Postmenopausal Breast Cancer Risk Research Articles

Abstract PO5-14-01: Weight loss and omega-3 polyunsaturated fatty acid intervention in overweight and obese peri- and postmenopausal women with increased breast cancer risk modifies the gut microbiome and is associated with circulating biomarkers

Abstract Background: Obesity-associated gut microbiome dysbiosis is thought to increase risk for postmenopausal breast cancer through alteration of estrogen metabolism and an increase in pro-inflammatory microbe abundance. Many studies have reported an increase in the Firmicutes/Bacteroidetes phyla ratio as a biomarker of obesity and is associated with adverse metabolic outcomes. Marine omega-3 eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids are thought to have favorable metabolic and inflammation resolving properties resulting in reduced risk for several epithelial cancers. One possible mechanism is the effect of EPA and DHA on the gut microbiome. We assessed the effect of weight loss and/or omega-3 supplementation on the gut microbiome and circulating molecular breast cancer risk factors. Methods: 46 peri/postmenopausal overweight and obese women at increased risk for breast cancer were enrolled into a weight-loss intervention and after 2 weeks randomized to 3.25 g/day combined EPA and DHA or placebo (PMC8416797). Fecal samples were collected at 0, 2-weeks and 6-months, with matched fecal samples for all timepoints available for 26 patients. Fecal samples at 6-months were available for 34 patients. 12M read depth metagenomic sequencing was performed on DNA isolated from feces to determine shifts in the gut microbiome. Fasting and non-fasting blood was also collected for circulating biomarker analysis. Body composition by DXA scan were also performed at baseline and 6-month time points. Results: Mean baseline BMI was 32 kg/m2. There was no significant difference between arms in age, baseline BMI, % body fat, or baseline Firmicutes/Bacteroidetes ratio. We identified gut microbiota species (A. hadrus and P. faecium) that correlated with metabolic parameters (% body fat, adiponectin/leptin ratio, and fasting insulin), species (P. dorei and B. ovatus) that correlated with estradiol levels, and mucin-degrading species (D. formicigenerans and R. gnavus) whose abundance correlated with inflammation (as measured by circulating monocyte-chemoattractant protein 1 (MCP-1)). Median 6-month weight change for all randomized subjects was -10% from baseline. Favorable change in the Firmicutes/Bacteroidetes ratio was associated both with the degree of weight loss and with omega-3 supplementation, although significant species modification differed between weight loss and omega-3 PUFA groups. Women with both >10% weight loss and omega-3 supplementation had a significantly reduced Firmicutes abundance and lower Firmicute/Bacteroidetes ratio than other groups. Species abundance shifts appear to differ between weight loss and omega-3 supplementation with 3 species modified by weight loss and 12 species shifted by omega-3 PUFA administration. Omega-3 PUFA supplementation significantly reduced proportional abundance of Dorea formicigenerans, which was a microbe associated with inflammation. Conclusions: Omega-3 supplementation at 3.25 g/day compared to placebo had a greater net effect on changing the gut microbiome in overweight and obese women at increased risk for breast cancer undergoing a weight loss intervention. Change in the gut microbiome may serve as a useful response biomarker in Phase II prevention trials of omega-3 fatty acid and weight loss. Citation Format: Katherine L. Cook, Erin Giles, Amy Kreutzjans, Shahid Umar, Christie Befort, Bruce Kimler, Stephen Hursting, Carol Fabian. Weight loss and omega-3 polyunsaturated fatty acid intervention in overweight and obese peri- and postmenopausal women with increased breast cancer risk modifies the gut microbiome and is associated with circulating biomarkers [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-14-01.

A low-glucose eating pattern is associated with improvements in glycemic variability among women at risk for postmenopausal breast cancer: an exploratory analysis.

High glycemic variability (GV) is a biomarker of cancer risk, even in the absence of diabetes. The emerging concept of chrononutrition suggests that modifying meal timing can favorably impact metabolic risk factors linked to diet-related chronic disease, including breast cancer. Here, we examined the potential of eating when glucose levels are near personalized fasting thresholds (low-glucose eating, LGE), a novel form of timed-eating, to reduce GV in women without diabetes, who are at risk for postmenopausal breast cancer. In this exploratory analysis of our 16-week weight loss randomized controlled trial, we included 17 non-Hispanic, white, postmenopausal women (average age = 60.7 ± 5.8 years, BMI = 34.5 ± 6.1 kg/m2, HbA1c = 5.7 ± 0.3%). Participants were those who, as part of the parent study, provided 3-7 days of blinded, continuous glucose monitoring data and image-assisted, timestamped food records at weeks 0 and 16. Pearson's correlation and multivariate regression were used to assess associations between LGE and GV, controlling for concurrent weight changes. Increases in LGE were associated with multiple unfavorable measures of GV including reductions in CGM glucose mean, CONGA, LI, J-Index, HBGI, ADDR, and time spent in a severe GV pattern (r = -0.81 to -0.49; ps < 0.044) and with increases in favorable measures of GV including M-value and LBGI (r = 0.59, 0.62; ps < 0.013). These associations remained significant after adjusting for weight changes. Low-glucose eating is associated with improvements in glycemic variability, independent of concurrent weight reductions, suggesting it may be beneficial for GV-related disease prevention. Further research in a larger, more diverse sample with poor metabolic health is warranted.Clinical trial registration: ClinicalTrials.gov, NCT03546972.

