Health behaviors in breast cancer survivors to lower the risk for breast cancer

This article evaluates lifestyle behaviors breast cancer survivors adopt in order to lower the risk of recurrence.

In the past years the number of breast cancer survivors has increased as a result of early detection and medical advances regarding cancer therapies. However, breast cancer survivors are at great risk of breast cancer recurrence (return of the cancer) and other health problems directly related to the cancer or the treatment. Using a test called Oncotype DX doctors are now able to determine the likelihood of breast cancer recurrence in women with early stage breast cancer responsive to female hormones (estrogen/progesterone positive). This test can also predict how the cancer will respond to hormonal therapy or chemotherapy. Oncotype DX uses a sample of the tumor to measure the activity of certain genes expressed by cancer cells. The results of the test are reported as a number from 0 to 100 (known as the Recurrence Score). A lower score means a smaller chance that the cancer will return. 

Previous studies have shown that a normal body mass index or BMI, a healthy diet which contains at least 5 servings of fresh fruits and vegetables daily and regular physical activity may reduce the risk of cancer recurrence and offer additional health benefits in cancer survivors. This study included 186 early-stage breast cancer survivors who received the Oncotype DX test to assess breast cancer recurrence risk during their clinical care. Patients were asked to complete a questionnaire regarding their lifestyle (BMI maintenance, fruit and vegetable intake and physical activity) and their awareness of the benefits of a healthy lifestyle on cancer risk reduction.

Most women were aware that the 3 behaviors might lower cancer risk. However, despite this awareness, 62% of women did not maintain a healthy BMI, 37% were not physically active and 36% did not report eating fruits and vegetables regularly. Only 16% of the participants met recommendations for all three behaviors. Survivors with higher recurrence risk, as indicated by the Oncotype DX test, were no more likely to engage in healthy behaviors than patients with low or intermediate risk. Also, patients who underwent chemotherapy as breast cancer management were less likely to maintain a healthy BMI than women who did not receive chemotherapy. However, they were more likely to adopt a fruit and vegetables diet. Women who were white, who had a college degree or higher income, were more likely to adopt a healthy lifestyle.

In summary, most breast cancer survivors are aware that maintaining a normal BMI, consuming fruits and vegetables daily and engaging in regular physical activity may reduce cancer risk and wish to use these strategies to lower their risk for breast cancer recurrence. Unfortunately, a large proportion of cancer survivors do not adopt a healthier lifestyle. 

The findings of this study may inspire health care professionals to develop new strategies to help breast cancer survivors to adhere to a healthy lifestyle, with a special focus on maintaining a normal BMI. The weakness of this study stems from the fact that the data in the questionnaires is self-reported, thus may provide equivocal information.