Breast Cancer
Episodes
Dr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
Dr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
Dr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
-
Rhonda Aging Breast Cancer Omega-3 Probiotics Coffee Vitamin B12 Vaccine Vitamin K Skin Sulforaphane Sauna Time-Restricted Eating Protein COVID-19 NAD+ Moringa SupplementsDr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
-
Dr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
-
Rhonda Sleep Breast Cancer Omega-3 Pregnancy Melatonin Vaccine Curcumin Bone Sauna COVID-19 Ketogenic DietDr. Rhonda Patrick answers audience questions on various health, nutrition, and science topics in this Q&A session.
-
Dr. Ruth Patterson describes how obesity - along with the growth factors estrogen and insulin - affect the risk of breast cancer development and recurrence.
-
Dr. Ruth Patterson discusses how skipping breakfast and eating late into the evening may contribute to worse metabolic health.
-
Dr. Ruth Patterson discusses how simply changing when one eats can have a profound effect on the risk of breast cancer recurrence.
-
Dr. Ruth Patterson describes the advantages of an earlier eating window on inflammation and blood glucose control.
-
In this clip, Dr. Ruth Patterson discusses the effect that meal frequency has on breast cancer risk.
-
In this clip, Dr. Ruth Patterson discusses how eating in accordance with the body's natural circadian rhythm may reduce the risk of breast cancer.
-
Dr. Ruth Patterson describes how eating following the body's circadian clock enables the body to focus on repair rather than on digestion.
-
Dr. Ruth Patterson discusses how healthful choices, such as even modest weight loss, can have beneficial effects that reduce the risk of breast cancer and a variety of other diseases
-
Dr. Ruth Patterson discusses the beneficial effects that time-restricted eating can have on the biomarkers of health - independent of weight loss.
-
Non-pharmaceutical approach to lowering hemoglobin A1c using time-restricted eating | Ruth Patterson ClipDr. Patterson explains how a lifestyle approach - an altered eating window - can be an effective way to reduce blood sugar levels.
-
Fasting Metabolism Breast Cancer Insulin Resistance Podcast Inflammation Video Insulin Time-Restricted EatingDr. Ruth Patterson discusses the role of fasting in the prevention and survivorship of breast cancer.
Topic Pages
-
Alcohol
Alcohol metabolism generates acetaldehyde and elevates estrogen levels, causing DNA damage and hormonal proliferation driving breast carcinogenesis.
-
Breast milk and breastfeeding
Breastfeeding reduces breast cancer risk by lowering cumulative estrogen exposure and inducing terminal differentiation and exfoliation of mammary epithelium.
-
Sulforaphane
Sulforaphane activates NRF2, represses ER/HER2 signaling, and inhibits HDACs, curtailing breast-cancer cell proliferation and stemness.
News & Publications
-
Roughly one-tenth of postmenopausal breast cancers are linked to high body mass index (BMI)—a measure of excess body fat. However, BMI is unreliable, especially in older women, because it doesn’t account for age, sex, or ethnicity. Using newer, more accurate body fat assessments, a recent study predicted that nearly 40% of breast cancers are due to excess body fat.
The study involved 1,033 women with breast cancer and 1,143 women without. Researchers calculated their body fat using BMI and CUN-BAE, a body fat estimator that accounts for age and sex. Then, they calculated the proportion of breast cancer cases linked to body fat.
They found that 23% of postmenopausal breast cancer cases were linked to excess body fat when assessed by BMI, but the estimate jumped to 38% with CUN-BAE. Among women with hormone receptor-positive tumors, CUN-BAE indicated a striking 41.9% of cases were attributable to excess body fat—more than double the 19.9% predicted with BMI.
These findings suggest that using BMI alone underestimates the cancer burden from excess body fat, especially for hormone receptor-positive breast cancer. Approximately 43% of postmenopausal women in the U.S. have obesity, markedly increasing their risk for breast cancer. Sulforaphane, a bioactive compound derived from broccoli, exerts potent anticancer effects. Learn more in this episode featuring Dr. Jed Fahey.
-
Higher omega-3 intake may reduce breast cancer risk by half. www.verywellhealth.com
Higher intake of omega-3 fatty acids may reduce the risk of breast cancer, a 2022 study found. Women with the highest omega-3 intake were as much as 49 percent less likely to develop breast cancer than those with the lowest intake.
Researchers conducted a study that included more than 3,200 women, roughly half of whom had breast cancer. The women provided information about what they typically ate, including foods rich in omega-3 fatty acids, and whether they were pre- or postmenopausal.
The researchers found that a higher intake of omega-3 in the form of alpha-linolenic acid reduced breast cancer risk by 49 percent; a higher intake in the form of eicosapentaenoic acid reduced risk by 32 percent. The links between omega-3s and breast cancer risk were strongest among premenopausal women and women with hormone-sensitive tumors. Interestingly, higher omega-3 intake markedly reduced the risk of breast cancer among women who had obesity or overweight but not among those who had healthy weights.