Multi-Trait Body Shape Phenotypes and Breast Cancer Risk in Postmenopausal Women: A Causal Mediation Analysis in the UK Biobank Cohort

Body shape phenotypes combining multiple anthropometric traits have been linked to postmenopausal breast cancer (BC). However, underlying biological pathways remain poorly understood. This study investigated to what extent the associations of body shapes with postmenopausal BC risk is mediated by biochemical markers. The study included 176,686 postmenopausal women from UK Biobank. Four body shape phenotypes were derived from principal component (PC) analysis of height, weight, body mass index, waist and hip circumferences, and waist-to-hip ratio (WHR). The four-way decomposition of the total effect was used to estimate mediation and interaction effects simultaneously as well as the mediated proportions. After 10.9 years median follow-up, 6,396 incident postmenopausal BC were diagnosed. There was strong evidence of positive associations between PC1 (general obesity) and PC2 (tall, low WHR), and BC risk. The association of PC1 with BC risk was positively mediated by testosterone and negatively by insulin-like growth factor-1 (IGF-1), with the overall proportion mediated (sum of the mediated interaction and pure indirect effect (PIE)) accounting for 11.4% (95% confidence intervals: 5.1 to 17.8%) and -12.2% (-20.5% to -4.0%) of the total effect, respectively. Small proportions of the association between PC2 and BC were mediated by IGF-1 (PIE: 2.8% (0.6 to 4.9%)), and sex hormone-binding globulin (SHBG) (PIE: -6.1% (-10.9% to -1.3%)). Our findings are consistent with differential pathways linking different body shapes with BC risk, with a suggestive mediation through testosterone and IGF-1 in the relationship of a generally obese body shape and BC risk, while IGF-1 and SHBG may mediate a tall/lean body shape-BC risk association.

Abstract LB149: Metabolic syndrome and obesity-related cancer risk and survival: An umbrella review

Abstract Background: Recent evidence suggests that metabolic syndrome (MetS) may be a potential risk factor for obesity-related cancer (ORC) owing to shared risk factors like physical inactivity, hyperglycemia, insulin resistance, gut microbiome dysfunction, and inflammation. We conducted an umbrella review of systematic reviews with meta-analysis to synthesize the evidence on the association between MetS and ORC incidence and survival. Methods: The study protocol was registered with PROSPERO (CRD42021230899). Searches in five databases (Medline, Embase, CINAHL, Cochrane Library, and Scopus) retrieved 2,524 systematic reviews with meta-analyses (SRMA) after duplicates were removed. SRMA were eligible if they evaluated MetS with ORC incidence or survival, were conducted in an adult population (≥18 years), and included the pre-defined study-specific data. Using Covidence, two reviewers independently screened titles and abstracts (2,524) and then reviewed full text (41), selecting 23 SRMAs for inclusion. Data extraction was then completed independently by two reviewers. The outcomes were pooled using a random-effects model with the package “meta” in R. Sub-group analyses were conducted for a priori chosen factors, as outlined in the protocol. SRMA were appraised using the AMSTAR 2 criteria. Results: 23 SRMA published between 2001 and 2023 met our inclusion criteria, comprising a total of 112 studies, ~52,543,335 total individuals, and ~355,808 ORC cases. After pooled analyses, MetS was associated with a statistically significant 10% increased risk of ORC [RR(95% CI): 1.10(1.06-1.14)]. MetS was also statistically significantly associated with poorer ORC-specific survival [RR(95% CI): 1.10(1.02-1.18)], though there was no association between MetS and overall survival [RR(95% CI): 1.04(0.97-1.11)]. When stratified by sex, both male and female individuals with MetS had a statistically significant higher risk of ORC [RR(95% CI): 1.12(1.06-1.17), 1.10(1.01-1.19), respectively]. When stratified by cancer site, individuals with MetS demonstrated a higher risk of colorectal cancer [RR(95% CI): 1.12(1.06-1.18)]. We also observed suggestive associations between MetS and liver, pancreatic, and postmenopausal breast cancer risk, but these were not statistically significant [RR(95% CI): 1.20(1.00-1.45), 1.20(0.96-1.50), 1.12(0.99-1.27), respectively]. All associations were supported by “critically low” quality evidence according to the AMSTAR2 criteria. This was primarily because these SRMAs either did not follow a pre-specified written and published protocol, or did not provide a list of all potentially relevant studies that were read in full-text form but excluded from the review. Conclusions: These results emphasize the important role that MetS may play in the development of ORC as well as in the survival of patients with ORC. Conducting high-quality reviews is needed to increase the certainty of evidence, reduce potential bias, and improve knowledge in this field. Citation Format: Maci Winn, Prasoona Karra, Ryzen Benson, Svenja Pauleck, Nathorn Chaiyakunapruk, Win Khaing, Tallie Casucci, Mary M. McFarland, Siwen Hu-Lieskovan, Michelle Litchman, Yizhe Xu, Mary Playdon, Sheetal Hardikar. Metabolic syndrome and obesity-related cancer risk and survival: An umbrella review [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB149.

