Body mass index (BMI), waist-to-hip ratio (WHR), and tumor characteristics affect disease-free survival. Larger breast size may increase breast cancer risk, but its influence on disease-free survival is unclear. The purpose of this study was to elucidate whether breast size independently influenced disease-free survival in breast cancer patients.
Body measurements were obtained preoperatively from 772 breast cancer patients in a population-based ongoing cohort from southern Sweden. The research nurse measured breast volumes with plastic cups used by plastic surgeons doing breast reductions. Clinical data were obtained from patient charts and pathology reports.
Patients with a BMIÂ =Â 25Â kg/m(2) had larger tumors (pÂ Â 0.85 had larger tumors (pÂ =Â 0.013), more advanced histological grade (pÂ =Â 0.0016), and more axillary nodal involvement (pÂ =Â 0.012). Patients with rightÂ +Â left breast volumeÂ =Â 850Â mL were more likely to have larger tumor sizes (pÂ =Â 0.018), more advanced histological grade (pÂ =Â 0.031), and more axillary nodal involvement (pÂ =Â 0.025). There were 62 breast cancer events during the 7-year follow-up. Breast volumeÂ =Â 850Â mL was associated with shorter disease-free survival (pÂ =Â 0.004) and distant metastasis-free survival (pÂ =Â 0.001) in patients with estrogen receptor (ER)-positive tumors independent of other anthropometric measurements and age. In patients with ER-positive tumors, breast size was an independent predictor of shorter disease-free (HR 3.64; 95Â % CI 1.42-9.35) and distant metastasis-free survival (HR 6.33; 95Â %CI 1.36-29.43), adjusted for tumor characteristics, BMI, age, and treatment.
A simple and cheap anthropometric measurement with standardized tools may help identify a subgroup of patients in need of tailored breast cancer therapy.
Whether cancer predisposing familial factors are associated with childhood tumors is unclear. The purpose was to study the incidence of childhood and adult tumors in extended families of children with cancer. Family history of cancer was obtained through questionnaires, and the Swedish Population-, and Cancer Registries for 194 childhood cancer patients aged =18 years, diagnosed 1972-2009. Standardized cancer incidence ratios (SIR), and 95% confidence intervals (CI) were estimated and compared with expected rates. Overall, 21 of the 194 patients had any relative with a childhood tumor. When restricted to first- to third degree relatives, increased incidences of childhood (SIR: 2.5; 95% CI: 1.3-4.4) and adult tumors (SIR: 1.5; 95% CI: 1.3-1.7), especially in the prostate (SIR: 2.7; 95% CI: 1.9-3.8) and breast (SIR: 1.7; 95% CI: 1.2-2.4) were observed. Prostate and breast cancers were observed at earlier than average ages. No TP53 mutations or known cancer predisposing syndromes were found in families with multiple childhood tumors. Familial factors may increase the risk for childhood cancer and modify the age of onset of common adult tumors. Studying extended families with multiple childhood tumors may be a valuable approach to understanding the etiology of childhood tumors.
We have studied the use of complimentary alternative medicine (CAM) among 233 consecutive breast cancer patients operated on at the Lund University Hospital, Sweden between 2002 and 2004. Questionnaires were administered preoperatively (n = 233), and again 3-6 months post-operatively (n = 167) and one year after surgery (n = 88). At baseline, 14,5% used CAM, 3-6 months post-operatively 14,4% used CAM and one year after surgery 18,2% used CAM. The most common products contained omega-3, garlic, ginseng and roseroot. We identified use of 35 different types of CAM products and seven of these could potentially increase the risk of breast cancer or interact with tamoxifen or aromatase inhibitors: soy, garlic, ginko biloba, echinacea, ginseng, valerian and phytoestrogens (excluding soy). Five and a half percent of the patients used either hormone replacement therapy (HRT) or hormonal contraception at the pre-operative visit, after they had received their breast cancer diagnosis. In conclusion, it is important that doctors discuss the use of CAM and exogenous hormone therapy with their breast cancer patients given the prevalence of these drugs.