These findings suggest that omega-3s reduce the risk of breast cancer, the second leading cause of cancer-related death among women. Inflammation plays a key role in the pathogenesis of many cancers, including breast cancer. Learn how omega-3 fatty acids reduce inflammation in this clip featuring Dr. Bill Harris.
-
Estrogen plus progestin use may be associated with increased breast cancer incidence, especially when its use is initiated close to menopause. (2013) www.sciencedaily.com
From the article:
The researchers found that breast cancer incidence was higher in estrogen plus progestin users than incidence in nonusers. Women who started hormone therapy closer to menopause had a higher breast cancer risk with a weakening influence as the time from menopause increased.
“Because survival after breast cancer diagnosis did not differ between estrogen plus progestin users and nonusers, the higher breast cancer incidence of those using estrogen plus progestin may lead to increased breast cancer mortality on a population basis,” the authors write.
[…]
“In general, tumors in estrogen plus progestin users in the WHI Observational Study were not significantly different from those in non-hormone users with regard to number of positive lymph nodes or tumor size, but were more likely to be well differentiated and positive for hormone receptors, findings which are similar to other observational studies.” This, however, did not translate into a survival benefit.
-
Women who took conjugated equine estrogen had more than twice the risk of developing benign proliferative breast disease. (2008) www.sciencedaily.com
From the article:
In the Women’s Health Initiative study, 10,739 postmenopausal women with hysterectomy were assigned to either conjugated equine estrogen or a placebo. Previous analyses did not show an increase in breast cancer incidence in the women who took estrogen alone after a median follow-up of seven years.
To determine whether the hormone increases the risk of benign proliferative breast disease [condition that is associated with increased risk of breast cancer], Tom Rohan, M.D., Ph.D., of the Albert Einstein College of Medicine in New York and colleagues identified and examined non-cancerous breast biopsies in each of the Women’s Health Initiative trial arms.
A total of 232 cases of benign proliferative breast disease were identified, with 155 cases among the women who took estrogen supplements and 77 in the placebo group. The risk of developing benign disease increased by more than two-fold for women taking conjugated equine estrogen, compared with those taking a placebo.
[…]
Although the women taking conjugated equine estrogen have not yet shown a significant increased risk of breast cancer in the Women’s Health Initiative study, if this hypothesis holds true, they might show increased risk later. Ongoing follow up of the study participants may help to resolve this issue.
-
Local overproduction of the estrogen-producing enzyme aromatase may push breast cancer development more than estrogen receptor overproduction. (2011) www.sciencedaily.com
From the article:
That means they inserted a gene into mice that expresses human aromatase in the animal’s mammary tissue – a gene the researchers can turn on or off.
They compared this new mouse model to one they had developed several years ago – a conditional mouse model in which a gene that produces estrogen receptors (ER) could also be turned on and off.
While they study found that both mouse models experienced the earliest stages of tumor formation, known as preneoplasia, the aromatase over-expressing mice model exhibited both increased preneoplasia and outright development of cancer. These mice also expressed proteins that are tightly linked to cancer, Furth says.
The researchers also found, to their surprise, that aromatase over-expressing mice expressed more estrogen receptors than did the ER-conditional mice. “Increased aromatase produced both more estrogen and the receptors that the hormone needs to enter breast cells,” says Díaz-Cruz. “This is obviously a greater risk for development of breast cancer than just over-expression of estrogen receptors.”
[…]
These mice also over-expressed progesterone receptors, downstream targets of estrogen receptors that can be cancer-promoting in some settings, as shown in this study in the context of aromatase over-expression.
[…]
Finally, they tested the effect of local versus systemic estrogen on development of preneoplasia. The researchers made three comparisons: between mice in which the ER was over-expressed; mice that had excess estrogen due to aromatase; and mice that were given more estrogen systemically. “If we give extra systemic estrogen, we don’t see any increased risk of breast cancer, but the risk increases with extra expression of ER, and is higher still with local production of aromatase,” says Díaz-Cruz. “That suggests that estrogen production in the breast is an important risk factor for development of breast cancer.”
-
Raising estrogen levels benefited 30% of women whose metastatic breast cancer no longer responded to standard anti-estrogen treatment. (2009) www.sciencedaily.com
From the article:
Sixty-six postmenopausal women with breast cancer that had spread beyond the breast participated in the study. All participants were originally diagnosed with estrogen receptor positive (ER ) breast tumors, meaning estrogen stimulated tumor growth. Seventy-five percent of breast cancer cases are ER . All participants had received aromatase inhibitor treatment, which severely lowers estrogen levels, but their metastatic tumors had later reappeared or resumed growing.