Higher number of steps is related to lower endogenous progesterone but not estradiol levels in women.

Sex steroid hormones are important not only for reproduction but also for many aspects of women's health, including the risk of breast cancer. Physical activity has been shown to influence sex hormone levels in women. This study aimed to investigate a relationship between the average daily number of steps and the sex hormone (estradiol and progesterone) levels in premenopausal women. Data were collected from 85 healthy, urban women of reproductive age who performed at least 180 minutes/week of moderate physical activity for two complete menstrual cycles. Physical activity was measured using wrist bands. Estradiol and progesterone concentrations were measured in daily-collected saliva samples in the second menstrual cycle. There was a significant negative association between the average number of steps taken daily and salivary progesterone levels after adjusting for potential confounding factors (age, BMI). Women who took more than 10,000 steps a day had significantly lower progesterone levels compared to women who took less than 10,000 steps. The association between physical activity and estradiol levels was statistically insignificant. Our results indicate that taking at least 10,000 steps a day reduces progesterone levels, but this intensity of physical activity may not be high enough to affect estradiol levels. Daily step tracking is a valuable element of health promotion, but currently recommended levels of physical activity may not be high enough for healthy premenopausal women to significantly reduce both sex hormone levels and thus their risk of postmenopausal breast cancer.

New role of fat-free mass in cancer risk linked with genetic predisposition

Cancer risk is associated with the widely debated measure body mass index (BMI). Fat mass and fat-free mass measurements from bioelectrical impedance may further clarify this association. The UK Biobank is a rare resource in which bioelectrical impedance and BMI data was collected on ~ 500,000 individuals. Using this dataset, a comprehensive analysis using regression, principal component and genome-wide genetic association, provided multiple levels of evidence that increasing whole body fat (WBFM) and fat-free mass (WBFFM) are both associated with increased post-menopausal breast cancer risk, and colorectal cancer risk in men. WBFM was inversely associated with prostate cancer. We also identified rs615029[T] and rs1485995[G] as associated in independent analyses with both PMBC (p = 1.56E–17 and 1.78E–11) and WBFFM (p = 2.88E–08 and 8.24E–12), highlighting splice variants of the intriguing long non-coding RNA CUPID1 (LINC01488) as a potential link between PMBC risk and fat-free mass.

Infertility and risk of postmenopausal breast cancer in the women's health initiative.

Although infertility (i.e., failure to conceive after ≥ 12months of trying) is strongly correlated with established breast cancer risk factors (e.g., nulliparity, number of pregnancies, and age at first pregnancy), its association with breast cancer incidence is not fully understood. Previous studies were primarily small clinic-based or registry studies with short follow-up and predominantly focused on premenopausal breast cancer. The objective of this study was to assess the relationship between infertility and postmenopausal breast cancer risk among participants in the Women's Health Initiative (analytic sample = 131,784; > 25years of follow-up). At study entry, participants were asked about their pregnancy history, infertility history, and diagnosed reasons for infertility. Incident breast cancers were self-reported with adjudication by trained physicians reviewing medical records. Cox proportional hazards models were used to estimate risk of incident postmenopausal breast cancer for women with infertility (overall and specific infertility diagnoses) compared to parous women with no history of infertility. We examined mediation of these associations by parity, age at first term pregnancy, postmenopausal hormone therapy use at baseline, age at menopause, breastfeeding, and oophorectomy. We observed a modest association between infertility (n = 23,406) and risk of postmenopausal breast cancer (HR = 1.07; 95% CI 1.02-1.13). The association was largely mediated by age at first term pregnancy (natural indirect effect: 46.4% mediated, CI 12.2-84.3%). These findings suggest that infertility may be modestly associated with future risk of postmenopausal breast cancer due to age at first pregnancy and highlight the importance of incorporating reproductive history across the life course into breast cancer analyses.

