneous obese rat model with impaired glucose tolerance (WNIN/GR-Ob rat). A single dose of solubilized DMBA suspension (40 mg/kg body weight) was orally administered to the animals at the age of 60 days to induce breast tumors. The tumor incidence, latency period, tumor frequency, and tumor volume were measured. Histology, immunohistochemistry, and immunoblotting were performed to evaluate the tumor morphology and expression levels of signal molecules. The development of mammary tumors in GR-Ob rats was characterized by early onset and shorter latency periods compared to control lean rats. While 62% of obese rats developed breast tumors, tumor development in lean rats was only 21%. Overexpression of ER, PR, Ki67, and p53 markers was observed in tumor tissues of obese rats in comparison with lean rats. The levels of the hallmarks of cell proliferation and angiogenesis involved in IGF-1/PI3K/Akt/GSK3β/β-catenin signaling pathway molecules were upregulated in obese rat breast tumors compared to lean rats. Furthermore, obesity with prediabetes is associated with changes in IGF-1 signaling and acts on PI3K/Akt/GSK3β/β-catenin signaling, which results in rapid cell proliferation and development of breast tumors in obese rats than the lean rats. These results indicate that tumor onset and development were faster in spontaneous obese rat models with impaired glucose tolerance than in their lean counterparts.

The Relationship among Bowel [18]F-FDG PET Uptake, Pathological Complete Response, and Eating Habits in Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy

Recently, the impact of patients’ eating habits on both breast cancer (BC) management and inflammation have been proven. Here, we investigated whether inflammatory habits could correlate with baseline bowel [18]F-fluorodeoxyglucose (FDG) uptake and the latter, in turn, with pathological Complete Response (pCR) to neoadjuvant chemotherapy (NAC). We included stage I−III BC undergoing standard NAC at IRCCS Humanitas Research Hospital, Italy. Patients fulfilled a survey concerning eating/lifestyle behaviors and performed a staging [18]F-FDG positrone emission tomography/computed tomography (PET/CT). In the absence of data on the effects of individual foods, we aggregated drink and food intake for their known inflammatory properties. Data were recorded for 82 women (median age, 48). We found positive correlations between colon mean standardized uptake value (SUVmean) and pro-inflammatory drinks (alcohol and spirits; r = +0.33, p < 0.01) and foods (red and cured meats; r = +0.25, p = 0.04), and a significant negative correlation between rectum SUVmean and anti-inflammatory foods (fruits and vegetables; r = −0.23, p = 0.04). Furthermore, colon SUVmean was significantly lower in patients with pCR compared to non pCR (p = 0.02). Our study showed, for the first time, that patients’ eating habits affected bowel [18]F-FDG uptake and that colon SUVmean correlated with pCR, suggesting that PET scan could be an instrument for identifying patients presenting unhealthy behaviors.

A review of the Mediterranean diet and nutritional genomics in relation to cancer in women

Cancer is the leading cause of death among women all over the world. Female tissue-specific cancers are the most commonly diagnosed among women and account for most cancer-related deaths. The main risk factors for women's cancer are hereditary factors, specific exposure to dangerous chemicals, disorders such as hormone imbalance, and lifestyle. High body mass index, low physical activity, low intake of fruit and vegetables, smoking, excessive alcohol consumption, lack of cancer screening and treatment are the most common risk factors. Nutrigenetics and nutrigenomics are both part of nutritional genomics. Nutrigenetics is how a person's body reacts to nutrients based on his/her genotype. It can be used to create a personalized diet, maintain a person's health, avoid disease, and if necessary to sustain therapy. Nutrigenomics studies the impact of nutrition on gene expression and the epigenomic, proteomic, transcriptomic and metabolomic effects of dietary intake. There is evidence that diet matters for different women's cancers, and is related to cancer progression, survival and treatment. The optimum combination for cancer prevention is a diet rich in vitamins and fibre, with low meat consumption, low milk intake and moderate use of alcohol. The Mediterranean diet looks to be an optimal diet with a good nutrition pattern, qualifying it as a therapy to prescribe.