The study compared a high 30-milligram daily dose of estrogen to a low 6-milligram daily dose, and evaluated how well the treatments controlled the women’s metastatic cancers and how the treatments affected their quality of life. The high dose results in estrogen levels in the blood comparable to that of pregnant women, while the low dose gives estrogen levels similar to that of women who are ovulating, Ellis indicates.
In both the high- and low-dose groups about 30 percent of participants experienced a clinical benefit — their tumors either shrank or stopped growing. Interestingly, the researchers demonstrated that they could predict fairly accurately which patients would have this positive response. They conducted standard positron emission tomography (PET) scans before estrogen treatment and 24 hours later. If metastatic tumors flared, or glowed more brightly, in the PET scans after estrogen was started, they were much more likely to be affected by estrogen therapy. In 80 percent of women with PET flare reactions, tumors responded to estrogen therapy, and in 87 percent of women without PET flares, tumors did not respond to estrogen.
[…]
“The older women in the study were, the fewer estrogen-related symptoms they had,” says Ellis also professor of medicine in the Division of Oncology. “But overall, we demonstrated clearly that the low dose was better tolerated than the high dose and was just as effective for controlling metastatic diseas.”
-
Women whose breast cancer came back after treatment had almost twice as much estradiol in their blood than did women who remained cancer-free. (2008) www.sciencedaily.com
From the article:
In the current nested case-control study, 153 WHEL [Healthy Eating and Living Study] participants whose cancer had recurred were matched with 153 participants who remained cancer-free. These pairs were alike in terms of tumor type, body size, age, ethnicity, use of chemotherapy and other variables. Two-thirds of the participants were using tamoxifen, Rock said.
When they enrolled, researchers tested the women’s blood for concentrations of the steroid hormones estradiol (the primary human estrogen) and testosterone. They analyzed different forms of estradiol and testosterone in the blood, such as how much was bound to transport proteins (such as to the sex hormone binding globulin, or SHBG) and how much was “free” circulating and able to enter a cell.
Researchers found that higher estradiol concentrations, in all forms, significantly predicted cancer recurrence. Overall, women whose cancer came back had an average total estradiol concentration that was more than double the average for women who remained cancer-free. Increased levels of testosterone or SHBG levels were not associated with recurrence, contradicting the findings of several previous studies.
-
Tumor cell-independent estrogen signaling may drive disease progression by mobilizing immune cells associated with tumor treatment resistance. (2016) www.sciencedaily.com
From the article:
Conejo-Garcia and colleagues found that estrogen signaling is closely linked to both the accumulation and activity of myeloid-derived suppressor cells (MDSCs), a set of immune cells associated with tumors treatment resistance. Estrogen enables immunosuppression in a two-pronged approach involving MDSCs. First, the estrogen drives the mobilization of MSDCs. Then, at the same time, it makes a subset of the MDSCs more immunosuppressive in vivo. Estrogen supplementation accelerated the growth of multiple models estrogen-insensitive tumors in immunocompetent animals, while ablating estrogen production by resecting the ovaries boosted anti-tumor immunity and delayed malignant progression. Importantly, differences in tumor progression disappeared in immunodeficient mice, demonstrating that estrogen-mediated acceleration of tumor growth depends on dampening protective anti-tumor immunity.
They also demonstrated how ERα is responsible for enhancing the activity of multiple pathways that are already associated with cancer development. This estrogen receptor activated the STAT3 pathway, which has already been linked to cancer cell survival and the expansion of MDSCs in cancer-bearing hosts. It was also able to activate this pathway by enhancing the activity of JAK2 and SRC, two proteins linked to cancer development and immune response.
These cancer pathways are activated in a variety of inflammatory cancers in non-tumor cells, such as breast cancer, ovarian cancer, and melanoma. Since estrogen is present not just pre-menopausal women but men and post-menopausal women as well, the authors propose that investigating anti-estrogen therapeutic strategies could lead to new treatments for a variety of cancers. This strategy could halt the mobilization of MDSCs and tumor initiation.
-
Estradiol may induce BDNF/TrkB signaling in non-estrogen-dependent breast cancer to promote brain metastases, mouse study suggests. (2019) www.sciencedaily.com
From the article:
After all, triple negative breast cancers lack estrogen receptors (along with progesterone receptors and HER2, thus the name triple negative), and so these cancers can’t possibly be influenced by estrogen. Right?
[…]
Technically, Cittelly and colleagues including postdoctoral researcher, Maria Contreras-Zarate, PhD, found that estrogen induces astrocytes (brain cells) to produce growth factors called brain-derived neurotrophic factor (BDNF) and Epidermal Growth Factor (EGF), and that these factors turns on two genetic migration/invasion switches in cancer cells, namely TRKB and EGFR.