How does weight gain since the age of 18 years affect breast cancer risk in later life? A meta-analysis

Early life factors are important risk factors for breast cancer. The association between weight gain after age 18 and breast cancer risk is inconsistent across previous epidemiologic studies. To evaluate this association, we conducted a meta-analysis according to PRISMA guidelines and the established inclusion criteria. We performed a comprehensive literature search using Medline (Ovid), Embase, Scopus, Cochrane Library, and ClinicalTrials.gov to identify relevant studies published before June 3, 2022. Two reviewers independently reviewed the articles for final inclusion. Seventeen out of 4,725 unique studies met the selection criteria. The quality of studies was assessed using the Newcastle-Ottawa Scale (NOS), and all were of moderate to high quality with NOS scores ranging from 5 to 8. We included 17 studies (11 case-control, 6 cohort) in final analysis. In case-control studies, weight gain after age 18 was associated with an increased risk of breast cancer (odds ratio [OR] = 1.25; 95% CI = 1.07–1.48), when comparing the highest versus the lowest categories of weight gain. Menopausal status was a source of heterogeneity, with weight gain after age 18 associated with an increased risk of breast cancer in postmenopausal women (OR = 1.53; 95% CI = 1.40–1.68), but not in premenopausal women (OR = 1.01; 95% CI = 0.92–1.12). Additionally, a 5 kg increase in weight was positively associated with postmenopausal breast cancer risk (OR = 1.12; 95%CI = 1.05–1.21) in case-control studies. Findings from cohort studies were identical, with a positive association between weight gain after age 18 and breast cancer incidence in postmenopausal women (relative risk [RR] = 1.30; 95% CI = 1.09–1.36), but not in premenopausal women (RR = 1.06; 95% CI = 0.92–1.22). Weight gain after age 18 is a risk factor for postmenopausal breast cancer, highlighting the importance of weight control from early adulthood to reduce the incidence of postmenopausal breast cancer.

Sex-steroid hormones and risk of postmenopausal estrogen receptor-positive breast cancer: a case-cohort analysis.

Sex-steroid hormones are associated with postmenopausal breast cancer but potential confounding from other biological pathways is rarely considered. We estimated risk ratios for sex-steroid hormone biomarkers in relation to postmenopausal estrogen receptor (ER)-positive breast cancer, while accounting for biomarkers from insulin/insulin-like growth factor-signaling and inflammatory pathways. This analysis included 1208 women from a case-cohort study of postmenopausal breast cancer within the Melbourne Collaborative Cohort Study. Weighted Poisson regression with a robust variance estimator was used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) of postmenopausal ER-positive breast cancer, per doubling plasma concentration of progesterone, estrogens, androgens, and sex-hormone binding globulin (SHBG). Analyses included sociodemographic and lifestyle confounders, and other biomarkers identified as potential confounders. Increased risks of postmenopausal ER-positive breast cancer were observed per doubling plasma concentration of progesterone (RR: 1.22, 95% CI 1.03 to 1.44), androstenedione (RR 1.20, 95% CI 0.99 to 1.45), dehydroepiandrosterone (RR: 1.15, 95% CI 1.00 to 1.34), total testosterone (RR: 1.11, 95% CI 0.96 to 1.29), free testosterone (RR: 1.12, 95% CI 0.98 to 1.28), estrone (RR 1.21, 95% CI 0.99 to 1.48), total estradiol (RR 1.19, 95% CI 1.02 to 1.39) and free estradiol (RR 1.22, 95% CI 1.05 to 1.41). A possible decreased risk was observed for SHBG (RR 0.83, 95% CI 0.66 to 1.05). Progesterone, estrogens and androgens likely increase postmenopausal ER-positive breast cancer risk, whereas SHBG may decrease risk. These findings strengthen the causal evidence surrounding the sex-hormone-driven nature of postmenopausal breast cancer.

Abstract B086: Association of breast cancer-relevant DNA repair genes with postmenopausal breast cancer risk in UK Biobank

Abstract Purpose. Several polymorphisms have been described in DNA damage signaling and repair genes and some of the polymorphisms have been implicated in genetic susceptibility to breast cancer. However, there is no consensus result yet for most of these polymorphisms. In this study, we focused on evaluating selected SNPs in BRCA1, BRCA2, ATM, XRCC1, XRCC2, XRCC3, and XPD (ERCC2) genes that have been previously reported to be associated with breast cancer risk and are available in the UK Biobank. Methods. This study included 150,929 postmenopausal women (5,969 with BCa) from UK Biobank, a population-based prospective cohort. Cancer diagnoses were ascertained through the linkage to the UK National Health Service Central Registers. DNA was extracted from blood samples collected from participants at enrollment in UK Biobank. Samples were genotyped using the Applied Biosystems UK BiLEVE Axiom Array or the Applied Biosystems UK Biobank Axiom Array. The positions of markers in the data are in GRCh37 coordinates. SNPs with frequency &amp;lt; 1% in the study population were excluded from analyses. We included the following SNPs in the final analyses: XRCC3-rs861539, BRCA1-rs16942, BRCA1-rs4986852, XRCC1-rs25487, XRCC1-rs25489, XRCC1-rs1799782, XPD (ERCC2)-rs13181, XPD (ERCC2)-rs1799793, XRCC2-rs3218536, ATM-rs1800056, ATM-rs1800057, BRCA2-rs144848, BRCA2-rs4987117, and BRCA2-rs11571833. Information on breast cancer risk factors was collected at baseline. Cox proportional hazards regression models were used to analyze the association between each SNP and breast cancer risk while adjusting for known breast cancer risk factors. The risk estimates were presented as hazard rations (HRs) and their corresponding 95% confidence intervals (CIs). Results. The mean age of the study population at enrollment was 60.1 years (range 40-71 years). Heterozygous carriers of BRCA2-rs11571833 T allele were found to have an increased risk of breast cancer (HR=1.22, 95% CI 1.02, 1.46, p-trend = 0.033) compared to the homozygous carriers of the BRCA2-rs11571833 A allele. No other significant associations between other SNPs and breast cancer risk were found. Conclusions. We found a significant association between SNP BRCA2-rs11571833 and postmenopausal breast cancer risk. Our findings contribute to the existing evidence on the association of high-risk polymorphisms in DNA damage signaling and repair genes with postmenopausal breast cancer risk. Citation Format: Carmen Smotherman, Brian Sprague, Dejana Braithwaite, Huaizhen Qin, Lusine Yaghjyan. Association of breast cancer-relevant DNA repair genes with postmenopausal breast cancer risk in UK Biobank [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Breast Cancer Research; 2023 Oct 19-22; San Diego, California. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_1):Abstract nr B086.

