Citations 2
Association of lifestyle factors and pathological characteristics in patients with early breast cancer and overweight/obesity: Results from the Breast Cancer Weight Loss (BWEL) trial.
Sposetti, Caterina , McCall, Linda, Weiss, Anna , Thomson, Cynthia A. , Hahn, Olwen, Minasian, Lori M. , Nebeling, Linda , Hopkins, Judith O. , Bernstein, Vanessa , Stearns, Vered, White, Julia , Ligibel, Jennifer A. , Ballman, Karla V. , Goodwin, Pamela J. , Hershman, Dawn L. , Paskett, Electra D. , Mayer, Erica L. , Winer, Eric P. , Partridge, Ann H. , Carey, Lisa A.
Journal of Clinical Oncology | May 28, 2025 | Volume: 43 | Issue: 16_suppl | Pages: 561-561
10.1200/jco.2025.43.16_suppl.561
561 Background: Obesity and other lifestyle factors are associated with breast cancer (BC) risk and outcomes. These relationships appear to vary in pre- vs postmenopausal women. Here we explore associations between pathological features, diet quality and physical activity (PA) in patients (pts) with BC enrolled in the BWEL (Alliance for Clinical Trials in Oncology A011401) trial, stratifying for menopausal status. Methods: BWEL is a phase III trial evaluating the impact of a weight loss intervention on disease outcomes in 3180 pts with stage II-III HER2– BC and body mass index ≥27 kg/m 2 . The first 542 BWEL pts underwent assessment of PA (7-Day PA Recall) and diet (24-hour Diet Recall) at enrollment. Healthy Eating Index 2020 (HEI) score (0-100, higher value = healthier diet) and minutes/week (min/wk) of moderate/vigorous PA (MVPA) were calculated. Estrogen receptor (ER) and progesterone receptor (PR) expression level (%) were abstracted from pathology reports. Analyses of links between HEI score, MVPA min/wk, % ER/PR, stratified by menopausal status, were conducted using t-tests; differential associations by menopausal status used linear regression models with interaction term. Results: In 523 pts with available pathology data, 76.5% had ER/PR+ BC, 56.2% were postmenopausal. Median HEI score was 50.1 (range 18.1-96.4), median MVPA min/wk was 0 (range 0-630), median time from diagnosis to enrollment was 10.0 months (range 2.4-13.1). In postmenopausal pts, higher diet quality was linked to increased % ER and PR (HEI above vs below median, mean % ER 78.0 vs 66.1, p=0.012; mean % PR 57.7 vs 43.1, p=0.004). The relationship between HEI score and % ER/PR differed significantly by menopausal status (interaction term of menopausal status and % ER: p=0.006; and % PR: p=0.012); there were no significant associations between HEI scores and % ER/PR in premenopausal pts. There were no significant associations between PA and % ER/PR. Conclusions: Healthier diet was associated with higher % ER and PR in postmenopausal pts with BC, but no relationship was seen in premenopausal pts. These data suggest that lifestyle factors may influence BC pathologic features related to outcomes in older women. Support: U10CA180821, U10CA180882, UG1CA189823, U24CA196171, https://acknowledgments.alliancefound.org . Clinical trial information: NCT02750826 . % ER mean (SD) p value % PR mean (SD) p value Post-Menopausal HEI* score≤50.1 [n=134]>50.1 [n=156] 66.1 (43.3)78.0 (36.8) 0.012 43.1 (41.8)57.7 (41.0) 0.004 MVPA † min/wk0 [n=147]≥1 [n=147] 74.5 (39.3)70.3 (41.2) 0.37 50.0 (41.8)53.0 (42.0) 0.41 Pre-Menopausal HEI* score≤50.1 [n=124]>50.1 [n=103] 70.5 (38.5)65.5 (43.0) 0.15 53.5 (41.1)49.1 (43.0) 0.43 MVPA † min/wk0 [n=112]≥1 [n=113] 66.3 (41.0)66.3 (41.2) 0.99 49.5 (41.4)52.6 (42.7) 0.59 *Healthy Eating Index. † Moderate/Vigorous Physical Activity.
