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Life Style Choices and Recurrence Risk

Posted 9/21/2009

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Most of us are eager to hear of anything we might do to reduce our risk of recrurrence. Since the reality is that having appropriate treatment (surgery, radiation, chemotherapy, hormone therapy) is all that has been proven to be helpful, some women turn to any possible behaviors that might be of value. I have written several times in the past re the likely benefit of exercise and weight control. This recent article suggests that there may be associations between recurrence risk and obesity, alcohol use, and smoking. Here is a quote:

Breast cancer survivors might be able to reduce their risk for contralateral breast cancer by making lifestyle modifications. A new study published online September 8 in the Journal of Clinical Oncology has found that obesity, alcohol use, and smoking all significantly increase the risk for second primary invasive contralateral breast cancer among breast cancer survivors.

Researchers from the Fred Hutchinson Cancer Research Center in Seattle, Washington, found that obese women had a 50% increased risk for contralateral breast cancer, and those who consumed 7 or more alcoholic drinks per week had a 90% increased risk. Survivors who currently smoked had a 120% increased risk of developing a second breast cancer.

The risk was particularly high in women who were current smokers and who consumed at least 1 alcoholic beverage a day. The authors found that this subgroup of women had a 7.2-fold (95% confidence interval [CI], 1.9 - 26.5) elevated risk for contralateral breast cancer.

Do note that these are still speculations and here is one particular comment to remember:

But given the low rates of hormonal therapy use in this cohort, "it is reasonable to ask whether the relationship between weight and alcohol use seen in this study would be maintained in women with ER-positive tumors treated according to current adjuvant therapy guidelines," writes Jennifer A. Ligibel, MD, from the Dana-Farber Cancer Institute, Harvard Medical School, in Boston, Massachusetts, in an editorial.

"Thus, further work is needed to define the impact of modifiable factors on the risk of second primary breast cancers from modern observational data sets including women treated with modern hormonal therapy regimens," she notes.

If you want to read more:

http://cme.medscape.com/viewarticle/709073

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