Abstract A029: Metabolomic profiles among African-American and White breast cancer survivors: An exploratory comparison of correlations with body weight and body composition

Abstract Objective: Obesity, a strong risk and prognostic factor for postmenopausal breast cancer, is associated with numerous disruptions to the metabolome. However, it remains unclear whether obesity-metabolite associations vary when considering direct measures of adiposity versus body weight, particularly among breast cancer survivors. This analysis aims to compare correlations of body mass index (BMI) and dual-energy x-ray absorptiometry (DXA) derived measures of adiposity (percent fat, total fat) with global serum metabolites. Methods: A cross-sectional analysis was conducted among 60 postmenopausal breast cancer survivors, including 25 African-American and 35 White women within five years of their breast cancer diagnosis who were seen for care at the University of Maryland (UM) Greenebaum Comprehensive Cancer Center (Baltimore, Maryland) and the Cancer Institute at the UM St. Joseph Medical Center (Towson, Maryland). Measured height and weight were used to calculate body mass index (kg/m2); percent fat, total fat and lean mass were quantified using DXA. Global metabolomic profiling in EDTA plasma samples was performed by liquid chromatography-tandem mass spectrometry at Metabolon, Inc. Metabolites were log transformed and partial correlations of BMI, percent fat and total fat (adjusted for age, race and fasting status) were estimated. Analyses of total fat also adjusted for lean mass. The Benjamini Hochberg procedure was used to control the false discovery rate for multiple comparisons. Results: A total of 1353 metabolites, including those with known and unknown identities, were detected. After excluding metabolites with a coefficient of variation ³ 25% or with ³ 30% of values below the limit of detection, 978 metabolites remained for analyses. The median BMI among all women (n=60) was 29.7 kg/m2 ranging from 20.7-46.7 kg/m2. Percent fat ranged from 30.5 – 54.3% with a median of 41.1% while the median total fat was 27.9 kg (17.2-62.7 kg). BMI was strongly correlated with %fat (r=0.8, p=6.6e-08) and total fat after adjustment for lean mass (r=0.6, p=5.7e-05). In analyses of all women, after adjustment for age, race and fasting status, 73 metabolites correlated with BMI, 110 with percent fat and 92 with total fat adjusted for lean mass (q-value &amp;lt;.15). Of those, 27 metabolites correlated with all three metrics while 39 metabolites were distinctly correlated with BMI only, 10 with percent fat only and 21 with total fat only. BMI, percent fat and total fat were most commonly correlated with lipids and amino acids. Conclusions: Preliminary analyses suggest characterizing obesity with metrics of body composition may provide further insight into obesity-metabolite associations among breast cancer survivors. Analyses are ongoing to assess differences in correlations by race and to examine metabolite patterns via metabolite set enrichment analyses. Citation Format: Cher M Dallal, Li Feng, Charles Ma, Katherine Tkaczuk, Stephen Thomas, Joanne F. Dorgan. Metabolomic profiles among African-American and White breast cancer survivors: An exploratory comparison of correlations with body weight and body composition [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Breast Cancer Research; 2023 Oct 19-22; San Diego, California. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_1):Abstract nr A029.

