Skip to main content

Lifestyle and Breast Cancer

  • Chapter
  • First Online:
Breast Cancer

Abstract

The potential for lifestyle factors to influence breast cancer incidence, breast cancer recurrence risk, and breast cancer overall survival is being addressed in observational studies and emerging randomized clinical trials. Factors under evaluation include obesity and weight loss/maintenance, physical activity, dietary fat intake, and various dietary patterns. Studies have demonstrated that interventions targeting weight, diet, and physical activity lead to better quality of life and fewer disease and treatment-related side effects in breast cancer survivors [1–3]. While preliminary evidence suggests lifestyle factors can influence breast cancer incidence and outcome, validation studies are needed to support this concept [4, 5]. We summarize below the current evidence linking lifestyle factors and breast cancer incidence and outcome with emphasis on the findings from full-scale randomized trials and the status of ongoing randomized trials in this area.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Schmitz KH, Courneya KS, Matthews C et al (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42:1409–1426

    Article  PubMed  Google Scholar 

  2. Segal R, Pond G, Vallis M, et al. (2011) Randomized trial of a lifestyle intervention for women with early-stage breast cancer (BC) receiving adjuvant hormone therapy: initial results. J Clin Oncol 29: abstract 512

    Google Scholar 

  3. Rock CL, Flatt SW, Byers TE et al (2015) Results of the Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) Trial: a behavioral weight loss intervention in overweight or obese breast cancer survivors. J Clin Oncol 33(28):3169–3176

    Article  PubMed  PubMed Central  Google Scholar 

  4. Chlebowski RT (2013) Nutrition and physical activity influence on breast cancer incidence and outcome. Breast 22S2:S30–S37

    Article  Google Scholar 

  5. Ligibel JA, Chlebowski RT (2014) Lifestyle issues in breast cancer survivors. In: Harris JR, Lippman ME, Morrow M, Osborne CK (eds) Diseases of the breast, 5th edn, vol 676. Lippincott Williams & Wikins, Philadelphia, p 681

    Google Scholar 

  6. Carroll KK, Gammal EB, Plunkett ER (1968) Dietary fat and mammary cancer. Can Med Assoc J 98(12):590–594

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Kroenke CH, Kwan ML, Sweeney C et al (2013) High- and low-fat dairy intake, recurrence, and mortality after breast cancer diagnosis. J Natl Cancer Inst 105(9):616–623

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Boeke CE, Eliassen AH, Chen WY et al (2014) Dietary fat intake in relation to lethal breast cancer in two large prospective cohort studies. Breast Cancer Res Treat 146(2):383–392

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Brenner DR, Woodside JV, Lunny PM, et al (2015) Dietary fat and breast cancer mortality: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. [Epub ahead of print]

    Google Scholar 

  10. Prentice RL, Caan B, Chlebowski RT et al (2006) Low-fat dietary pattern and risk of invasive breast cancer: the Women’s Health Initiative randomized controlled dietary modification trial. JAMA 295:629–642

    Article  CAS  PubMed  Google Scholar 

  11. Anderson GL, Manson J, Wallace R et al (2003) Implementation of the Women’s Health Initiative study design. Ann Epidemiol 13(Suppl. 9):S5–17

    Article  PubMed  Google Scholar 

  12. Patterson RE, Kristal AR, Tinker LF et al (1999) Measurement characteristics of the Women’s Health Initiative food frequency questionnaire. Ann Epidemiol 9:178–187

    Article  CAS  PubMed  Google Scholar 

  13. Tinker LF, Burrows ER, Henry H et al (1996) Women’s Health Initiative: overview of the nutrition component. In: Kummel DA, Kris-Atherton PM (eds) Nutrition in Women’s Health. ASPEN Publishers, Gaithersburg, MD, pp 510–542

    Google Scholar 

  14. Thomson CA, Horn LV, Caan BJ et al (2014) Cancer incidence and mortality during the intervention and post intervention periods of the Women’s Health Initiative Dietary Modification Trial. Cancer Epidemiol Biomarkers Prev 23(12):2924–2935

    Article  PubMed  PubMed Central  Google Scholar 

  15. Chlebowski RT, Aragaki AK, Anderson GL, et al (2016) Low-fat dietary pattern and breast cancer mortality in the Women’s Health Initiative (WHI) randomized trial. American Association for Cancer Research Annual Meeting, April 18, 2016, Abstract CT043

    Google Scholar 

  16. Martin LJ, Li Q, Melnichouk O et al (2011) A randomized trial of dietary intervention for breast cancer prevention. Cancer Res 71:123–133

    Article  CAS  PubMed  Google Scholar 

  17. Cade JE, Taylor EF, Burley VJ, Greenwood DC (2011) Does the Mediterranean dietary pattern or the Healthy Diet Index influence the risk of breast cancer in a large British cohort of women? Eur J Clin Nutr 65:920–928

