Soy, Nuts, Beans May Help Prevent Breast Cancer’s Return

Ernie Mundell wrote . . . . . . . . .

Women who’ve survived breast cancer may want to up their dietary intake of soy, nuts, beans and whole grains, a new analysis finds.

A higher intake of soy compounds called isoflavones was especially tied to better odds that cancer would not return, according to researchers at Johns Hopkins University in Baltimore and elsewhere.

The findings can’t yet determine the ideal dosages of isoflavones or other nutrients that appear to prevent recurrence, the authors said, so more research is needed in that area.

The study also can’t determine “whether starting to consume them after diagnosis has the same effect as a lifelong dietary habit before diagnosis,” senior study author Dr. Channing Paller said in a Hopkins news release. That’s information that “patients are looking for,” he said.

The review of data on nutrition and breast cancer recurrence was conducted by Paller’s group at Johns Hopkins Kimmel Cancer Center, along with researchers at other centers worldwide.

Investigators looked at data from 22 major studies that focused on soybeans, lignans (compounds found in a variety of plants such as seeds and nuts), cruciferous vegetables (crunchy veggies like cabbage, broccoli and cauliflower), and green tea.

They also looked at the effect of phytonutrients (compounds derived from plants) that are found in these foods.

Paller and her colleagues discovered that a high intake of soy isoflavones was linked to a 26% reduction in breast cancer recurrence.

The greatest benefit came from a daily intake of 60 milligrams — that’s equivalent to two or thee cups of soy milk, three ounces of tofu or a half-cup of cooked soybeans, the authors said.

The benefit of soy isoflavones in preventing breast cancer death was smaller, however — only about a 12% reduction. That benefit was highest when women ate about one or two servings of soy products per day.

For women who worry that eating soy might not be safe after a breast cancer diagnosis because soy isoflavones can act like estrogen in the body, the American Cancer Society offers this advice: “Some studies have suggested that soy food intake might lower the risk of breast cancer coming back, although more research is needed to confirm this. While eating soy foods doesn’t seem to pose a risk, the evidence regarding the effects of taking soy or isoflavone supplements, which often contain much higher levels of these compounds, is not as clear.”

Paller’s team also looked at lignans, found in a myriad of plants such as seeds, nuts, legumes, whole grains, fruit and vegetables. Flaxseeds, cashew nuts, broccoli and brussels sprouts contain especially high concentrations of lignans.

High levels of enterolactone — formed when lignans are broken down by the digestive system — appeared to reduce the odds for death from breast cancer by 28%, the study found, and to cut the odds for an early death from any cause by 31%.

The lignan and soy findings were solid enough to recommend that breast cancer survivors use them in any dietary guidelines.

Other findings didn’t have enough data behind them for that, but were “suggestive,” the researchers said.

For example, they found that drinking lots of green team was tied to a 44% reduction in breast cancer’s return for women who’d been treated for stage 1 or 2 breast cancers.

As to the influence of cruciferous vegetables on breast cancer outcomes, Paller and colleagues say the evidence simply isn’t there to draw any conclusions about possible benefit.

The findings were published recently in the journal JNCI Cancer Spectrum.

“It is critically important to stress that these studies were conducted on women who received medical and/or surgical treatment for breast cancer, and that these foods and phytonutrients should not be considered as alternatives to treatment,” stressed Paller, an associate professor of oncology at Johns Hopkins.

Source: HealthDay

 

 

 

 

MRI Might Boost Cancer Detection for Women With Dense Breasts

Cara Murez wrote . . . . . . . . .

Nearly half of women have dense breast tissue, which can be a double whammy on their odds for breast cancer.

Not only are dense breasts a risk factor for cancer, but this glandular and fibrous connective tissue make it harder to detect cancers on a mammogram, the usual method for breast cancer screening.

New research looked at other kinds of imaging to see which might be more effective for the 47% of women who have dense breasts with low levels of fatty tissue.