Phytoestrogen: A protective shield for post-menopausal symptoms and breast cancer risk

Menopause is a physiological unavoidable condition in women’s life which leads to vasomotor, psychological, urogenital and chronic diseases collectively termed as post-menopausal symptoms (PMS). Hormone replacement therapy (HRT) is conventional line of treatment for treating PMS in which estrogens replacement is major choice for better therapeutic efficacy against symptoms like hot flushes, osteoporosis, hormonal balances, insomnia, obesity etc. However, estrogen is reported risk factor for breast cancer. The review discusses Ayurveda based strategies for management of PMS with phytoestrogen herbs, diet, lifestyle modification, de-addiction measures, yoga, aroma therapies etc. supported by evidence-based documentation.Herbs namely Dhanyaka (Coriander sativum), Manjishtha (Rubia cordifolia L), Chandana (Santalum album L), Ashwagandha (Withania somnifera L. Dunal), Jatamansi (Nardostachys jatamansi DC), Shatavari (Asparagus racemosus L), Kumari (Aloe vera L), Yashtimadhu (Glycyrrhiza glabra L), Haridra (Curcuma longa L), Triphala (Combination of fruits of Haritaki, Bibhitak, Amalaki in the proportion 1:2:4), Gokshura (Tribulus terrestris L), Arjuna (Terminalia Arjuna L.), Guduchi (Tinospora cordifolia L.), Ela (Elettaria cardamomum L), Narikela (Coccus nucifera L), Masha (Phaseolus vulgaris L), Mudga (Vigna radiata L). Shunthi (Zinziber officinale Roxb), Methika (Trigonella foenumgraecum L), Tila (Sesamum indicum L) are the natural sources of phytoestrogens. Phytoestrogen don’t exert side effects like synthetic estrogen molecules. These herbs are useful for management of various symptoms of PMS. Having anti-cancer potential against breast carcinoma these are useful for prevention of risk of breast cancer.

Association between Serum Insulin and Interleukin-6 levels with Breast Cancer in Post-Menopausal Iraqi Women

Background: Obesity rates are increasing day by day affecting all populations at different ages. The most prevalent kind of cancer among women worldwide is breast cancer, with increasing rates in the present time and in the future. Substantial connections between obesity and breast cancer are demonstrated. Elevated circulating levels of insulin and interleukin-6 have a substantial link to obesity and breast cancer development. Objective: This study aimed to examine the serum levels of insulin and interleukin-6 in postmenopausal breast cancer patients and to study the connection between these biomarkers and breast cancer development. Method: In this research, 120 postmenopausal women actively participated., 30 had a body mass index of &gt;30kg/m2 diagnosed with breast cancer and considered as obese (group 1), 30 with a body mass index of &lt;30kg/m2 with breast cancer and considered as not obese (group 2), 30 had a body mass index of &gt;30 kg/m2 who were apparently healthy and were obese (group 3), and 30 participants with a body mass index of &lt;30 kg/m2 , were apparently healthy and were not obese (group 4). Five millilitres of venous blood were provided by each individual. Insulin and interleukin-6 levels in the blood were measured using ELISA (enzyme-linked immunosorbent assay) kits. Results: Serum insulin levels were higher in the groups of obese participants (groups 1 and 3) than the groups of non-obese participants (groups 2 and 4), serum levels of interleukin-6 were the lowest in the healthy control group without obesity (group 4). Substantial moderate correlation was found between body mass index and both insulin and interleukin-6. Postmenopausal breast cancer risk is increased with elevations of serum insulin and interleukin-6. Conclusions: Elevated levels of serum interleukin-6 and insulin were linked to higher body mass index. In addition, in addition interleukin-6 elevated levels were linked to the cancer state of the non-obese patients. Risk of breast cancer increased with higher levels of circulating insulin and intereukin-6. Received: Mar,, 2023 Accepted: May, 2023 Published: Jan.2023

International Pooled Analysis of Leisure-Time Physical Activity and Premenopausal Breast Cancer in Women From 19 Cohorts.

There is strong evidence that leisure-time physical activity is protective against postmenopausal breast cancer risk but the association with premenopausal breast cancer is less clear. The purpose of this study was to examine the association of physical activity with the risk of developing premenopausal breast cancer. We pooled individual-level data on self-reported leisure-time physical activity across 19 cohort studies comprising 547,601 premenopausal women, with 10,231 incident cases of breast cancer. Multivariable Cox regression was used to estimate hazard ratios (HRs) and 95% CIs for associations of leisure-time physical activity with breast cancer incidence. HRs for high versus low levels of activity were based on a comparison of risk at the 90th versus 10th percentiles of activity. We assessed the linearity of the relationship and examined subtype-specific associations and effect modification across strata of breast cancer risk factors, including adiposity. Over a median 11.5 years of follow-up (IQR, 8.0-16.1 years), high versus low levels of leisure-time physical activity were associated with a 6% (HR, 0.94 [95% CI, 0.89 to 0.99]) and a 10% (HR, 0.90 [95% CI, 0.85 to 0.95]) reduction in breast cancer risk, before and after adjustment for BMI, respectively. Tests of nonlinearity suggested an approximately linear relationship (Pnonlinearity = .94). The inverse association was particularly strong for human epidermal growth factor receptor 2-enriched breast cancer (HR, 0.57 [95% CI, 0.39 to 0.84]; Phet = .07). Associations did not vary significantly across strata of breast cancer risk factors, including subgroups of adiposity. This large, pooled analysis of cohort studies adds to evidence that engagement in higher levels of leisure-time physical activity may lead to reduced premenopausal breast cancer risk.

