Three studies led by Dana-Farber Cancer Institute researchers offer encouraging signs for breast cancer patients. Two studies focus on breastfeeding after breast cancer diagnosis and treatment. The studies found that it is safe and feasible for young patients with certain genetic mutations to breastfeed without increasing the risk of cancer recurrence or cancer in the other breast, and that it is safe and feasible for hormone receptor-positive (HR+) breast cancer patients who become pregnant after a break in endocrine therapy to breastfeed. A third study shows that a telephone coaching program can significantly increase physical activity in overweight patients, potentially improving outcomes. The studies were presented at the European Society for Medical Oncology (ESMO) 2024 Congress in Barcelona, Spain.
Breastfeeding after breast cancer is safe and feasible for breast cancer survivors
Two studies presented at ESMO show that breastfeeding after a breast cancer diagnosis is not only possible but also safe for many patients. Dana-Farber researchers and patients contributed to both studies.
The first study was a collaboration between researchers from 78 hospitals and cancer treatment centers around the world and included 474 women with inherited mutations in the cancer susceptibility genes BRCA1 or BRCA2 who had become pregnant after being diagnosed with stage I-III invasive breast cancer under the age of 40.
The researchers divided the patients into two groups: those who breastfed after delivery and those who did not, and followed their health over time. At an average of seven years after delivery, there was no difference between the two groups in the incidence of cancer in the breast opposite the site where the tumor first developed. Disease-free survival (the period during which a patient is cancer-free) and overall survival were also the same in both groups.
The second study presents breastfeeding outcomes from the POSITIVE trial, which demonstrated the early safety of temporarily interrupting endocrine therapy to try to conceive. The key secondary endpoint was breastfeeding outcomes. The study included 518 patients aged 42 years or younger with HR+, stage I-III breast cancer. Of these patients, 317 delivered a live birth and 196 chose to breastfeed. Breast-conserving surgery was a significant factor in favor of breastfeeding.
Previous research led by Dana-Farber has demonstrated that young breast cancer survivors who continue to breastfeed after undergoing breast-conserving therapy may have difficulty feeding from the treated breast and must rely on the contralateral healthy breast to feed their baby.
“These studies provide the first evidence regarding the safety of breastfeeding after breast cancer, both in young patients with BRCA mutations that predispose them to breast cancer and in those who become pregnant after interrupting endocrine therapy,” said Anne Partridge, MD, MPH, founder and director of Dana-Farber’s Breast Cancer Young Adult Program and principal investigator of the study. “Our findings highlight the possibility of supporting the needs of mothers and their infants without compromising maternal safety.”
Paper Proposal Session: Supportive and Palliative Care
Breastfeeding in women with hormone receptor-positive breast cancer who became pregnant after interruption of endocrine therapy: Results from the POSITIVE trial (1814O) Anne Partridge, MD, MPH, Co-Senior Investigator, Dana-Farber
Paper Proposal Session: Supportive and Palliative Care
Breastfeeding after breast cancer in young BRCA carriers: results from an international cohort study (1815O) Anne Partridge, MD, MPH, Dana-Farber, Co-Senior Investigator
Coaching programs to increase physical activity
The third study draws on data from the Breast Weight Loss After Breast Cancer (BWEL) trial, which is investigating whether participating in a weight loss program after a breast cancer diagnosis can reduce the risk of cancer recurrence in women whose body mass index (BMI) is in the overweight or obese range. The BWEL trial randomized 3,180 women with breast cancer to receive either a telephone coaching program combined with health education materials focused on reducing calories and increasing physical activity or health education materials alone. The primary objective of the study is to determine whether a weight loss program reduces the risk of cancer recurrence, and a secondary objective is to evaluate whether a weight loss program helps breast cancer survivors increase their physical activity and eat a healthier diet.
The study, presented at ESMO, looked at changes in exercise among 541 BWEL study participants who took part in a substudy evaluating exercise patterns over time. Half of the patients took part in a weight loss and education program, while the other half received educational materials only.
At the time of study enrollment, patients in both groups were exercising very little: an average of 0 minutes per week in the health education group and 10 minutes per week in the weight loss group. Six months after enrollment, women in the weight loss program increased their exercise by an average of 40 minutes per week, while women in the education group did not increase their exercise at all. Additionally, women who took part in the weight loss program were more likely to exercise 150 minutes or more per week (an amount of exercise associated with many health benefits) and less likely to report not exercising at all, compared to women in the education only group.
Of all patients in the study, those who participated in at least 150 minutes of moderate or vigorous physical activity per week lost more weight than those who did not.
“Our findings show that a telephone-delivered weight-loss intervention can motivate this group of patients to become more physically active,” says Jennifer Lizibel, M.D., director of Dana-Farber’s Leonard P. Zakim Center for Integrative Medicine and Healthy Living and lead author of the study. “We plan to continue following these patients to determine whether changes in exercise affect their cancer outcomes.”
Mini-Oral Presentation: Supportive and Palliative Care
Effects of Weight Loss Intervention (WLI) on Exercise Behavior in Breast Cancer Patients: Results from the Breast Weight Loss from Breast Cancer (BWEL) Trial (1817MO) Jennifer Ligibel, MD, Dana-Farber, Presenter
About Dana-Farber Cancer Institute
Dana-Farber Cancer Institute is one of the world’s leading cancer research and treatment centers. Dana-Farber’s mission is to reduce the burden of cancer through scientific research, clinical care, education, community engagement and advocacy. We provide the latest cancer treatments for adults at Dana-Farber Brigham Cancer Center and for children at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. Dana-Farber is the only hospital in the nation ranked in the top 10 of US News & World Report’s Best Cancer Hospitals rankings for both adult and pediatric care.
A global leader in oncology, Dana-Farber is committed to a unique and equal balance of cancer research and treatment, translating discoveries into new therapies for patients locally and around the world and offering more than 1,100 clinical trials.
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