One emerged as an effective alternative: Breast MRI was superior to other methods, using that detection criteria.

Researchers also looked at hand-held breast ultrasound, automated breast ultrasound and digital breast tomosynthesis.

All showed about the same level of effectiveness, said study co-author Dr. Vivianne Freitas, an assistant professor at the University of Toronto and a staff radiologist at the Joint Department of Medical Imaging, also in Toronto.

“I would say supplementary image modalities in those with dense breasts and negative mammogram are recommended and should be performed,” Freitas said. “This is my first message to [patients who have dense breasts].”

Even though the studies found MRI superior in terms of cancer detection, Freitas urged patients to discuss the pros and cons of each method with their health care providers.

Among the concerns about breast MRI is its availability and its price.

“The costs are actually the biggest barrier for our widespread implementation of MRI,” Freitas said.

Screening mammograms are highly effective for women with fatty breasts, detecting about 98% of cancers. For those with dense breasts, they can give false reassurance, however.

Both dense tissue and breast cancer show up as white on the image, making it harder to detect cancer in dense breasts, Freitas said.

On average, women have a lifetime risk of 12% to 13% for developing breast cancer. A history of treated breast cancer or previous breast biopsies with high-risk lesions boosts that to an intermediate risk.

High-risk patients, with a lifetime risk of 20% or higher, were not included in this study because MRI benefits for them have already been established.

To investigate the effectiveness of screening methods, the researchers did a meta-analysis of 22 studies that included more than 261,000 patients who had been screened for breast cancer.

The studies included 10 that covered hand-held breast ultrasound; four on automated breast ultrasound; three on breast MRI; and eight on digital breast tomosynthesis.

More than 132,000 of the women had dense breasts and a negative mammogram. Researchers found 541 undetected cancers in that group. Breast MRI detected even tiny cancers.

Still, more research is needed, researchers said. It’s important to investigate the cost effectiveness of breast MRI and any impact each method may have on death rates.

Susan Brown, a managing director at the Susan G. Komen breast cancer organization in Dallas, reviewed the findings.

She noted that MRI technology is much more sensitive but also not very specific, which can lead to false positives.

Brown said she would like to see the additional research that the authors also said was needed on the impact of other screening methods on cancer survival.

“We don’t know if using breast MRI as a supplemental screening to mammography for women at average risk with dense breasts really saves lives,” she said.

In the absence of clinical guidelines, Brown said decisions on follow-up screening is a personal judgment call.

Komen’s policy focus has been on removing barriers to breast imaging, she said.

Although the Affordable Care Act enabled widespread access to free screening mammograms, patients who need additional screening because of an inconclusive or abnormal mammogram may still incur high out-of-pocket costs.

“Our position is that mammography is one step, the initial step, in early detection and is alone not able to diagnose breast cancer in every woman, and women with breast density is an example,” Brown said.

People who face high costs for diagnostic and supplemental imaging are less likely to have those tests, she said, citing past research.

“As a result, if they have breast cancer, that delay in diagnosis can be associated with a much poorer outcome,” Brown said.

Nine U.S. states have eliminated cost sharing for these follow-up tests, Brown said. Several others have introduced legislation this year to address this issue. Federal legislation may also be reintroduced later this year.

“To have that screening test but then not to be able to follow up if there’s an abnormality can have really very negative consequences, of course, to those individuals that do have cancer,” Brown said.

The findings were published in the journal Radiology.

Source: HealthDay

How to Lower Heart Disease and Breast Cancer Risk at the Same Time

Teresa McUsic wrote . . . . . . . . .

It turns out that many of the lifestyle behaviors that help fight off breast cancer in women also can help them avoid heart disease.

Think of it as a “double win,” said cardiologist Dr. Ana Barac, director of the cardio-oncology program at MedStar Heart and Vascular Institute in Washington, D.C.