Prospective analysis of sleep characteristics, chronotype, and risk of breast cancer in the california teachers study

PurposePoor sleep quality and evening chronotype were associated with increased risk of breast cancer in a previous retrospective study in the California Teachers Study (CTS). The present analysis examines these sleep factors prospectively in the same cohort of women.MethodsFrom the CTS, we included 1,085 incident breast cancer cases and 38,470 cancer-free participants from 2012 through 2019. We calculated time at risk and used Cox proportional hazards regression models to estimate the hazard ratios (HRs) and control for risk factors such as age, race, body mass index, family history of breast cancer, and reproductive history. The sleep factors examined were quality, latency, duration, disturbance, and sleep medication use, based on a shortened version of the Pittsburgh Sleep Quality Index, as well as chronotype (preference for morning or evening activity). This analysis was limited to women who were post-menopausal at the time they answered these sleep-related questions.ResultsMeasures of sleep quality did not appear to be associated with subsequent breast cancer risk. The HR for evening chronotypes compared to morning chronotypes was somewhat elevated (HR 1.19, 95% CI 1.04, 1.36).ConclusionWhile the measures of sleep quality and duration were not associated with post-menopausal breast cancer risk in this prospective analysis, the modestly elevated risk observed for evening chronotypes was consistent with the prior retrospective analysis.

Trajectories of body mass index across the lifecourse and associations with post-menopausal breast cancer by estrogen receptor status

BackgroundAssociations between a high body mass index (BMI) at single timepoints during child- and adulthood and risks of post-menopausal breast cancer are well-established, but associations with BMI across the lifecourse remains largely unknown. Therefore, we examined whether lifecourse BMI trajectories were associated with risks of post-menopausal breast cancer overall and by estrogen receptor (ER) status. MethodsWe included 6698 Danish women born 1930–1946. Information on BMI at ages 6–15 years came from the Copenhagen School Health Records Register, and information on BMI at ages 20, 30, 40, 50 and/or 50–64 years came from the Diet, Cancer and Health cohort. Breast cancer cases (n = 577) were identified in the Danish Breast Cancer Cooperative Group database. Six BMI trajectories were identified using latent class trajectory modelling. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression models. ResultsCompared to women with a trajectory characterized by an average BMI gain across life, women with the two trajectories with steep increases in BMI during childhood and adolescence that thereafter largely stabilized, had lower risks of post-menopausal breast cancer and ER-positive tumors. The adjusted HRs for ER-positive tumors were 0.67 (95% CI: 0.47–0.95) and 0.68 (95% CI: 0.46–1.01), respectively. In contrast, women with a trajectory with a low gain in BMI during childhood and adolescence followed by a subsequent steep increase during adulthood, had higher risks of post-menopausal breast cancer and ER-positive tumors when compared to women with an average BMI gain. The adjusted HR for ER-positive tumors was 1.28 (95% CI: 0.98–1.67). ConclusionsOur findings suggest that the timing of excess gain in BMI across the lifecourse impacts subsequent post-menopausal breast cancer risks. Thus, the BMI development across life is likely useful in the identification of women at increased risks of post-menopausal breast cancer.

DNA repair genes, air pollution, and breast cancer risk

PurposeWe investigated if selected polymorphisms in DNA repair genes modify the association between air pollution and breast cancer (BCa) risk. MethodsWe included 150,929 postmenopausal women (5969 with BCa) from UK Biobank, a population-based prospective cohort. Information on BCa risk factors was collected at baseline. Cox proportional hazards regression was used to examine interactions of exposure for which we previously found associations with BCa in this cohort (2007 PM10 and cumulative average PM10) with 15 SNPs, adjusting for BCa risk factors. The associations between PM10 and BCa risk were stratified by genotype level. ResultsThe positive associations of 2007 PM10 and cumulative average PM10 with BCa risk were stronger in women with one or two copies of XRCC2 rs3218536C allele versus none (2007 PM10 Hazard Ratio (HR) per 1 µg/m3 = 1.04, 95% Confidence Interval (CI) 1.02–1.07, HR = 1.01, 95% CI 1.00–1.02, respectively, versus HR = 0.94, 95% CI 0.83–1.06, p-interaction = 0.02; cumulative average PM10 HR per 1 µg/m3 = 1.11, 95% CI 1.07–1.15, HR = 1.07, 95% CI 1.05–1.08 versus HR = 0.92, 95% CI 0.78–1.09, p-interaction = 0.05). The association of cumulative average PM10 with BCa was stronger in women with two copies of XRCC1 rs25489 T allele versus one or none (HR = 3.04, 95% CI 1.54–5.96 vs. HR = 1.06, 95% CI 1.02–1.11 and HR = 1.07, 95% CI 1.06–1.09; p-interaction = 0.06). ConclusionsOur results suggest stronger associations of 2007 PM10 and cumulative average PM10 with postmenopausal BCa risk in carriers of XRCC2 rs3218536C allele and stronger associations of cumulative average PM10 in those with two copies of XRCC1 rs25489 T allele.

