Abstract PD11-03: Assessing the impact of 12 months lifestyle interventions on breast cancer secondary prevention: A modeling approach

Abstract

Background Healthy lifestyle, including caloric restriction, balanced diet and physical activity, is important in primary and secondary prevention of breast cancer (BC). It is known that Mediterranean diet reduces metabolic syndrome and insulin resistance that are associated with increased risk of BC onset and recurrence. Physical activity decreases BMI, blood concentrations of testosterone, estrogens, insulin, its resistance and strengthens anti-inflammatory pathways against tumor cells. Since January 2014, at our Institution we promoted a project named “Lifestyle Program” for high risk BC patients underwent to primary surgery. Here we presented the results of 12 months of “Lifestyle Program”. Patients and methods Since January 2014 we have prospectively enrolled all high risk patients between 18 and 70 years treated to our department for invasive early-stage breast cancer (stage I-III). High risk has been defined by one or more of the following inclusion criteria: body mass index (BMI) > 25, diagnosis of metabolic syndrome, increased level of blood testosterone and/or insulin. All high risk patients receive a periodical personalized educational intervention by a physiatrist for physical activity and by a nutritionist for a mediterranean diet low in animals fat and enriched of fibers, fruits and vegetables. All patients underwent to screening for anxiety and depression through HADS questionnaire scores. All data were analyzed by Chi-square test assuming statistical significance at p<0.05. Results 98 BC patients were included; 21.4% of them had a metabolic syndrome. Median age was 56 years old (range 27-75). Most of patients enrolled had ER+ (85.7%), Her2/neu negative (79.6%), stage I (48%) BC. We observed a statistically significant reduction of BMI (BMI>25 in 94.9% of pts at baseline vs 63.2% after 12 months of lifestyle; p=<0.0001), glycemic (>110 mg/dl in 23.5% of pts at baseline vs 10.2% at 12 months; p=<0.0001), insulin levels (>27 uU/ml in 20.6% of pts at baseline vs 2.9% after 12 months; p<0.0001), testosterone (>1,2 ng/ml in 17.6% of pts at baseline vs 4.1% at 12 months; p<0.0001), cholesterol (>200 mg/dl in 46.9% of pts at baseline vs 35.7% at 12 months; p<0.0001), triglycerides (>170 mg/dl in 13.3% of pts at baseline vs 10.2% at 12 months; p<0.0001) and arthralgia (37.7% at baseline vs 17.3% at 12 months; p=0.0008). We also noted a significantly reduction of anxiety and depression after 12 months of lifestyle program (25.4% and 12% respectively at diagnosis vs 13.4% and 4.5% at 12 months respectively; p=0,0064 and p<0.0001). Conclusions Promoting healthy lifestyle can reduce risk factors involved in BC recurrence and ensure psychological benefit and compliance to endocrine therapy. A multidisciplinary approach allows greater adherence to healthy attitudes in BC high risk patients. Citation Format: Mirco Pistelli, Valentina Natalucci, Lucia Bastianelli, Laura Scortichini, Veronica Agostinelli, Filippo Merloni, Agnese Savini, Marianna Capecci, Maria Gabriella Ceravolo, Roberta Serrani, Maurizio Ricci, Marina Taus, Albano Nicolai, Elena Barbieri, Rossana Berardi. Assessing the impact of 12 months lifestyle interventions on breast cancer secondary prevention: A modeling approach [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PD11-03.

Effects of a Home-Based Lifestyle Intervention Program on Cardiometabolic Health in Breast Cancer Survivors during the COVID-19 Lockdown

“…Briefly, participant inclusion criteria were: ≤12-month post-surgery and post chemo- or radio-therapy adjuvant; stage 0 to III BC without metastases or recurrences diagnosis at recruitment in follow-up; aged 30–70 years; non-physically active (i.e., not engaged in at least 60 min/week of structured exercise during the previous 6 months); with a risk factor for recurrence. As reported in previous studies [ 39 , 40 , 41 , 42 ], the risk factors for recurrence were: body mass index (BMI) at diagnosis ≥25 kg/m 2 , testosterone ≥0.4 ng/mL; serum insulin ≥25 µU/mL (170 pmol/L); metabolic syndrome (at least 3 of the following 5 factors): a, glycemia ≥100 mg/dL (6.05 mmol/L); b, triglycerides ≥150 mg/dL (1.69 mmol L); c, HDL-C <50 mg/dL (1.29 mmol/L); d, waist circumference ≥80; e, blood pressure ≥130/85 mmHg. Exclusion criteria were: disabling pneumological, cardiological, neurological, orthopedic comorbidities, or mental illnesses that prevent the exercise performance; treatment with beta blockers, non-dihydropyridine calcium channel blockers, or amiodarone due to their potential effect on heart rate response to exercise; treatment with antidepressant drugs.…”

A home-based lifestyle intervention program reduces the tumorigenic potential of triple-negative breast cancer cells

“…Recruitment details are described in Natalucci et al 3 . Briefly, inclusion criteria were: ≤ 12 months post-surgery and post chemo- or radio-therapy adjuvant; stage 0 to III BC without metastases or recurrences diagnosis at recruitment; aged 30–70 years; non-physically active (i.e., not engaged in regular activity according to the International Physical Activity Questionnaire Short Form (IPAQ-SF) 17 , 18 for at least 6 months; with a high risk of recurrence 19 , 20 . Exclusion criteria were: disabling pneumatological, cardiological, neurological, orthopedic comorbidities, or mental illnesses that prevent exercise performance; treatment with beta-blockers, non-dihydropyridine calcium channel blockers, or amiodarone due to their potential effect on heart rate response to exercise; treatment with antidepressant drugs.…”