“This may explain why breast cancers diagnosed in younger women are more likely to metastasize to the brain – pre-menopausal women have more estrogen, and it may be influencing the microenvironment of the brain in ways that aid cancer,” Cittelly says.
-
Higher levels of the "good" estrogen metabolite were associated with a 24-27% reduced risk of all-cause mortality in breast cancer survivors. (2019) www.sciencedaily.com
From the article:
“A lot of research has been done to link these two metabolites with the probability of developing breast cancer,” said the study’s first author Tengteng Wang, a doctoral candidate in the UNC Gillings School of Global Public Health. “So far, we believe we are the first to look at the association of metabolites in relation to mortality after 18 years of breast cancer diagnosis.”
Estrogen is a hormone in the body that drives development of female sex characteristics. Free estrogen in the body is broken down into several byproducts, one of which is 2-hydroxyestrone, or 2-OHE, which is known is a “good” type of byproduct. Researchers report that it is known to interfere with the cancer-linked effects of estrogen. Another metabolite, which is called 16-alpha-hydroxyestrone, is known as a “bad” metabolites because of its pro-cancer effects that lead to abnormal growth and DNA damage.
[…]
In their study, researchers examined the balance of these two metabolites in relation to mortality. Specifically, they found that if the level of 2-OHE was more than, or equal to, 1.8 times the level of 16-alpha-OHE in urine, there was an associated 26 percent reduction in any cause of death in women with breast cancer. They also saw that there was a lower risk of breast cancer death, or cardiovascular death, for women who had higher levels of the “good” metabolite.
They studied these associations in group of 687 women who were diagnosed with breast cancer between 1996 and 1997, and who participated in the Long Island Breast Study Project.
[…]
Researchers say they have additional questions remaining after the study, such as whether the subtype of breast cancer a woman has is important for the pattern they saw, and whether treatments that women may or may not have received could be playing a role as well.
-
Study in mice suggests that overexpression of estrogen receptor 1 gene can impact post-menopausal breast cancer risk and prevention strategies. (2022) www.sciencedaily.com
From the article:
In a study using a first-of-its kind mouse model of aging that mimics breast cancer development in estrogen receptor-positive post-menopausal women, investigators at Georgetown Lombardi Comprehensive Cancer Center and colleagues have determined that over-expression, or switching on of the Esr1 gene, could lead to elevated risk of developing estrogen receptor-positive breast cancer in older women.
In a second study from the same research lab, investigators found that in the specially bred mice given anti-hormonal drugs (e.g., tamoxifen and letrozole) similar to those currently used by women to lower their breast cancer risk, the elevated risk of developing breast cancer due to over-expression of Esr1 could be lowered or reversed.
[…]
“If validated in human studies, detection of over-expression of Esr1-related genes could be a new signature to add to current prognostic tools that would help post-menopausal women at risk for estrogen receptor-positive breast cancer decide what their best risk reduction strategy might be.”
[…]
The investigators were guided in their study by the use of the PAM50 (Prediction Analysis of Microarray 50) prognostic tool. The tool reads a sample of the tumor and determines expression levels for a group of 50 genes. The scientists found that many genes related to proliferation of breast cancer cells in the PAM50 tool were significantly expressed only in Esr1 mice and this correlated with development of the same type of estrogen receptor-positive breast cancers that develop in humans, thereby giving them new evidence of which other genes might be implicated in inducing breast cancer in post-menopausal women. In current clinical practice, the results of the PAM50 test have helped predict the chance of metastasis for some ER-positive, HER2-negative breast cancers.
-
Physical activity cuts breast cancer death risk by 60 percent. jamanetwork.com
Scientists have long known that being physically active reduces a woman’s risk of developing breast cancer. But a new study shows that breast cancer survivors who are physically active are as much as 60 percent less likely to die than those who are inactive.
Researchers tracked 315 women who were breast cancer survivors. The women provided information about the type and duration of their daily physical activities, and the researchers categorized them as being active, moderately active, or inactive.
They found that compared to breast cancer survivors who were inactive, those who were active were 58 percent less likely to die, and those who were moderately active were 60 percent less likely to die. The protective effects of exercise were seen even after taking into account different cancer treatments.
Breast cancer is the most common form of cancer (after skin cancer) among women living in the United States. With nearly 290,000 cases diagnosed in 2022, experts expect breast cancer to claim the lives of nearly 44,000 women.
This study adds to the robust library of scientific literature supporting the role of exercise and physical activity in promoting survivorship among people who have breast cancer. Other evidence suggests that time-restricted eating promotes survivorship, too. Learn more in this episode featuring Dr. Ruth Patterson.