Lifestyle Factors and Energy Intakes with Risks of Breast Cancer among Pre- and Post- Menopausal Women in Taiwan.

Although the incidence of invasive breast cancer (BC) among women in Asian is generally lower than that in Western countries, the incidence of BC has been on the rise in the past three decades in Asian countries. This hospital-based case-control study aimed to explore the relationship between dietary and metabolic factors and BC risk in pre- and post-menopausal women. We enrolled 285 patients with newly diagnosed BC at the National Taiwan University Hospital and 297 controls from the local community and hospital staff. Before receiving anticancer therapy, all patients with BC and control participants completed a 57-question semi-quantitative Food Frequency Questionnaire. For pre-menopausal women, plant-based factor scores rich in seeds and nuts, soy, fruits, and seaweeds correlated significantly with reduced BC risks, whereas menarche occurring at <12 years of age, reduced physical activity, and high-density lipoprotein <40 mg/dL were associated with increased BC risks. For post-menopausal women, plant-based dietary factor scores were also associated with reduced risks, whereas increased body mass index and energy intake levels correlated with increased BC risks. Diets rich in plant-based dietary patterns are protective against BC risk, regardless of menopausal status. Habitual physical activity is protective against BC risk among pre-menopausal Taiwanese women. Maintaining optimal weight and caloric intake is beneficial for reducing post-menopausal BC risk.

RS17817449 FTO gene variation associated with familial disease burden rather than individual risk for breast cancer

Introduction: Breast cancer (BC) is the most common malignancy in the female population globally. Obesity is associated with an increased risk of postmenopausal BC, BC recurrence, and mortality. Fat mass and obesity-associated (FTO) gene polymorphisms have attracted the most attention due to several single-nucleotide polymorphisms (SNPs) that may have an impact on obesity and different types of cancer. The primary goal of our work was to assess the association of the SNP rs17817449 FTO, physical status/metabolic changes, and dietary habits with the occurrence of BC. Methods: We conducted research as a population-genetic study including 93 women with a diagnosis of BC during their lifetime. Genomic DNA was extracted from the swabs of the buccal mucosa. Genotyping was achieved by polymerase chain reaction-restriction fragment length polymorphism. The IBM SPSS Statistics program v. 23.0 was used for statistical analysis. All values of p &lt; 0.05 were considered statistically significant. Results: The risk genotype of the FTO gene (rs17817449) GG was detected in 16 subjects (17.2%), the heterozygous TG in 46 subjects (49.5%), while the normal genotype TT was recorded in 29 subjects (31.2%). We found no statistically significant difference in the body mass index values of the three genotype groups, p = 0.72, χ2 = 2.1 and no significant relationship between the allelic or genotypic frequencies of the rs17817449 FTO gene polymorphism and other variables examined in our study. Analysis of the distribution of hereditary diseases in the family according to the molecular subtype of BC showed statistically significant p-values, p = 0.02. Conclusion: While previous research has suggested a potential link between FTO gene polymorphism, obesity, and BC, our study did not find a statistically significant association between the aforementioned variables. Future studies with a larger number of subjects in different populations should confirm the role of the FTO genotype in the risk of BC.

Circulating 27-hydroxycholesterol, lipids, and steroid hormones in breast cancer risk: a nested case–control study of the Multiethnic Cohort Study

BackgroundLaboratory studies have indicated that a cholesterol metabolite and selective estrogen receptor modulator, 27-hydroxycholesterol (27HC), may be important in breast cancer etiology and explain associations between obesity and postmenopausal breast cancer risk. Epidemiologic evidence for 27HC in breast cancer risk is limited, particularly in multiethnic populations.MethodsIn a nested case–control study of 1470 breast cancer cases and 1470 matched controls within the Multiethnic Cohort Study, we examined associations of pre-diagnostic circulating 27HC with breast cancer risk among African American, Japanese American, Native Hawaiian, Latino, and non-Latino White postmenopausal females. We used multivariable logistic regression adjusted for age, education, parity, body mass index, and smoking status. Stratified analyses were conducted across racial and ethnic groups, hormone receptor (HR) status, and use of lipid-lowering drugs. We assessed interactions of 27HC with steroid hormones.Results27HC levels were inversely related to breast cancer risk (odds ratio [OR] 0.80; 95% confidence interval [CI] 0.58, 1.12), but the association was not statistically significant in the full model. Directions of associations differed by racial and ethnic group. Results suggested an inverse association with HR-negative breast cancer (OR 0.46; 95% CI 0.20, 1.06). 27HC interacted with testosterone, but not estrone, on risk of breast cancer; 27HC was only inversely associated with risk among those with the highest levels of testosterone (OR 0.46; 95% CI 0.24, 0.86).ConclusionThis is the first US study to examine circulating 27HC and breast cancer risk and reports a weak inverse association that varies across racial and ethnic groups and testosterone level.