Such a win could benefit a substantial number of women. In the U.S., an estimated 9.1 million have coronary heart disease, and heart disease overall is the leading cause of death for women. In 2019, about 3.8 million women in the U.S. were living with breast cancer, with an estimated 43,250 deaths expected this year.

While some risk factors, such as age and family history, cannot be changed, here are five things women can do to lower their risk for both conditions.

What to eat – and not to eat

To prevent heart disease and breast cancer, the American Heart Association and American Cancer Society offer similar guidance for an ideal diet, which includes eating a variety of fruits and vegetables; choosing whole grains rather than refined grain products; avoiding processed meat; and limiting added sugar.

Even for women already diagnosed with breast cancer, “diet is a huge part of staying healthy,” Barac said. Evidence, she said, suggests an association between a healthy diet and an improved breast cancer prognosis. For example, a 2020 study in the Journal of Clinical Oncology found that reducing fat intake and increasing vegetable, fruit and grain intake may reduce the risk of dying from breast cancer in postmenopausal women.

More clear-cut, though, is the data for cardiovascular disease, Barac said. “We have strong evidence that in people with cardiovascular disease, including coronary heart disease, eating a healthy diet improves outcomes.” A 2020 analysis in the journal Nutrients found people with cardiovascular disease who followed a Mediterranean diet – focusing on vegetables, fruits, legumes, nuts, olive oil, whole grains and fish – had a lower risk of dying from any cause, including cardiovascular disease.

Maintain a healthy weight

Having obesity is a risk factor for cardiovascular disease, as well as for breast cancer after menopause, according to a 2018 AHA scientific statement about cardiovascular disease and breast cancer.

Body mass index, or BMI, is a calculation of height and weight that determines a person’s weight category. Obesity is defined as a BMI of 30 or greater.

Get up and get moving

At least 150 minutes a week of moderate-intensity aerobic exercise, such as brisk walking, is recommended for adults. Unfortunately, federal survey data show only about 1 in 5 U.S. women say they meet that requirement. And research suggests getting less than the recommended amount of physical activity each week is associated with an elevated risk for both cardiovascular disease and breast cancer.

Sedentary time poses the same risks.

“If you are sitting for a long time, you need to get up and walk around,” even if you exercise that day, said Dr. Tochukwu Okwuosa, a cardiologist and associate professor at Rush Medical College in Chicago. Getting up every hour for even a minute or two will benefit the body, she said.

Beware the booze (and the hormones)

The takeaway here is moderation for those who drink alcohol – and not starting for those who don’t. Moderation means no more than one drink a day for women, the AHA and cancer society say.

And “make sure you don’t binge,” Okwuosa said. For women, binge drinking typically translates to four or more drinks in a two-hour period, according to the National Institute on Alcohol Abuse and Alcoholism.

Excessive drinking can increase the risk for liver disease, breast cancer and a range of cardiovascular problems, including high blood pressure, heart disease and stroke.

Okwuosa said women also should be aware of the risks associated with postmenopausal hormone replacement therapy, which has been linked to an increased risk of breast cancer and cardiovascular disease.

If a woman has a history of breast cancer or any cardiovascular disease, or the more risk factors she has, “then the chance that hormone replacement therapy could be not a good thing for you is higher,” Okwuosa said.

Women should talk to their health care team about the risks and benefits of options for managing menopause symptoms to find the best treatment strategy for them.

Get screened

Knowing if you have high blood pressure, high cholesterol or diabetes – and then working with a health care professional to treat it – can help prevent those conditions from causing heart disease and other cardiovascular conditions.

The AHA advises blood pressure screening for adults at each regular health care visit or once a year if blood pressure is normal. It also recommends cholesterol screening every four to six years, starting at age 20, for adults at normal risk for heart disease and stroke, or more often for those at elevated risk. For diabetes, the American Diabetes Association recommends screening starting at age 35, or sooner for those at elevated risk.