-
Urinary excretion of isothiocyanates – bioactive compounds derived from cruciferous vegetables – is associated with a lower risk of breast cancer, a 2003 study found. Women with the highest levels of isothiocyanates in their urine were half as likely to have breast cancer, compared to women with the lowest levels.
Researchers measured isothiocyanates in the urine of 674 women, half of whom had breast cancer. They also collected information about the women’s demographics, lifestyles, reproductive histories, and dietary intake of cruciferous vegetables.
They found high urinary isothiocyanate levels reduced the women’s risk of having breast cancer by half, even after considering age, menopausal status, and other factors that influence breast cancer risk. This protective association was true in pre- and postmenopausal women.
Isothiocyanates are bioactive compounds derived from glucosinolates, a large class of precursor molecules found in cruciferous vegetables. Robust evidence demonstrates that isothiocyanates switch on the activity of cellular protective mechanisms that reduce the risk of many chronic diseases, including cancer.
Assessing isothiocyanate exposure via dietary reports of glucosinolate intake is often inaccurate due to reporting biases as well as differences in plant glucosinolate content, which varies across species and cultivars. In addition, inter-individual differences in how people metabolize isothiocyanates and their precursors may influence exposure. Measuring urinary isothiocyanate metabolites likely provides more accurate measures of habitual intake and metabolite-specific exposures that positively influence risk.
Sulforaphane is an isothiocyanate with potent antioxidant, anti-inflammatory, and anticancer properties. Learn more about sulforaphane’s effects on cancer in this clip featuring Dr. Jed Fahey.
-
Broccoli sprout extract may promote tumor-infiltration of immune cells and drive cell death in breast cancer. onlinelibrary.wiley.com
Nearly four million women living in the United States have a history of breast cancer. Evidence suggests that dietary interventions improve breast cancer outcomes and enhance survival. Findings from a recent study indicate that consumption of an isothiocyanate-rich broccoli sprout extract may improve outcomes in women with breast cancer.
Isothiocyanates are byproducts of a reaction between compounds present in cruciferous vegetables. Isothiocyanates inhibit the activity of enzymes that transform procarcinogens into carcinogens. One of the most studied isothiocyanates is sulforaphane, which is derived from broccoli and is particularly abundant in broccoli sprouts.
The study involved 30 women (average age, 61 years) who were about to undergo surgery to remove breast cancer tumors. The investigators randomly assigned half of the women to receive 200 micromoles of isothiocyanates from a broccoli sprout extract every day for two weeks prior to their surgery. (This daily dose of broccoli sprout extract is roughly equivalent to that provided in 500 grams – a little more than one pound – of fresh broccoli.) The remaining half of the women received a placebo. The investigators measured isothiocyanate metabolites and cytoprotective proteins in the women’s urine and biomarkers of anticancer activity in the excised tumor tissue.
They identified multiple proteins in the participants' urine that indicated increased activity of cytoprotective pathways, including the Nrf2-mediated oxidative response pathway. They also observed changes in biomarkers of anticancer activity, including a trend toward increased levels of proteins that regulate programmed cell death and immune cells that recognize and kill cancer cells, as well as a trend toward decreased levels of proteins involved in proliferation. These changes were not statistically significant, however.
These findings indicate that consumption of an isothiocyanate-rich broccoli sprout extract may improve outcomes in women with breast cancer. The authors posited that the absence of statistically significant findings was likely due to their small sample size and suggested further study with a larger sample.
-
Risk of death from breast cancer was 49 percent lower among women with higher running activity. www.sciencedaily.com
Breast cancer is the most common form of cancer among women, with roughly 237,000 cases diagnosed in the United States each year. Nearly one-fourth of women with breast cancer will die within 15 years of diagnosis. Findings from a 2014 study indicate that running reduces the risk of death from breast cancer.
Most public health organizations recommend that adults of all ages engage in at least 150 minutes of moderate-intensity exercise or at least 75 minutes of vigorous-intensity exercise each week, or an equivalent combination of both. Most adults fall far short of these recommendations, however.
Data from epidemiological, clinical, and mechanistic studies suggest that exercise reduces the risk of cancer-related death. However, scientists are unsure about how much or what type of exercise is best. Running and walking are both aerobic forms of exercise, but they differ in intensity, with running categorized as vigorous, and walking categorized as moderate. The authors of the study investigated whether running and walking differed in their effects on breast cancer-related death risk.
The authors drew on data collected in the National Runners' and Walkers' Health Study, a long-term assessment of the health benefits associated with running and walking. They compared death rates among 272 runners and 714 walkers who had previously been diagnosed with breast cancer, taking age, race, menopause, family history, breastfeeding and oral contraceptive use into account. They quantified the intensity of the women’s activity as metabolic equivalents, or METs, a measure of the rate of energy expended per unit of time.