    Article  CAS  PubMed  Google Scholar 

  18. Demetriou CA, Hadjisavvas A, Loizidou MA et al (2012) The Mediterranean dietary pattern and breast cancer risk in Greek-Cypriot women: a case-control study. BMC Cancer 12:113

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Buckland G, Travier M, Cottet V et al (2012) Adherence to the Mediterranean diet and risk of breast cancer in the EPIC cohort study. Int J Cancer 132(12):2918–2927

    Article  PubMed  Google Scholar 

  20. Fung TT, Hu FB, McCullough ML et al (2006) Diet quality is associated with the risk of estrogen receptor negative breast cancer in postmenopausal women. J Nutr 136:466–472

    CAS  PubMed  Google Scholar 

  21. Kim EHJ, Willett WC, Fung T et al (2011) Diet quality indices and postmenopausal breast cancer survival. Nutr Cancer 63:381–388

    Article  PubMed  PubMed Central  Google Scholar 

  22. Schwingshacki L, Hoffman G (2016) Does a Mediterranean-type diet reduce cancer risk? Curr Nur Rep 5:9–17

    Article  Google Scholar 

  23. Toledo E, Salas-Salvado J, Donat-Vargas C et al (2015) Mediterranean diet and invasive breast cancer risk among women at high cardiovascular risk in the PREDIMED trial: a randomized clinical trial. JAMA Intern Med 175(11):1752–1760

    Article  PubMed  Google Scholar 

  24. Kushi LH, Doyle C, McCullough M et al (2012) American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 62:30–67

    Article  PubMed  Google Scholar 

  25. Thomson CA, McCullough ML, Wertheim BC et al (2014) Nutrition and physical activity cancer prevention guideline, cancer risk, and mortality in the women’s health initiative. Cancer Prev Res (Phila) 7(1):42–53

    Article  Google Scholar 

  26. Harris JR, Bergkvist L, Wolk A (2016) Adherence to the World Cancer Research/American Institute for Cancer Research recommendations and breast cancer risk. Int J Cancer 138(11):2657–2664

    Article  CAS  PubMed  Google Scholar 

  27. Ogden CL, Carroll MD, Fryar CD, Flegal KM (2015 Nov) Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief 219:1–8

    Google Scholar 

  28. Cheraghi Z, Poorolajal J, Hashem T et al (2012) Effect of body mass index on breast cancer during premenopausal and postmenopausal periods: a meta-analysis. PLoS One 7(12):e51446

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Neuhouse ML, Aragaki AK, Prentice RL et al (2015) Overweight, obesity and postmenopausal breast cancer risk. JAMA Oncol 5:611–621

    Article  Google Scholar 

  30. Chlebowski RT, Blackburn GL, Buzzard IM et al (1993) Adherence to a dietary fat intake reduction program in postmenopausal women receiving therapy for early breast cancer. J Clin Oncol 11(11):2072

    Article  CAS  PubMed  Google Scholar 

  31. Chlebowski RT, Blackburn G, Thomson CA et al (2006) Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women’s Intervention Nutrition Study (WINS). J Natl Cancer Inst 98(24):1767–1776

    Article  PubMed  Google Scholar 

  32. Chlebowski RT, Blackburn G, Hoy KM, et al (2008) Survival analysis from the Women’s Intervention Nutrition Study (WINS) evaluating dietary fat reduction and breast cancer therapy outcome. J Clin Oncol. ASCO Annual Meeting Proceedings (Post-Meeting Edition), vol 26, 15S (May 20 Suppl.), p 522

    Google Scholar 

  33. Pierce JP, Natarajan L, Caan BJ et al (2007) Influence of diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women’s Healthy Eating and Living (WHEL) randomized trial. JAMA 298(3):289–298

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Chlebowski RT, Blackburn GL (2007) Diet and breast cancer recurrence. JAMA 298(18):2135–6

    Google Scholar 

  35. Ligibel JA, Alfano CM, Hershman D et al (2015) Recommendations for obesity clinical trials in cancer survivors: American Society of Clinical Oncology statement. J Clin Oncol 33(33):3961–3967

    Article  PubMed  Google Scholar 

  36. Rack B, Andergassen U, Neugebauer J et al (2010) The German SUCCESS C Study-The first European lifestyle study on breast cancer. Breast Care 5:395–400

    Article  PubMed  PubMed Central  Google Scholar 

  37. Villarini A, Pasanisi P, Traina A et al (2012) Lifestyle and breast cancer recurrences: the DIANA-5 trial. Tumor 981:1–18

    Google Scholar 

  38. Ligibel JA, Segal R, Pond G et al (2011) Impact of the Lifestyle Intervention Study in Adjuvant Treatment of Early Breast Cancer (LISA) weight loss intervention upon physical activity. Cancer Res 70:S2–S6

