Abstract
Introduction
Breast cancer (BC) survivors are constantly increasing, and research investment for the identification of modifiable factors associated with BC recurrences is increasing too. The Western lifestyle, characterized by low levels of physical activity and a diet rich in refined carbohydrates, animal fats, and protein, is associated with high prevalence of metabolic syndrome, insulin resistance, and high serum levels of sex hormones and growth factors.
Discussion
The present work summarizes the association between all these metabolic and hormonal factors with the risk of BC and BC recurrences. Since metabolic syndrome and endocrine imbalance may be favorably modified through comprehensive change in lifestyle, dietary changes should be recommended both for BC prevention and treatment.
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References
World Cancer Research Fund, American Institute for Cancer Research (2007) Food, nutrition, physical activity and the prevention of cancer: a global perspective. AICR, Washington
Berrino F, Villarini A, De Petris M, Raimondi M, Pasanisi P (2006) Adjuvant diet to improve hormonal and metabolic factors affecting breast cancer prognosis. Ann N Y Acad Sci 1089:110–118. doi:10.1196/annals.1386.023
Vona-Davis L, Howard-McNatt M, Rose DP (2007) Adiposity, type 2 diabetes and the metabolic syndrome in breast cancer. Obes Rev 8:395–408. doi:10.1111/j.1467-789X.2007.00396.x
Vainio H, Bianchini F (2002) Weight control and physical activity. IARC Handbooks of cancer prevention, vol 6. IARC, Lyon
Lahmann PH, Hoffmann K, Allen N et al (2004) Body size and breast cancer risk: findings from the European prospective investigation into cancer and nutrition (EPIC). Int J Cancer 111:762–771. doi:10.1002/ijc.20315
Baer HJ, Colditz GA, Rosner B et al (2005) Body fatness during childhood and adolescence and incidence of breast cancer in premenopausal women: a prospective cohort study. Breast Cancer Res 7:R314–R325. doi:10.1186/bcr998
Tehard B, Kaaks R, Clavel-Chapelon F (2005) Body silhouette, menstrual function at adolescence and breast cancer risk in the E3N cohort study. Br J Cancer 92:2042–2048. doi:10.1038/sj.bjc.6602620
Lahmann PH, Schulz M, Hoffmann K et al (2005) Long-term weight change and breast cancer risk: the European prospective investigation into cancer and nutrition (EPIC). Br J Cancer 93:582–589. doi:10.1038/sj.bjc.6602763
Berclaz G, Li S, Price KN et al (2004) Body mass index as a prognostic feature in operable breast cancer: the International Breast Cancer Study Group experience. Ann Oncol 15:875–884. doi:10.1093/annonc/mdh222
Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 348:1625–1638. doi:10.1056/NEJMoa021423
Dawood S, Broglio K, Gonzalez-Angulo AM et al (2008) Prognostic value of body mass index in locally advanced breast cancer. Clin Cancer Res 14:1718–1725. doi:10.1158/1078-0432.CCR-07-1479
Griggs JJ, Sabel MS (2008) Obesity and cancer treatment: weighing the evidence. J Clin Oncol 26:4060–4062. doi:10.1200/JCO.2008.17.4250
Kroenke CH, Chen WY, Rosner B, Holmes MD (2005) Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol 23:1370–1378. doi:10.1200/JCO.2005.01.079
Chlebowski RT, Blackburn GL, Thomson CA et al (2006) Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women’s Intervention Nutrition Study. J Natl Cancer Inst 98:1767–1776
Litton JK, Gonzalez-Angulo AM, Warneke CL et al (2008) Relationship between obesity and pathologic response to neoadjuvant chemotherapy among women with operable breast cancer. J Clin Oncol 26:4072–4077. doi:10.1200/JCO.2007.14.4527
Camoriano JK, Loprinzi CL, Ingle JN, Therneau TM, Krook JE, Veeder MH (1990) Weight change in women treated with adjuvant therapy or observed following mastectomy for node-positive breast cancer. J Clin Oncol 8:1327–1334
Chlebowski RT, Weiner JM, Reynolds R, Luce J, Bulcavage L, Bateman JR (1986) Long-term survival following relapse after 5-FU but not CMF adjuvant breast cancer therapy. Breast Cancer Res Treat 7:23–30. doi:10.1007/BF01886732