Over a nine-year period, the risk of death from breast cancer was 49 percent lower among women who ran or walked 1.8 to 3.6 MET-hours per day and 68 percent lower for 3.6 MET-hours per day, when compared to less active women. Among runners only, the risk of death from breast cancer was 14 percent lower among women who ran 1.07 to 1.8 MET-hours per day, 87 percent lower for 1.8 to 3.6 MET-hours per day had a, and 95 percent lower for 3.6 hours or more per day, when compared to those who ran for less than 1.07 MET-hours per day.
The findings indicate that running promotes greater survival among women who have had breast cancer. The authors noted that the amount of exercise that provided the greatest protection exceeded current guidelines, suggesting that breast cancer survival could be increased by engaging in greater exercise doses than recommended. Other behaviors that may promote breast cancer survival include dietary modifications, especially time-restricted eating. Learn more about the effects of time-restricted eating on breast cancer survival in this clip featuring Dr. Ruth Patterson.
-
Drinking sugar-sweetened beverages increases risk of death from any cause among women with breast cancer. pubmed.ncbi.nlm.nih.gov
Obesity and metabolic disease are risk factors for developing breast cancer; however, they are highly modifiable with lifestyle changes. Sugar-sweetened beverages are the leading contributor of added sugars in the American diet and consuming them in excess greatly increases the risk of developing obesity and type 2 diabetes. Results of a long-term study show that sugar-sweetened beverage consumption among women with breast cancer increases the risk of death from any cause.
As adipose tissue accumulates fat, it becomes dysfunctional and can contribute to breast cancer growth by reducing glucose sensitivity and producing hormonal (e.g., estrogen) and inflammatory (e.g., interleukin-6) pro-cancer signals. Sugar-sweetened beverages contribute to the development of obesity and diabetes by providing large quantities of empty calories and spiking blood glucose and insulin levels due to the rapid absorption of sugar. Although previous research has established the mechanisms by which sugar overconsumption encourages cancer growth, few studies have examined the long-term effects of sugar-sweetened beverage consumption on cancer survival.
The authors examined data from more than 10,000 participants of the Nurses' Health Study (1980-2010) and Nurses' Health Study II (1991-2011), large-scale prospective studies that collected information regarding health and lifestyle from female nurses. Participants completed food frequency questionnaires, which provide a list of specific foods and ask participants to report how often they have consumed that food over the past year, upon entrance to the study and every four years thereafter until 2015. The researchers reviewed only data collected following breast cancer diagnosis.
Compared to non-consumers, participants who consumed three or more 8-ounce servings of sugar-sweetened beverages per week experienced a 35 percent increased risk of death due to cancer and 28 percent increased risk of death due to any cause. Participants consuming between one and three servings per week experienced a 31 percent increased risk of cancer-related death and 21 percent increased risk of death due to any cause compared to non-consumers. The data revealed no association between breast cancer risk and the consumption of beverages sweetened with non-nutritive (i.e., artificial) sweeteners.
In this long-term follow-up study, sugar-sweetened beverage consumption increased the risk of death among women with breast cancer, especially in women consuming more than three servings per week.
-
Fat cells relay pro-cancer signals to tumors, especially in people with obesity and type 2 diabetes. www.inverse.com
Obesity and metabolic diseases are strong risk factors for the development and progression of metastatic breast cancers in women who have completed menopause. Breast tumors contain a large number of white blood cells and adipocytes (i.e., fat cells); however, the role of adipocytes in metastatic breast cancer is unknown. Findings of a new report show that adipocytes shed molecular droplets called exosomes that relay cancer-promoting signals.
Adipocytes play a critical role in the tumor microenvironment, releasing proinflammatory cytokines such as interleukin-6 and tumor necrosis factor-alpha and fats that act as fuel for tumor growth. Tumor metastasis is induced by changes in gene expression that increase cell movement and angiogenesis (i.e., the growth of new blood vessels) and decrease cell death and adhesion (i.e., how tightly cells cling to each other). The mechanisms by which adipocytes deliver these pro-cancer and pro-metastatic signals is understudied.
The investigators obtained estrogen receptor-positive breast cancer cells and co-cultured them with adipocytes that were collected from female patients with or without type 2 diabetes who underwent bariatric (weight-loss) surgery. The researchers measured changes in gene and protein expression and performed fluorescence imaging to observe physical changes to adipocytes and cancer cells.
When cultured with adipocytes from patients with obesity, cancer cells increased expression of genes important for a process called epithelial-to-mesenchymal transition, a key stage of tumor metastasis. Compared to exosomes produced by adipocytes from participants without type 2 diabetes, exosomes from participants with diabetes increased the expression of metastasis genes in cancer cells to a greater extent. Microscope imaging revealed that cancer cells from participants with diabetes underwent physical changes associated with metastasis as well as gene expression.