Although mammograms cannot prevent breast cancer, they can help detect it early. For women at average risk for breast cancer, the cancer society recommends annual mammograms starting at age 45, with the option to start at age 40. Women 55 and older can switch to every other year or can choose to continue yearly mammograms.

Knowing your family history for breast cancer and cardiovascular problems is a big part of determining when and what type of screening you might need, Barac said.

Overall, she added, once health care professionals understand someone’s personal and family medical history, “we can use lifestyle medicine, in particular exercise and diet, to empower women and prevent cancer and heart disease.”

Source: American Heart Association

 

 

 

 

Too Little Exercise, Too Much Sitting Could Raise Breast Cancer Risk

Dennis Thompson wrote . . . . . . . . .

Sitting on the couch or behind a desk could be increasing your risk of breast cancer, a new genetics-driven study suggests.

People more likely to engage in physical activity based on their DNA had a 41% lower risk of invasive breast cancer, researchers report.

Previous research also has shown a link between exercise and reduced cancer risk, but “our study suggests that the strength of the relationship may be even stronger than suggested by observational studies,” said senior researcher Brigid Lynch, deputy head of cancer epidemiology for Cancer Council Victoria, in Melbourne, Australia.

“Our study also suggests that sedentary behavior may increase the risk of breast cancer,” Lynch continued. “The risk increase is greater for receptor-negative tumors, including triple-negative breast cancer — a more aggressive type of breast cancer with a poorer prognosis than other types.”

For this study, the Australian researchers performed a sophisticated genetic analysis of nearly 131,000 women from around the world, including nearly 70,000 who had been diagnosed with invasive breast cancer.

Previous research has identified genetic variants that are linked to a person’s overall predisposition to work out at all, engage in vigorous exercise or sit around all day, the study authors said.

The researchers applied these known variants to their international sample of women, to see if a genetic inclination for either physical activity or sedentary behavior would influence cancer risk.

Younger women whose genes would typically drive them to work out three or more days a week appear to have a 38% lower risk of breast cancer, the investigators found.

On the other hand, women genetically predisposed to be sedentary were 77% more likely to develop hormone receptor-negative breast cancers.

“The results of our study suggest that reducing the overall duration of sitting time is key,” Lynch said. “For women with desk jobs, try taking walking breaks throughout the day – don’t eat lunch at your desk, go out for a half hour walk instead.”

The findings were published in the British Journal of Sports Medicine.

Using genetics to judge a person’s expected physical activity levels is “a little controversial,” but these results jibe with previous studies that have tied exercise to cancer risk using self-reported behavior or wearable trackers that monitored how much people moved, said Dr. Jennifer Ligibel, an expert with the American Society of Clinical Oncology.

“Whether or not this provides a higher level of evidence than actually looking at what people do in terms of their activity and how that’s related to cancer, I think is the source of maybe a little debate,” said Ligibel, an oncologist with Dana-Farber Cancer Institute in Boston. “We already have a fair amount of research that has shown sedentary behavior is a cancer risk factor, and this verifies that using a different way of looking at the relationship.”

However, a genetics-driven study like this “raises interesting scientific questions for next steps,” said Karen Knudsen, chief executive officer at the American Cancer Society.

“What is it about those genetic alterations that are associated with changes in physical activity and reduced cancer risk?” Knudsen said “What are these variations that were identified? How do they affect metabolic programming of the individual? I think these are important next-step questions.”

There are many different theoretical means by which exercise could help ward off cancer, Lynch and Ligibel said.

For example, physical activity decreases the level of circulating sex hormones like estrogen, which “increase the risk of developing breast cancer, particularly in postmenopausal women,” Lynch said.

Exercise also suppresses inflammation, enhances the immune system, and lowers insulin levels and other growth factors associated with cancer, Ligibel said.

The American Cancer Society recommends that adults get 150 to 300 minutes of moderate intensity physical activity or 75 to 150 minutes of vigorous exercise each week.