Cavalieri E, Frenkel K, Liehr JG, Rogan E, Roy D (2000) Estrogens as endogenous genotoxic agents—DNA adducts and mutations. J Natl Cancer Inst Monogr 27:75–93
Creighton CJ, Casa A, Lazard Z et al (2008) Insulin-like growth factor-I activates gene transcription programs strongly associated with poor breast cancer prognosis. J Clin Oncol 26:4078–4085. doi:10.1200/JCO.2007.13.4429
Griggs JJ, Sorbero ME, Lyman GH (2005) Undertreatment of obese women receiving breast cancer chemotherapy. Arch Intern Med 165:1267–1273. doi:10.1001/archinte.165.11.1267
Phipps AI, Malone KE, Porter PL, Daling JR, Li CI (2008) Body size and risk of luminal, HER2-overexpressing, and triple-negative breast cancer in postmenopausal women. Cancer Epidemiol Biomarkers Prev 17:2078–2086. doi:10.1158/1055-9965.EPI-08-0206
Eliassen AH, Missmer SA, Tworoger SS et al (2006) Endogenous steroid hormone concentrations and risk of breast cancer among premenopausal women. J Natl Cancer Inst 98:1406–1415
Kaaks R, Rinaldi S, Key TJ et al (2005) Postmenopausal serum androgens, oestrogens and breast cancer risk: the European prospective investigation into cancer and nutrition. Endocr Relat Cancer 12:1071–1082. doi:10.1677/erc.1.01038
Kaaks R, Berrino F, Key T et al (2005) Serum sex steroids in premenopausal women and breast cancer risk within the European Prospective Investigation into Cancer and Nutrition (EPIC). J Natl Cancer Inst 97:755–765
Key T, Appleby P, Barnes I, Reeves G (2002) Endogenous sex hormones and breast cancer in postmenopausal women: reanalysis of nine prospective studies. J Natl Cancer Inst 94:606–616
Micheli A, Muti P, Secreto G et al (2004) Endogenous sex hormones and subsequent breast cancer in premenopausal women. Int J Cancer 112:312–318. doi:10.1002/ijc.20403
Rock CL, Flatt SW, Laughlin GA et al (2008) Reproductive steroid hormones and recurrence-free survival in women with a history of breast cancer. Cancer Epidemiol Biomarkers Prev 17:614–620. doi:10.1158/1055-9965.EPI-07-0761
Roy V, Perez EA (2006) New therapies in the treatment of breast cancer. Semin Oncol 33:S3–S8. doi:10.1053/j.seminoncol.2006.03.018
Berrino F, Pasanisi P, Bellati C et al (2005) Serum testosterone levels and breast cancer recurrence. Int J Cancer 113:499–502. doi:10.1002/ijc.20582
Micheli A, Meneghini E, Secreto G et al (2007) Plasma testosterone and prognosis of postmenopausal breast cancer patients. J Clin Oncol 25:2685–2690. doi:10.1200/JCO.2006.09.0118
Verheus M, Peeters PH, Rinaldi S et al (2006) Serum C-peptide levels and breast cancer risk: results from the European prospective investigation into cancer and nutrition (EPIC). Int J Cancer 119:659–667. doi:10.1002/ijc.21861
Gunter MJ, Hoover DR, Yu H et al (2009) Insulin, insulin-like growth factor-I, and risk of breast cancer in postmenopausal women. J Natl Cancer Inst 101:48–60. doi:10.1093/jnci/djn415
Kaaks R (1996) Nutrition, hormones, and breast cancer: is insulin the missing link? Cancer Causes Control 7:605–625. doi:10.1007/BF00051703
Bruning PF, Bonfrer JM, van Noord PA, Hart AA, Jong-Bakker M, Nooijen WJ (1992) Insulin resistance and breast-cancer risk. Int J Cancer 52:511–516. doi:10.1002/ijc.2910520402
Goodwin PJ, Ennis M, Pritchard KI et al (2002) Fasting insulin and outcome in early-stage breast cancer: results of a prospective cohort study. J Clin Oncol 20:42–51. doi:10.1200/JCO.20.1.42
Conover CA (1996) Regulation and physiological role of insulin-like growth factor binding proteins. Endocr J 43(Suppl):S43–S48. doi:10.1507/endocrj.43.Suppl_S43
Dickson R (1996) Biochemical control of breast development. In: Harris JR, Lippman ME, Morrow M, Hellman S (eds) Diseases of the breast. Lippincott-Raven, Philadelphia, pp 15–25
Stewart CE, Rotwein P (1996) Growth, differentiation, and survival: multiple physiological functions for insulin-like growth factors. Physiol Rev 76:1005–1026
Oh JS, Kucab JE, Bushel PR et al (2002) Insulin-like growth factor-1 inscribes a gene expression profile for angiogenic factors and cancer progression in breast epithelial cells. Neoplasia 4:204–217. doi:10.1038/sj.neo.7900229
Baxter RC, Butt AJ, Schedlich LJ, Martin JL (2000) Antiproliferative and pro-apoptotic activities of insulin-like growth factor-binding protein-3. Growth Horm IGF Res 10(Suppl A):S10–S11