These results revealed that exosomes shed from adipocytes act as the mechanism for delivery of pro-cancer compounds from adipocytes to breast cancer cells. Also, the strength of this pro-cancer signaling increased as insulin resistance increased. This study provides important insight into the relationship between obesity and cancer.
-
Vitamin D improves outcomes among breast cancer survivors. www.newswise.com
Breast cancer is the most common cancer in women worldwide, with nearly 2.6 million new cases diagnosed in 2020. Robust evidence demonstrates that nutritional factors may mediate the risk of many types of cancer. Findings presented at the annual conference of the American Society of Clinical Oncology suggest that vitamin D status influences outcomes among breast cancer survivors.
Vitamin D is a fat-soluble vitamin stored in the liver and fatty tissues. It plays key roles in several physiological processes. Research suggests that vitamin D exerts anti-cancer properties through its effects on the regulation of cell growth.
The current study involved nearly 4,000 women with breast cancer who were enrolled in the Pathways Study, an ongoing investigation of breast cancer survivorship. The study presenters measured vitamin D concentrations (measured in nanograms per milliliter, ng/ml) in blood samples collected from the women at the time of diagnosis. They categorized the women’s status as deficient (< 20 ng/ml), insufficient (20 to < 30 ng/ml), or sufficient (≥30 ng/ml) and then conducted a statistical analysis to determine if vitamin D status was related to the women’s survival. They also looked at factors that could influence vitamin D status, such as genetic variants, body mass index, race/ethnicity, and supplemental vitamin D intake.
They found that women categorized as having sufficient vitamin D concentrations had better survival outcomes than women categorized as deficient. Supplemental vitamin D intake, body mass index, and race/ethnicity had the greatest influence on vitamin D concentrations, and genetic variants had only a minor influence. Black women had the lowest vitamin D concentrations among the cohort, possibly contributing to their poorer outcomes following breast cancer diagnosis.
Although these findings have not been peer-reviewed, they suggest that vitamin D status influences outcomes among breast cancer survivors and underscore the need for further research to assess the roles that vitamin D plays in cancer.
-
A fasting-mimicking diet improved effectiveness and reduced toxicity of neoadjuvant chemotherapy in breast cancer patients. www.nature.com
Chemotherapeutic agents, powerful drugs used in cancer treatment, kill cancer cells but can also damage healthy cells. Chemotherapy administered to shrink a tumor prior to surgery is known as neoadjuvant chemotherapy. Findings from a recent study suggest that following a fasting-mimicking diet before neoadjuvant chemotherapy impacts both the toxicity and efficacy of the treatment.
A large body of evidence indicates that prolonged fasting can reduce the risk of chronic diseases by improving overall metabolic health. A fasting-mimicking diet, or FMD, is designed to achieve effects similar to a multiple day water-only fast while being easier to follow.
Previous preclinical research has demonstrated that prolonged fasting sensitizes cancer cells to chemotherapy while protecting healthy cells. Studies in animal models indicate that during prolonged fasting, healthy cells shift to a resting metabolism that protects them from nutrient scarcity; however, cancer cells are unable to do this. The current study investigated whether the fasting-mimicking diet influenced the toxicity or effectiveness of chemotherapy in women with early-stage breast cancer.
The authors of the randomized controlled study assigned 131 women with stage II/III breast cancer to receive either an FMD or their regular diet three days before and throughout neoadjuvant chemotherapy. Both groups of women experienced similar side effects, despite the fact that only those on the regular diet were given dexamethasone — a drug to lessen side effects. The authors suggest that these findings might eliminate the need for drugs to manage side effects. Researchers observed that women on the FMD were more likely to experience a 90 to 100 percent tumor cell loss as compared to women on a regular diet. Furthermore, patients on the FMD had less DNA damage in T-lymphocytes from chemotherapy than those on the regular diet.
These findings suggest that an FMD can curb damage to normal cells while increasing a cancer cell’s vulnerability to chemotherapy in women with breast cancer. Further clinical trials will determine if fasting or an FMD in conjunction with standard of care will be helpful in the treatment of other cancers.
-
Exercise reduces risk of breast cancer recurrence and mortality among women. www.eurekalert.org
Breast cancer is one of the leading causes of death among women living in the United States, claiming the lives of approximately 41,000 women each year. Findings from a new study suggest that regular physical activity can reduce the risk of developing breast cancer.
The Physical Activity Guidelines for Americans recommend that adults engage in at least 150 to 300 minutes of moderate-intensity, or 75 to 150 minutes of vigorous-intensity aerobic physical activity each week. Moderate-intensity exercises include brisk walking, light cycling, or playing doubles tennis. Vigorous-intensity exercises include jogging, hiking, rigorous cycling, or playing basketball, soccer, or singles tennis. Data indicate that fewer than 23 percent of Americans achieve recommended levels of activity.
