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Energy Balance And Breast Cancer Risk In Breast Cancer Family Registry
Career Catalyst Research
The overall objective of this study is to examine the association between energy balance and breast cancer risk, using data collected from nearly 6,000 women diagnosed with breast cancer and 6,000 controls enrolled in the Breast Cancer Family Registry between 1995 and 2006. Energy balance is determined by three behavioral factors including energy intake, physical activity and body composition; all are amenable to intervention. Animal models have shown strong evidence that energy restriction inhibits mammary tumor development. Nevertheless, human studies generally do not support an association between energy intake and breast cancer risk. In free-living humans, because physical activity and body size are important regulators of energy intake, failure to take into consideration the integrated effect of energy intake, physical activity and body size may obscure the true effect of energy balance on breast cancer risk. Taking advantage of the large sample size of the Breast Cancer Family Registry and the wealth of epidemiologic and clinical data that have been collected, the proposed study aims to investigate the jointed effect of energy intake, body size and physical activity on the risk of breast cancer using two complimentary designs: the population-based case-control design that consists of 4,400 population-based cases and 4,400 population-based controls, and the family-based design that consists of 1,700 sister-pairs. Although exploratory, the proposed study will examine further whether the effect of energy balance on breast cancer risk differs in pre- and post-menopausal women, in breast cancer cases with different estrogen and progesterone receptor status and in BRCA mutation carriers. These investigations have been rarely carried out in epidemiologic studies. Results from this study will advance our knowledge on the role of energy balance in the etiology of breast cancer. Studying the effect of energy balance by hormone receptor status and menopausal status may provide insights into the biological pathways linking energy balance and breast cancer risk. Because energy intake, physical activity and body size are modifiable, results from this study may assist the development of powerful intervention strategies to prevent breast cancer in the general population, as well as provide behavioral intervention guidance to BRCA mutation carriers who have a very high lifetime risk of developing breast cancer.
This research project will contribute to reductions in breast cancer incidence by identifying behavioral risk factors associated with beast cancer risk that are amenable to intervention. If the incidence of breast cancer can be reduced by 5% through behavioral interventions, at least 150,000 new breast cancer cases can be prevented each year in the world. Among the known risk factor of breast cancer such as family history of breast cancer, late age at first childbirth, nulliparity, early age at menarche and late age at menopause, most are not easily amenable or ethically to intervention. Modifiable risk factors such as diet, physical activity and body size represent an important area of research that may guide the development of behavioral intervention strategies coping with the worldwide epidemic of breast cancer.
Research in the areas of diet, physical activity and body composition usually focuses on a single behavioral risk factor. Less effort has been devoted to examine the combined effect of all three components of energy balance. The proposed study will examine the integrated effect of energy intake, body mass index and physical activity on breast cancer risk in both the general population and high-risk families. These analyses will advance our understanding on the role of energy balance in breast cancer development. Results from this study will also set the basis for future investigations on the biological pathways linking energy balance and breast cancer risk as well as behavioral interventions to reduce breast cancer incidence in the general population and to improve cancer outcomes of breast cancer survivors.