Norat T, Dossus L, Rinaldi S et al (2007) Diet, serum insulin-like growth factor-I and IGF-binding protein-3 in European women. Eur J Clin Nutr 61:91–98. doi:10.1038/sj.ejcn.1602494
Baglietto L, English DR, Hopper JL, Morris HA, Tilley WD, Giles GG (2007) Circulating insulin-like growth factor-I and binding protein-3 and the risk of breast cancer. Cancer Epidemiol Biomarkers Prev 16:763–768. doi:10.1158/1055-9965.EPI-06-0960
Campagnoli C, Pasanisi P, Peris C, Berrino F (2008) Insulin-like growth factor-I and breast cancer: epidemiological and clinical data. In: Pasqualini JR (ed) Breast cancer: prognosis, treatment and prevention, 2nd edn. INFORMA-Healthcare, Paris
Rinaldi S, Toniolo P, Muti P et al (2005) IGF-I, IGFBP-3 and breast cancer in young women: a pooled re-analysis of three prospective studies. Eur J Cancer Prev 14:493–496. doi:10.1097/00008469-200512000-00001
Pasanisi P, Venturelli E, Morelli D, Fontana L, Secreto G, Berrino F (2008) Serum insulin-like growth factor-I and platelet-derived growth factor as biomarkers of breast cancer prognosis. Cancer Epidemiol Biomarkers Prev 17:1719–1722. doi:10.1158/1055-9965.EPI-07-0654
Ford ES, Giles WH (2003) A comparison of the prevalence of the metabolic syndrome using two proposed definitions. Diabetes Care 26:575–581. doi:10.2337/diacare.26.3.575
Moller DE, Kaufman KD (2005) Metabolic syndrome: a clinical and molecular perspective. Annu Rev Med 56:45–62. doi:10.1146/annurev.med.56.082103.104751
Beji NK, Reis N (2007) Risk factors for breast cancer in Turkish women: a hospital-based case-control study. Eur J Cancer Care (Engl) 16:178–184. doi:10.1111/j.1365-2354.2006.00711.x
Connolly BS, Barnett C, Vogt KN, Li T, Stone J, Boyd NF (2002) A meta-analysis of published literature on waist-to-hip ratio and risk of breast cancer. Nutr Cancer 44:127–138. doi:10.1207/S15327914NC4402_02
Furberg AS, Veierod MB, Wilsgaard T, Bernstein L, Thune I (2004) Serum high-density lipoprotein cholesterol, metabolic profile, and breast cancer risk. J Natl Cancer Inst 96:1152–1160
Goodwin PJ, Boyd NF, Hanna W et al (1997) Elevated levels of plasma triglycerides are associated with histologically defined premenopausal breast cancer risk. Nutr Cancer 27:284–292
Han C, Zhang HT, Du L et al (2005) Serum levels of leptin, insulin, and lipids in relation to breast cancer in china. Endocrine 26:9–24. doi:10.1385/ENDO:26:1:019
Michalaki V, Koutroulis G, Syrigos K, Piperi C, Kalofoutis A (2005) Evaluation of serum lipids and high-density lipoprotein subfractions (HDL2, HDL3) in postmenopausal patients with breast cancer. Mol Cell Biochem 268:19–24. doi:10.1007/s11010-005-2993-4
Muti P, Quattrin T, Grant BJ et al (2002) Fasting glucose is a risk factor for breast cancer: a prospective study. Cancer Epidemiol Biomarkers Prev 11:1361–1368
Peeters PH, van Noord PA, Hoes AW, Fracheboud J, Gimbrere CH, Grobbee DE (2000) Hypertension and breast cancer risk in a 19-year follow-up study (the DOM cohort). Diagnostic investigation into mammarian cancer. J Hypertens 18:249–254. doi:10.1097/00004872-200018030-00002
Soler M, Chatenoud L, Negri E, Parazzini F, Franceschi S, la Vecchia C (1999) Hypertension and hormone-related neoplasms in women. Hypertension 34:320–325
Agnoli C, Berrino F, Abagnato CA, Muti P, Panico S, Crosignani P, Krogh V (2009) Metabolic syndrome and postmenopausal breast cancer in the ORDET cohort: a nested case–control study. Nutr Metab Cardiovasc Dis (in press)
Pasanisi P, Berrino F, De Petris M, Venturelli E, Mastroianni A, Panico S (2006) Metabolic syndrome as a prognostic factor for breast cancer recurrences. Int J Cancer 119:236–238. doi:10.1002/ijc.21812
Goodwin PJ, Ennis M, Bahl M et al (2009) High insulin levels in newly diagnosed breast cancer patients reflect underlying insulin resistance and are associated with components of the insulin resistance syndrome. Breast Cancer Res Treat 114:517–525. doi:10.1007/s10549-008-0019-0
Friedenreich CM, Cust AE (2008) Physical activity and breast cancer risk: impact of timing, type and dose of activity and population subgroup effects. Br J Sports Med 42:636–647. doi:10.1136/bjsm.2006.029132
Monninkhof EM, Elias SG, Vlems FA et al (2007) Physical activity and breast cancer: a systematic review. Epidemiology 18:137–157. doi:10.1097/01.ede.0000251167.75581.98
Peters TM, Schatzkin A, Gierach GL et al (2009) Physical activity and postmenopausal breast cancer risk in the NIH-AARP diet and health study. Cancer Epidemiol Biomarkers Prev 18:289–296. doi:10.1158/1055-9965.EPI-08-0768
Kellen E, Vansant G, Christiaens MR, Neven P, Van Limbergen E (2009) Lifestyle changes and breast cancer prognosis: a review. Breast Cancer Res Treat 114:13–22. doi:10.1007/s10549-008-9990-8
Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293:2479–2486. doi:10.1001/jama.293.20.2479
Holick CN, Newcomb PA, Trentham-Dietz A et al (2008) Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomarkers Prev 17:379–386. doi:10.1158/1055-9965.EPI-07-0771
Abrahamson PE, Gammon MD, Lund MJ et al (2006) Recreational physical activity and survival among young women with breast cancer. Cancer 107:1777–1785. doi:10.1002/cncr.22201
Enger SM, Bernstein L (2004) Exercise activity, body size and premenopausal breast cancer survival. Br J Cancer 90:2138–2141
Pierce JP, Stefanick ML, Flatt SW et al (2007) Greater survival after breast cancer in physically active women with high vegetable–fruit intake regardless of obesity. J Clin Oncol 25:2345–2351. doi:10.1200/JCO.2006.08.6819
Neilson HK, Friedenreich CM, Brockton NT, Millikan RC (2009) Physical activity and postmenopausal breast cancer: proposed biologic mechanisms and areas for future research. Cancer Epidemiol Biomarkers Prev 18:11–27. doi:10.1158/1055-9965.EPI-08-0756
Thiebaut AC, Kipnis V, Schatzkin A, Freedman LS (2008) The role of dietary measurement error in investigating the hypothesized link between dietary fat intake and breast cancer—a story with twists and turns. Cancer Invest 26:68–73. doi:10.1080/07357900701527918
Rock CL, Demark-Wahnefried W (2002) Nutrition and survival after the diagnosis of breast cancer: a review of the evidence. J Clin Oncol 20:3302–3316. doi:10.1200/JCO.2002.03.008
Holm LE, Nordevang E, Hjalmar ML, Lidbrink E, Callmer E, Nilsson B (1993) Treatment failure and dietary habits in women with breast cancer. J Natl Cancer Inst 85:32–36. doi:10.1093/jnci/85.1.32
Holmes MD, Stampfer MJ, Colditz GA, Rosner B, Hunter DJ, Willett WC (1999) Dietary factors and the survival of women with breast carcinoma. Cancer 86:826–835. doi:10.1002/(SICI)1097-0142(19990901)86:5<826::AID-CNCR19>3.0.CO;2-0
Pierce JP, Natarajan L, Caan BJ et al (2007) Influence of a 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 298:289–298. doi:10.1001/jama.298.3.289
Gold EB, Pierce JP, Natarajan L et al (2009) Dietary pattern influences breast cancer prognosis in women without hot flashes: the Women’s Healthy Eating and Living Trial. J Clin Oncol 27:352–359. doi:10.1200/JCO.2008.16.1067
Berrino F, Bellati C, Secreto G et al (2001) Reducing bioavailable sex hormones through a comprehensive change in diet: the diet and androgens (DIANA) randomized trial. Cancer Epidemiol Biomarkers Prev 10:25–33
Kaaks R, Bellati C, Venturelli E et al (2003) Effects of dietary intervention on IGF-I and IGF-binding proteins, and related alterations in sex steroid metabolism: the Diet and Androgens (DIANA) Randomised Trial. Eur J Clin Nutr 57:1079–1088. doi:10.1038/sj.ejcn.1601647
Serra-Majem L, Roman B, Estruch R (2006) Scientific evidence of interventions using the Mediterranean diet: a systematic review. Nutr Rev 64:S27–S47. doi:10.1111/j.1753-4887.2006.tb00232.x
Esposito K, Marfella R, Ciotola M et al (2004) Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 292:1440–1446. doi:10.1001/jama.292.12.1440
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Pasanisi, P., Villarini, A., Bruno, E. et al. Nutritional advice to breast cancer survivors. Support Care Cancer 18 (Suppl 2), 29–33 (2010). https://doi.org/10.1007/s00520-009-0701-8
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DOI: https://doi.org/10.1007/s00520-009-0701-8