The questionnaire-based study assessed the lifestyles of 1,340 women with breast cancer at multiple times throughout survivorship, including before, during, and after treatment. Women who met the guidelines before and after treatment were 55 percent less likely to have their cancer return and were 68 percent less likely to die from their cancer. But even if a woman didn’t start exercising until after her treatment began, she was likely to experience benefits, with a 46 percent lower risk of her cancer returning and a 43 percent lower risk of dying. These findings underscore the importance of engaging in regular activity as a means to reduce the risk of cancer recurrence and death and suggest that a breast cancer diagnosis can provide an impetus to begin exercising.
-
Sustained weight loss in women over 50 reduces breast cancer risk www.eurekalert.org
Breast cancer is one of the leading causes of death among women living in the United States, claiming the lives of approximately 41,000 women each year. Being overweight or obese increases a woman’s risk of developing breast cancer. Findings from a new study indicate that women who lose weight after the age of 50 years and keep the weight off have reduced risk of developing breast cancer.
More than two-thirds of women living in the United States are overweight or obese. Excess body fat increases a person’s risk for developing type 2 diabetes, a known risk factor for cancer. Body fat also alters hormone levels, which may increase the risk of developing hormone-sensitive cancers, such as breast cancer. In addition, body fat secretes a wide array of pro-inflammatory substances that damage DNA and inhibit apoptosis.
The study involved more than 180,000 women who were 50 years of age and older from cohorts of 10 different prospective studies. The women were weighed three times over a period of 10 years. Those who lost weight and kept it off had a lower risk of breast cancer than women who did not lose weight.
Among women who lost 4 to 10 pounds, 10 to 20 pounds, or 20 or more pounds, risk decreased by 13 percent, 16 percent, and 26 percent, respectively. Among women who lost 20 or more pounds but gained a portion of the weight back, risk was reduced by 23 percent.
These findings point to the importance of public health interventions that promote weight loss among women as a means to reduce cancer risk.
-
women with blood levels of vitamin D in the 60 ng/ml range had an 80% lower breast cancer risk compared to women with less than 20 ng/ml. www.sciencedaily.com
A pooled analysis of randomized controlled trials and prospective studies finds that women with blood levels of vitamin D in the 60 ng/ml range had an 80% lower breast cancer risk compared to women with less than 20 ng/ml.
Another randomized controlled trial found that men given 4,000 IU of vitamin D per day slowed cancer progression and improved tumors in men with low-grade prostate cancer (compared to men given placebo).
In a 2009 paper published in the Annals of Epidemiology by the authors of this study, they recommended vitamin D levels between 40 to 60 ng/ml based on lowest all-cause mortality data.
Many factors regulate how much vitamin D3 a person makes from UVB exposure from the sun. These factors include geographic location/time of year since some northern latitudes do not get UVB exposure certain times of the year, how much pigmentation a person has since melanin acts as a natural sunscreen and blocks UVB radiation, age since the aging process makes the production of vitamin D3 from the sun much less efficient, body fat since vitamin D3 is less bioavailable to mobilize from the skin into the bloodstream with increasing fat mass, and other factors such as sunscreen and time spent in the sun.
The best way to know how much vitamin D to supplement with is to get a blood test before and after supplementation.
-
A woman with late-stage breast cancer which had metastasized throughout her body is in complete remission after a new immunotherapy treatment where her own immune cells were manipulated and used to kill cancer cells.
She had previously been treated with multiple rounds of chemotherapy and hormonal treatment but her cancer continued to progress.
The experimental treatment involves harvesting immune cells that are at the site of a tumor (from a biopsy), sequencing the tumor to find specific mutations, growing the patient’s immune cells in a petri dish that specifically target the tumor (based on the genomic data), and infusing the immune cells back into the patient where they migrate to the tumor and kill cancer cells.
This new treatment shows much promise but larger trials are still needed before this experimental therapy can be used to treat metastatic breast cancer (which still remains uncurable).
-
Large randomized controlled trial finds that 70% of women with early-stage invasive breast cancer do not need chemotherapy in addition to hormone therapy based on a genomic test for this type of breast cancer.
This trial involved more than 10,000 patients across six countries with the most common form of early breast cancer, hormone-receptor positive, HER-2 negative breast cancer that hadn’t spread to the lymph nodes.
The genomic test (called Oncotype DX) measures the expression of 21 genes in tumor tissue and predicts the risk of recurrence on a scale of 0 to 100.
For those individuals with test scores between 11 and 25, there was a similar rate of cancer-free survival after 9 years for those who had chemo combined with hormone therapy and those who had hormone therapy alone. This new finding may spare a lot of unnecessary chemotherapy in certain patients with breast cancer.