Engaging in Health Behaviors to Lower Risk for Breast Cancer Recurrence

Suzanne C O'Neill,Lisa A Carey,Patti Vegella,Alice R Richman,Jessica T Defrank,Leonard R Henry,Noel T Brewer

doi:10.1371/journal.pone.0053607

Abstract

PurposeWhile post-treatment breast cancer survivors face up to twice the cancer risk of the general population, modifiable health behaviors may somewhat reduce this risk. We sought to better understand health behaviors that early stage breast cancer survivors engage in to reduce recurrence risk.MethodsData came from a cross-sectional multi-site survey of 186 early-stage breast cancer survivors who received genomic testing for breast cancer recurrence risk (Oncotype DX) during their clinical care. Study outcomes were meeting health behavior recommendations (daily fruit and vegetable intake, regular physical activity, and having a healthy body mass index (BMI)).ResultsApproximately three-quarters of survivors we surveyed believed the 3 behaviors might reduce their cancer risk but many did not engage in these behaviors for this purpose: 62% for BMI, 36% for fruit and vegetable consumption, and 37% for physical activity. Survivors with higher recurrence risk, as indicated by their genomic test results, were no more likely to meet any of the three health behavior recommendations. Adherence to health behavior recommendations was higher for women who were white, college-educated, and had higher incomes.ConclusionsMany nonadherent breast cancer survivors wish to use these behavioral strategies to reduce their risk for recurrence, suggesting an important opportunity for intervention. Improving BMI, which has the largest association with cancer risk, is an especially promising target.

Highlights

The numbers of women in the US [1] and worldwide [2] surviving breast cancer has continued to grow with advances in screening and treatment [3]
Level I evidence regarding efficacy of intervention is scant, considerable observational and some clinical trial data suggest an impact of health behavior modification in risk of relapse, including maintaining a healthy BMI [14,15], regular physical activity [16], and a low fat diet [17,18]
Guidelines from the American Cancer Society and other national organizations recommend that women with a history of breast cancer eat fruits and vegetables regularly, be physically active and maintain a healthy body weight [23,24]

Summary

Introduction

The numbers of women in the US [1] and worldwide [2] surviving breast cancer has continued to grow with advances in screening and treatment [3]. These survivors face elevated health risks, including cancer recurrence and second primary cancers [4,5]. Though evidence for cancer risk reduction from eating fruits and vegetables suggests a very small benefit or none at all [19,20], these behaviors may support overall health and maintenance of a healthy weight [21,22]. Guidelines from the American Cancer Society and other national organizations recommend that women with a history of breast cancer eat fruits and vegetables regularly, be physically active and maintain a healthy body weight [23,24]

Methods

Results

Discussion

Conclusion