While breast cancer risk factors like genetic predisposition and excess weight have been studied at length, researchers are gathering new evidence on how they impact a woman's chances of surviving the disease.
According to research presented at the Fifth AACR Conference on The Science of Cancer Health Disparities in San Diego this week, weight -- and more specifically, an extreme body mass index or high waist-to-hip ratio -- was shown to increase risk for mortality among patients with breast cancer, experts say. But the association varied by race/ethnicity.
In a study of data from 12,025 female patients with breast cancer from the California Breast Cancer Survivorship Consortium, research scientist Marilyn L. Kwan discovered that among non-Latina white women, being underweight or morbidly obese at the time of a breast cancer diagnosis was associated with worse survival. The relationship was not found in the other racial/ethnic groups, however.
For other groups, including African Americans, Kwan and her team honed in on another form of excess weight instead -- abdominal fat. “African-American women and Asian-American women with larger waist-to-hip ratios had poorer survival, an observation not seen in non-Latina white women and Latina women,” Kwan said in a release.
While researchers have known the danger abdominal fat poses to breast cancer patients for some time (a team at UNC also made the link back in 2006), it's the racial and ethnic disparity that Kwan points out as new. Her research joins a growing body of evidence suggesting that breast cancer recommendations and treatment should be more personalized.
According to the Mayo Clinic, a waist measurement of 35 inches (89 centimeters) or more indicates an unhealthy concentration of belly fat in women and a greater risk of problems, including breast cancer, diabetes and heart disease.
To trim it (especially the dangerous visceral variety), doctors recommend a portion-controlled, plant-based diet that is low in saturated fat, along with at least 150 minutes of moderate to vigorous aerobic activity per week. For long-lasting results, aim for a slow and steady weight loss of up to 2 pounds (1 kilogram) a week and forgo crunches or other targeted abdominal exercises, which experts say won't get rid of belly fat.
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One Treatment Does Not Fit All
In a landmark series of <a href="http://www.huffingtonpost.com/2012/09/24/breast-cancer-gene-study-new-treatment-black-women_n_1910142.html">studies that honed in on four major classes of breast cancer</a> last month, researchers have been able to provide clues as to why the disease differs between races. At North Shore-LIJ Health System's Monter Cancer Center, researchers found that <a href="http://www.huffingtonpost.com/2012/06/06/breast-cancer-genetics-race-therapy-treatment_n_1574724.html">Caucasian women may carry microRNAs that protect against breast cancer, genes that African American women don't carry.</a> The finding not only explains why cancer outcomes are often different between black and white women, it also supports the importance of personalized treatment for cancer that focuses on the genetic make-up of tumors, rather than a one-treatment-fits-all approach.
"D" Stands For Decreased Risk
A study published in the journal <em>Breast Cancer Research</em> in April revealed <a href="http://www.huffingtonpost.com/2012/04/08/vitamin-d-may-reduce-breast-cancer-in-black-women-study_n_1411599.html">African-American women with the highest levels of vitamin D also had a specific variation in the vitamin D receptor that cut their breast cancer risk in half</a>, compared to women without it. About a third of African Americans are vitamin D deficient, however, and melanin in the skin make it harder for many to get enough. Along with a healthy does of sunshine, experts recommend a vitamin D supplement of 600 IU per day.
Even Moderate Exercise Helps
In June, researchers at University of North Carolina in Chapel Hill found that women who<a href="http://www.huffingtonpost.com/2012/06/25/exercise-breast-cancer-risk-moderate_n_1619175.html"> exercise between 10 and 19 hours each week had a 30 percent lower risk of breast cancer</a>. And there isn't a need to break a serious sweat either. <em>All</em> levels of exercise intensity were linked with a decreased risk, the study authors said.
Regular Screening Are Key To Closing Racial Gaps
According to a study published in <em>Breast Cancer Research</em> in August, <a href="http://www.sciencedaily.com/releases/2012/09/120925153327.htm">mammograms may be the key to closing the breast cancer gap between black and white women.</a> When study participants received regular breast screening, "there was no difference in the rate of how many of them presented in the disease's later stages," researchers found. "This study reinforces the fact that racial gaps in breast cancer outcomes can be improved," said lead author Dr. Paula Grabler, an assistant professor of radiology at Northwestern University Feinberg School of Medicine and a radiologist at Northwestern Memorial Hospital.
Affordable Care Is Within Reach
In a <a href="http://thehill.com/blogs/healthwatch/public-global-health/259519-obama-sebelius-healthcare-law-is-fighting-breast-cancer">commemoration of Breast Cancer Awareness month Monday, President Obama and Health and Human Services Secretary Kathleen Sebelius</a> credited the Affordable Care Act with bringing on "a new day for women's health and the fight against breast cancer." According to Sebelius, the healthcare law "means that women can get the potentially life-saving services they need to detect breast cancer before it spreads, without worrying how a copay would affect their family budget."
Existing Treatments Work
A September study by Washington University researchers suggests basal-like breast tumors, one of the deadliest forms of the disease that has been shown to disproportionately affect younger women and those who are African-American, <a href="http://www.huffingtonpost.com/2012/09/24/breast-cancer-gene-study-new-treatment-black-women_n_1910142.html">have a similar genetic makeup to ovarian tumors and could potentially be treated with the same drugs. </a> This means some women may be able to forgo less effective treatments that are typically used for basal-like tumors and have been know to cause heart problems and lead to the development of other cancers, including leukemia.
Triple-Negative Treatments Are Closer
The notoriously fatal triple-negative breast cancer (TNBC) may have met its match, according to researchers from Memorial Sloan-Kettering Cancer Center in New York who found that a form of the small pox virus can be used against TBNC. In the study released this week, researchers found that a certain form of smallpox vaccine was able to kill 90 percent of TBNC cells in four days of treatment. It also inhibited blood flow to the cancer stopping its spread. TNBC is found in about 15 out of every 100 cases and is more likely to occur in Hispanics and African Americans.