Not only does exercise protect against many different types of cancer, but “emerging data suggests that physical activity will reduce the risk of development of aggressive disease,” Knudsen noted.

This study showed some cancer risk benefit with just 50 minutes of moderate activity each week, Lynch said.

“We also found benefits for engaging in vigorous activity more than 10 minutes at a time, at least three times per week,” Lynch said.

Source: HealthDay

 

 

 

 

2 Studies Show Some Cancer Patients Can Skip Secondary Treatments After Surgery

Carla K. Johnson wrote . . . . . . . . .

After surgery, some cancer patients can safely skip radiation or chemotherapy, according to two studies exploring shorter, gentler cancer care.

Researchers are looking for ways to precisely predict which cancer patients can avoid unneeded treatment to cut down on harmful side effects and unnecessary costs.

One new study used a blood test to determine which colon cancer patients could skip chemotherapy after surgery. Another suggests some low-risk breast cancer patients can omit radiation after lumpectomy.

The research was discussed at the annual meeting of the American Society of Clinical Oncology, which wrapped up recently in Chicago. The colon cancer study, funded by the Australian and U.S. governments and nonprofit groups, was published by the New England Journal of Medicine.

The findings could allow doctors to “focus on the patients we think would truly benefit from chemotherapy and avoid the side effects for patients for whom it’s likely unnecessary,” said Dr. Stacey Cohen of Fred Hutchinson Cancer Center in Seattle, who reviewed the colon cancer findings and was not involved in the research.

COLON CANCER

Many colon cancer patients are given chemotherapy after surgery, even though they may be cured. The drugs can come with side effects such as nausea, anemia and memory problems.

But pinpointing which patients might not need further treatment has been tricky. Scientists studied whether a blood test could help doctors make the call.

The study involved 455 patients who had surgery because cancer had spread into the colon wall. After surgery, one group received a blood test, customized to their tumor’s genetic profile, to detect any remaining bits of cancer DNA.

Their care was guided by the blood test: If it showed no signs of remaining cancer, the patients did not get chemotherapy. Meanwhile, doctors made chemo decisions for the rest of the patients in the usual way, guided by analysis of the tumor and nearby tissue.

Fewer patients in the blood test group got chemo — 15% vs. 28%. But about 93% of both groups were still free of cancer after two years. In other words, the blood test group fared equally well with less chemotherapy.

“In patients where cancer DNA is not detected after surgery, the chance of cancer relapse is very low, suggesting that chemotherapy is very unlikely to benefit these patients,” said Dr. Jeanne Tie of the Peter MacCallum Cancer Centre in Melbourne, Australia, who led the research.

Skipping chemo makes “a big difference in a person’s quality of life if that can be done without having to put them at jeopardy for recurrence,” said ASCO president Dr. Everett Vokes, who specializes in head and neck and lung cancer at University of Chicago Medicine.

BREAST CANCER

The other study followed 500 older women with a common form of early-stage breast cancer and low levels of a protein known as Ki67, a marker for fast-growing cancer.

After surgery, the women took hormone-blocking pills, a standard treatment for this type of cancer, but they did not get radiation treatment.

After five years, 10 of the women saw cancer return in the same breast, and there was one breast cancer death. There was no comparison group, but researchers said the results compare favorably to historical data for similar patients who had radiation.

“We estimate the benefits of radiation would be very small in this population compared to the side effects,” said Dr. Timothy Whelan of McMaster University in Hamilton, Ontario, who led the study, which was supported by the Canadian Breast Cancer Foundation and the Canadian Cancer Society.

Radiation can cause skin problems, fatigue and, less commonly, long-term heart problems and second cancers.

The study is a “feel-good” message for patients with low-risk tumors and will help doctors understand which of their patients they “can comfortably, with confidence” omit radiation, said Dr. Deborah Axelrod of NYU Langone Health, who was not involved in the research.

Source: AP