Pregnancy After Breast Cancer in Young BRCA Carriers
Kim, Hee Jeong , Bernstein‐Molho, Rinat , Pogoda, Katarzyna , Carrasco, Estela , Bajpai, Jyoti , Phillips, Kelly‐Anne , Rousset‐Jablonski, Christine , Renaud, Tiphaine , Cui, Wanda, Wong, Stephanie M. , Ruddy, Kathryn J. , Rozenblit, Mariya, Marchis, Laura De , Mriňáková, Bela , Meister, Sarah , Livraghi, Luca , Clatot, Florian , Yerushalmi, Rinat , Angelis, Carmine De , Meattini, Icro , Cichowska-Cwalińska, Natalia, Berlière, Martine , Salama, Mahmoud , Giorgi, Ugo De , Sonnenblick, Amir , Chiodi, Camila , Maria, Camille, Azim, Hatem A. , Molinelli, Chiara , Paesmans, Marianne , Ameye, Lieveke , Hatse, Sigrid , Nevelsteen, Ines , Neven, Patrick , Rompuy, Chantal Van, Duhoux, François, Bini, Federica , Cont, Nicoletta Tomasi, Pais, Helena Luna , Mohar, Alejandro , Palacios, Tamara, Pastò, Brenno , Bonadio, Renata Colombo , Peretz‐Yablonski, Tamar , Anghelone, Chiara Annunziata Pasqualina, Valle, Angelica Della , Campanella, Maria, Bas, Raphaëlle, Talouet, Solenne de, Bonadona, Valérie, Lasset, Christine , Acheritogaray, Marion , Sénéchal, Claire , Mariño, Monica , Feldman, Didi, Pesce, Romina , Allemand, Carol, Riggi, Cecilia, Iriarte, Maria Belen, Salgado, Alfonso Cortés, Gión, María , Prat, Aleix , Hester, Anna, Dunckelmann, Sofia, Bartsch, Rupert , Mannsbarth, Constantin, Božović‐Spasojević, Ivana, Dimitrijević, Marija, Visani, Luca , Bettazzi, Beatrice, Sini, Valentina, Rognone, Alessia, Patricelli, Maria Grazia , Rabaiotti, Emanuela , Acconci, Giulia, Baldacci, Erica, Bianchini, Giulia, Kleiterp, Sieta, Moha, Daoud Ait, Sekar, Anberson, Loi, Francesco , Dessì, Mariele, O’Connor, Sarah , Nesci, Stephanie, Michael, Chris, Larson, Nicole L. , Lopetegui, Nerea M., Rocco, Roberta Di, Bengala, Carmelo , Haddad, Stephanie , Safran, Emma, Negri, Serena , Dell'Oro, Cristina, Marchetta, Liliana, Lustberg, Maryam B. , Blansky, Deanna , Ansari, Norin , Aguilar-y-Méndez, Dione, Swain, Monique , Miller, Madison , Leach, Richard E., Synowiec, Agnieszka , Hancinova, M., Tarbaj, L., Beslija, S. , Cerić, Timur , Hasanbegovic, B. , Bianchi, Manuel A., Álvaro, Laura, Bergman, Louise Eriksson, Damian, Cristina , Eriksson, Louise , Cui, Wanyuan , Prat, Aleix , De Angelis, Carmine , Meattini, Icro , Rousset-Jablonski, Christine , Phillips, Kelly-Anne , Cui, Wanda , Wong, Stephanie M , Livraghi, Luca , Lustberg, Maryam , Pogoda, K. , Lambertini, Matteo , Blondeaux, Eva , Agostinetto, Elisa , Hamy, Anne‐Sophie , Meglio, Antonio Di , Hilbers, Florentine , Punie, Kevin , Ignatiadis, Michail , Moore, Halle C. F. , Toss, Angela , Peccatori, Fedro A , Ferrari, Alberta , Paluch–Shimon, Shani , Fruscio, Robert , Vernieri, Claudio , Dieci, Maria Vittoria , Matikas, Alexios , Rozenblit, Mariya , Villarreal‐Garza, Cynthia , Mastro, Lucia Del , Puglisi, Fabio , Estevez-Diz, Maria Del Pilar , Rodriguez-Wallberg, Kenny A , Sánchez-Bayona, Rodrigo , Lee, Young‐Jin , Boni, Luca , Partridge, Ann H. , Azambuja, Evandro de , Amant, Frédéric , Brems, Hilde , Han, Sileny , Smeets, Ann , Wildiers, Hans , Giugliano, Federica , Criscitiello, Carmen , Borea, Roberto , Arecco, Luca , Chirco, Alessandra, Venturelli, Marta , Cortesi, Laura , Ponzone, Riccardo , Balmañà, Judith , Graffeo, Rossella , Ros, Lucia Da , Miolo, Gianmaria , Garutti, Mattia , Spazzapan, Simon , Viel, Alessandra , Fidalgo, José Alejandro Pérez , Guarneri, Valentina , Heudel, Pierre‐Etienne , Trédan, Olivier , Bonadona, Valérie , Córdoba, Octavi , Cortés, Javier , Saavedra, Cristina , Rodriguez, Adela R. , Adamo, Bárbara , Harbeck, Nadia , Marhold, Maximilian , POPOVIC, LAZAR S. , Krivokuća, Ana , Livi, Lorenzo , Sposetti, Caterina , Bianchini, Giampaolo , Gentilini, Oreste D , Fontana, Andrea , Pistelli, Mirco , Linn, Sabine C. , Sarin, Rajiv , Atzori, Francesco , O’Connor, Sarah, James, Paul A. , Michael, Chris, Couch, Fergus J. , Olson, Janet E. , Yadav, Siddhartha , Carey, Lisa A. , Abdou, Yara George , Zagami, Paola , Baldassarri, Margherita , Mariamidze, Elene , Graff, Stephanie L. , Matos, Leonor Vasconcelos de , Ferreira, Arlindo Rebelo , Dell’Oro, Cristina, Inzoli, Alessandra , Costa, Clarissa , Jeon, June Evelyn , Woodruff, Teresa K. , Fabi, Alessandra , Palazzo, Antonella , Paris, Ida , Kufel-Grabowska, Joanna , Sokolović, Emir , Foulkes, William D. , Bianchi, Manuel Alva, Tolosa, Pablo , Antone, Nicoleta Zenovia , Damian, Cristina
JAMA | December 7, 2023 | Volume: 331 | Issue: 1 | Pages: 49
ImportanceYoung women with breast cancer who have germline pathogenic variants in BRCA1 or BRCA2 face unique challenges regarding fertility. Previous studies demonstrating the feasibility and safety of pregnancy in breast cancer survivors included limited data regarding BRCA carriers.ObjectiveTo investigate cumulative incidence of pregnancy and disease-free survival in young women who are BRCA carriers.Design, Setting, and ParticipantsInternational, multicenter, hospital-based, retrospective cohort study conducted at 78 participating centers worldwide. The study included female participants diagnosed with invasive breast cancer at age 40 years or younger between January 2000 and December 2020 carrying germline pathogenic variants in BRCA1 and/or BRCA2. Last delivery was October 7, 2022; last follow-up was February 20, 2023.ExposurePregnancy after breast cancer.Main Outcomes and MeasuresPrimary end points were cumulative incidence of pregnancy after breast cancer and disease-free survival. Secondary end points were breast cancer–specific survival, overall survival, pregnancy, and fetal and obstetric outcomes.ResultsOf 4732 BRCA carriers included, 659 had at least 1 pregnancy after breast cancer and 4073 did not. Median age at diagnosis in the overall cohort was 35 years (IQR, 31-38 years). Cumulative incidence of pregnancy at 10 years was 22% (95% CI, 21%-24%), with a median time from breast cancer diagnosis to conception of 3.5 years (IQR, 2.2-5.3 years). Among the 659 patients who had a pregnancy, 45 (6.9%) and 63 (9.7%) had an induced abortion or a miscarriage, respectively. Of the 517 patients (79.7%) with a completed pregnancy, 406 (91.0%) delivered at term (≥37 weeks) and 54 (10.4%) had twins. Among the 470 infants born with known information on pregnancy complications, 4 (0.9%) had documented congenital anomalies. Median follow-up was 7.8 years (IQR, 4.5-12.6 years). No significant difference in disease-free survival was observed between patients with or without a pregnancy after breast cancer (adjusted hazard ratio, 0.99; 95% CI, 0.81-1.20). Patients who had a pregnancy had significantly better breast cancer–specific survival and overall survival.Conclusions and RelevanceIn this global study, 1 in 5 young BRCA carriers conceived within 10 years after breast cancer diagnosis. Pregnancy following breast cancer in BRCA carriers was not associated with decreased disease-free survival.Trial RegistrationClinicalTrials.gov Identifier: NCT03673306