Abstract
Simple SummaryHigh body mass index (BMI) is correlated with an increased production of hormones (estrogens, insulin, testosterone, leptin), and pro-inflammatory cytokines, which have been associated with breast cancer (BC) risk and recurrence. Regular physical activity (PA) decreases BMI and blood concentrations of testosterone, estrogens, insulin and pro-inflammatory cytokines. Moreover, the Mediterranean diet (MD) reduces obesity, metabolic syndrome (MS) and insulin resistance, which are all associated with increased risk of BC onset and recurrence. Despite the accumulating evidence of the detrimental effect of physical inactivity and overweight on BC recurrence, weight control and PA counseling are not yet current practice. The principal aim of the lifestyle intervention is to promote weight loss through diet and physical activity in overweight and/or high-risk breast cancer survivors. Moreover, implementing a “lifestyle interventions program” in clinical practice can lead to improvements in psychophysical well-being and favor the correction of cardiovascular risk factors and compliance with endocrine therapy, potentially translating into a prognostic advantage.A healthy lifestyle plays a strategic role in the prevention of BC. The aim of our prospective study is to evaluate the effects of a lifestyle interventions program based on special exercise and nutrition education on weight, psycho-physical well-being, blood lipid and hormonal profile among BC patients who underwent primary surgery. From January 2014 to March 2017, a multidisciplinary group of oncologists, dieticians, physiatrists and an exercise specialist evaluated 98 adult BC female patients at baseline and at different time points. The patients had at least one of the following risk factors: BMI ≥ 25 kg/m2, high testosterone levels, high serum insulin levels or diagnosis of MS. Statistically significant differences are shown in terms of BMI variation with the lifestyle interventions program, as well as in waist circumference and blood glucose, insulin and testosterone levels. Moreover, a statistically significant difference was reported in variations of total Hospital Anxiety and Depression Scale (HADS) score, in the anxiety HADS score and improvement in joint pain. Our results suggested that promoting a healthy lifestyle in clinical practice reduces risk factors involved in BC recurrence and ensures psycho-physical well-being.
Highlights
Breast cancer (BC) is the most common tumor and the main cancer death cause among females worldwide
From a database of 1320 BC patients referred to the Breast Unit Azienda Ospedaliera Universitaria (AOU) Ospedali Riuniti
Our study demonstrates the importance and effectiveness of a specific exercise education provided in the hospital, prescribed and supervised by a qualified and specialized exercise trainer, who starts working with the patient at the end of her therapeutic regime and continues to provide support to help the patient gradually move towards an active lifestyle
Summary
Breast cancer (BC) is the most common tumor and the main cancer death cause among females worldwide. A woman’s life risk for BC has increased progressively from the. Two risk factors groups are mentioned: the former group includes non-hereditary factors, and the latter group contains several inherited mutations, together with BC family and personal history. The most common BCs are sporadic, 5–7% of cases are hereditary, and BRCA1 and BRCA2 genes mutations have a predominant role [2]. Gender and age are the most relevant risk factors; early menarche, late menopause, delayed first pregnancy and low parity are important reproductive factors increasing BC risk [3]. Pregnancy and breast-feeding represent protective factors [4]
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