    Google Scholar 

  39. Goodwin PJ, Segal RJ, Vallis M et al (2014) Randomized trial of a telephone-based weight loss intervention in postmenopausal women with breast cancer receiving letrozole: the LISA trial. J Clin Oncol 32(21):2231–2239

    Article  PubMed  Google Scholar 

  40. Park J, Morley TS, Kim M, Clegg DJ, Scherer PE (2014) Obesity and cancer – mechanisms underlying tumour progression and recurrence. Nat Rev Endocrinol 10(8):455–465

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Gershuni VM, Ahima RS, Tchou J (2016) Obesity and breast cancer: a complex relationship. Curr Surg Rep 4:14

    Article  Google Scholar 

  42. Hardefeldt PJ, Edirimanne S, Eslick GD (2012) Physical activity reduces the risk of breast cancer. San Antonio Breast Cancer Symposium December 5, 2012

    Google Scholar 

  43. Lahart IM, Metsios GS, Nevill AM, Carmichael AR (2015) Physical activity, risk of death and recurrence in breast cancer survivors: a systematic review and meta-analysis of epidemiological studies. Acta Oncol 54(5):635–654

    Article  PubMed  Google Scholar 

  44. Holmes MD, Chen WY, Feskanich D et al (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293:2479–2486

    Article  CAS  PubMed  Google Scholar 

  45. Rose DP, Connolly JM, Chlebowski RT et al (1993) The effects of a low-fat dietary intervention and tamoxifen adjuvant therapy on the serum estrogen and sex hormone-binding globulin concentrations of postmenopausal breast cancer patients. Breast Cancer Res Treat 27(3):253–262

    Article  CAS  PubMed  Google Scholar 

  46. Kaas R, Bellati C, Venturelli E et al (2003) Effects of dietary intervention on IGF-1 and IGF-binding proteins, and related alterations of sex steroid metabolism: the Diet and Androgens (DIANA) Randomized Trial. Eur J Clin Nutr 57:1079–1088

    Article  Google Scholar 

  47. Irwin M, Varma K, Alvarez-Reeves M et al (2009) Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the Yale Exercise and Survivorship Study. Cancer Epidemiol Biomark Prev 18:1306–1313

    Google Scholar 

  48. Scott E, Daley AJ, Doll H et al (2013) Effects of an exercise and hypocaloric healthy eating program on biomarkers associated with long-term prognosis after early on stage breast cancer: a randomized controlled trial. Cancer Causes Control 24:181–191

    Article  CAS  PubMed  Google Scholar 

  49. Swisher AK, Abraham J, Bonner D et al (2015) Exercise and dietary advice intervention for survivors of triple-negative breast cancer: effects on body fat, physical function, quality of life, and adipokine profile. Support Care Cancer 23(10):2995–3003

    Article  PubMed  PubMed Central  Google Scholar 

  50. Nechuta S, Chen WY, Cai H et al (2016) A pooled analysis of post-diagnosis lifestyle factors in association with late estrogen-receptor-positive breast cancer prognosis. Int J Cancer 138(9):2088–2097

    Article  CAS  PubMed  Google Scholar 

  51. Ligibel JA, Giobbie-Hurder A, Shockro L et al (2016) Randomized trial of a physical activity intervention in women with metastatic breast cancer. Cancer. doi:10.1002/cncr.29899. [Epub ahead of print]

    Google Scholar 

  52. Ellen Lee C, Warden SJ, Szuck B, Lau J (2016) A preliminary study on the efficacy of a community-based physical activity intervention on physical function-related risk factors for falls among breast cancer survivors. Am J Phys Med Rehabil 29. [Epub ahead of print]

    Google Scholar 

  53. Courneya KS, Segal RJ, Vallerand JR et al (2016) Motivation for different types and doses of exercise during breast cancer chemotherapy: a randomized controlled trial. Ann Behav Med 19. [Epub ahead of print]

    Google Scholar 

  54. Goodwin PJ (2016) Obesity and breast cancer outcomes: how much evidence is needed to change practice? J Clin Oncol 34(7):646–648

    Article  PubMed  Google Scholar 

  55. Runowicz CD, Leach CR, Henry NL et al (2016) American Cancer Society/American Society of clinical oncology breast cancer survivorship care guideline. J Clin Oncol 34(6):611–635

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rowan T. Chlebowski M.D., Ph.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chlebowski, R.T. (2017). Lifestyle and Breast Cancer. In: Veronesi, U., Goldhirsch, A., Veronesi, P., Gentilini, O., Leonardi, M. (eds) Breast Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-48848-6_72

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-48848-6_72

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-48846-2

  • Online ISBN: 978-3-319-48848-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics