Exercise and Maintaining Healthy Weight Most Important Lifestyle Factors for Reducing Recurrence Risk

Many studies have found a link between regular exercise and a lower risk of being diagnosed with breast cancer or breast cancer coming back (recurrence). At the same time, much research has shown that being overweight increases the risk of breast and other cancers, as well as increasing the risk of recurrence.

A review study suggests that exercising regularly and maintaining a healthy weight are the two most important lifestyle choices a woman diagnosed with breast cancer can make to reduce her risk of recurrence.

The research was published in the Feb. 21, 2017 issue of the Canadian Medical Association Journal. The researchers summarized their results in six main points:

  • Exercise: Women who’ve been diagnosed with breast cancer should exercise moderately at least 30 minutes per day, 5 days a week, or do 75 minutes of vigorous exercise per week. Women should also do two to three sessions of strength training for large muscle groups (glutes, back, chest, and hamstrings) per week.
  • Avoid weight gain: Weight gain during or after breast cancer treatment is linked to worse outcomes. Women who are overweight or obese at diagnosis also have poorer outcomes.
  • Stop smoking: While it’s unclear if stopping smoking after a breast cancer diagnosis affects the risk of recurrence, smoking causes a number of other health problems.
  • Limit alcohol: Limiting drinking to one or zero alcoholic drinks per day may help reduce the risk of recurrence.
  • Vitamin supplementation: Moderate consumption of vitamin C may be helpful, although more research is needed. Vitamin D supplements can help maintain bone strength.
  • Diet: No specific type of diet has been shown to reduce the risk of breast cancer recurrence. Research suggests that patients do not need to avoid soy, and that soy products may help women maintain a healthy weight if they’re used to replace higher-calorie meat protein.

Overall, the researchers found that exercise had the most potential to reduce the risk of recurrence and improve survival — exercise reduced the risk of dying from breast cancer by about 40%.

Along with a healthy diet and lifestyle choices, regular exercise is one of the best things women can do to keep the risk of recurrence as low as it can be. This study adds to other research suggesting that regular exercise reduces recurrence risk. Regular exercise also helps keep your physical and mental health in top shape. No matter how old you are, it’s never too late or too soon to get moving. And once you do start, keep at it!

Bottom line: Regular exercise reduces recurrence risk of breast cancer.

About the author: Raja P. Reddy, MD is a board certified diagnostic radiologist specializing in breast imaging. He is also a contributing editor for Women’s Imaging Specialists, a leading provider of outpatient women’s imaging services in the greater Atlanta, GA area.


Many Women at High Risk of Genetic Mutation Don’t Get Testing

A study has found that after being diagnosed with breast cancer, most women want genetic testing but don’t get it, and only about half of women at high risk of a genetic mutation are tested. The study was published as a Research Letter in the Feb. 7, 2017 issue of the journal JAMA.

Most inherited cases of breast cancer are associated with one of two abnormal genes: BRCA1 (Breast Cancer gene one) or BRCA2 (Breast Cancer gene two).

Women with an abnormal BRCA1 or BRCA2 gene:

  • have up to an 85% lifetime risk of developing breast cancer
  • have a much higher-than-average lifetime risk of ovarian cancer; estimates range from 15% to 60%

U.S. guidelines say that BRCA testing should be considered when:

  • many women in a family have been diagnosed with breast and/or ovarian cancer, particularly if the women were younger than 50 when diagnosed
  • some women in a family have been diagnosed with cancer in both breasts
  • there is both breast and ovarian cancer in a family
  • men in a family have been diagnosed with breast cancer
  • there is breast cancer in a family and either male relatives on the same side of the family have been diagnosed with prostate cancer at a young age or relatives on the same side of the family have been diagnosed with gastrointestinal cancers, such as pancreas, gall bladder, or stomach cancer
  • a family is of Ashkenazi (Eastern European) Jewish descent

To do the study the researchers sent a survey on genetic testing to 2,529 women who had been diagnosed with stage 0 to stage II breast cancer between July 2013 and September 2014. The women were between 20 and 79 years old and lived in Georgia and Los Angeles, Calif.

The survey found that 66% of the women said they wanted genetic testing, but only 29% actually had genetic testing. In addition, only 60% of high-risk women who had genetic testing met with a genetic counselor.

The most common reasons high-risk women gave for not having genetic testing were:

  • my doctor didn’t recommend it (56.1%)
  • too expensive (13.7%)
  • didn’t want it (10.7%)
  • my family didn’t want me to have it (0.2%)

“We found that genetic counseling and testing are not well-matched to medical need,” said Allison Kurian, M.D., associate professor of medicine and of health research and policy at Stanford, who is the study’s lead author. “Women are very interested in genetic testing but many fail to receive it. This is particularly worrisome because it means that doctors are missing the opportunity to prevent cancers in mutation carriers and their family members.”

“Genetic testing results can affect what sort of surgery a woman may choose to treat her existing breast cancer, as well as what treatments she should pursue to reduce the risk of forming new cancers in the future,” said Reshma Jagsi, M.D., professor and deputy chair of radiation oncology at the University of Michigan and one of the study’s senior authors. “We don’t have a crystal ball, but genetic testing can be a powerful tool for certain women. It is worrisome to see so many of those women at highest risk for mutations failing even to have a visit focused on genetic counseling.”

Bottom line: Many high-risk women who should have genetic testing aren’t having the screening done. Women with a genetic mutation linked to breast cancer have a number of options to reduce breast cancer risk and the risk of breast cancer recurrence.

About the author: Raja P. Reddy, MD is a board certified diagnostic radiologist specializing in breast imaging. He is also a contributing editor for Women’s Imaging Specialists, a leading provider of outpatient women’s imaging services in the greater Atlanta, GA area.


Low-Dose Aspirin May Lower Breast Cancer Risk

Taking low-dose aspirin at least three times per week may reduce women’s risk of breast cancer by up to 20 percent, a new study suggests. Many people take low-dose aspirin (also called baby aspirin) to reduce the risk of heart disease. A low dose of aspirin is 81 mg per day. Aspirin reduces inflammation and is also a weak aromatase inhibitor. Aromatase inhibitor medicines — Arimidex, Aromasin, and Femara — are used to treat hormone-receptor-positive breast cancer.

Earlier studies have suggested that people who regularly take low-dose aspirin may have a lower risk of breast and some other cancers. Still, these studies didn’t look at whether any possible risk reduction was linked to the characteristics of the breast cancer.

A preliminary study suggests that women who take low-dose aspirin 3 or more times per week have a lower risk of hormone-receptor-positive, HER2-negative breast cancer. The study used data from more than 57,000 women who were part of the California Teachers Study.

In the 23% of women who reported using low-dose aspirin regularly, researchers saw a 20% reduction in the risk of developing HR-positive/HER2 negative breast cancer, some of the most common forms of the disease.

The risk was inversely associated with taking a low-dose aspirin three or more times a week, compared with those women who had no regular low-dose aspirin use. Women who took other nonsteroidal anti-inflammatory medications such as ibuprofen did not see as much of a difference, nor did those taking a regular high-dose aspirin. Previous studies have showed mixed results in breast cancer impact among women who took a regular high-dose aspirin.

The new study did not look at why there might be an association between lower cancer risk and aspirin, but author Leslie Bernstein, a professor in the Division of Cancer Etiology in the Department of Population Sciences at the Beckman Research Institute of the City of Hope Comprehensive Cancer Center, said one reason may be because aspirin can lower inflammation.

“Simply things like obesity or inflammatory conditions are a risk factor for breast cancer, so this may be one reason it could help,” Bernstein said.

Yet, it’s too soon to suggest taking baby aspirin to reduce breast cancer risk.

If more study bears out the link between baby aspirin and breast cancer prevention, Bernstein said low-dose aspirin may also help prevent recurrence.

The study was published online May 1 in the Breast Cancer Research journal. It was funded by the U.S. National Cancer Institute and the California Breast Cancer Research Fund.

Bottom line: People who regularly take low-dose aspirin may have a lower risk of breast cancer and some other cancers.

About the author: Raja P. Reddy, MD is a board certified diagnostic radiologist specializing in breast imaging. He is also a contributing editor for Women’s Imaging Specialists, a leading provider of outpatient women’s imaging services in the greater Atlanta, GA area.