TY - JOUR
T1 - Lifestyle Characteristics in Women Carriers of BRCA Mutations
T2 - Results From an Italian Trial Cohort
AU - Bruno, Eleonora
AU - Oliverio, Andreina
AU - Paradiso, Angelo
AU - Daniele, Antonella
AU - Tommasi, Stefania
AU - Terribile, Daniela A
AU - Filippone, Alessio
AU - Digennaro, Maria
AU - Pilato, Brunella
AU - Danza, Katia
AU - Guarino, Donatella
AU - Rossi, Cristina
AU - Rossi, Maria Maddalena
AU - Venturelli, Elisabetta
AU - Giussani, Marta
AU - Peissel, Bernard
AU - Pasanisi, Patrizia
N1 - Copyright © 2020 Elsevier Inc. All rights reserved.
PY - 2021/6
Y1 - 2021/6
N2 - BACKGROUND: Women with deleterious mutations in BRCA1/2 have a high lifetime penetrance of developing breast cancer and/or ovarian cancer. Genetic and/or environmental factors may influence BRCA penetrance, and identifying modifiable exposures might be valuable for prevention.PATIENTS AND METHODS: We implemented a multicenter prospective 2-arm (1:1) randomized controlled trial to investigate whether a Mediterranean dietary intervention with moderate protein restriction would reduce potential modulators of BRCA penetrance such as insulin-like growth factor 1 (IGF-1), body weight, and metabolic risk factors. We studied the baseline characteristics of women with BRCA-positive disease who joined the trial cohort, focusing on the relationships between selected lifestyle exposures, metabolic/anthropometric parameters, and BRCA-related cancer.RESULTS: A total of 502 women (304 with a previous diagnosis of breast cancer and/or ovarian cancer and 198 unaffected) with deleterious BRCA mutations, with or without a previous cancer, aged 18 to 70 years and without metastases were included. Late age at menarche and pregnancy were negatively associated with BRCA-related cancer, especially in women with BRCA1-positive disease. Higher fat mass and the presence of 4 or 5 metabolic risk factors were significantly associated with BRCA-related cancer (hazard ratio, 1.87, 95% confidence interval, 1.21-2.88; and hazard ratio, 1.87, 95% confidence interval, 1.11-3.19, respectively), with greater effect in BRCA2-positive women.CONCLUSIONS: Our findings confirm previous observations about reproductive factors in women with BRCA disease and suggest a potential impact of metabolic factors in BRCA-related cancer. The prospective follow-up of the trial cohort will enable us to study the environmental modulators of BRCA penetrance and their impact in relation to the history of BRCA-related cancer. [ClinicalTrials.gov NCT03066856].
AB - BACKGROUND: Women with deleterious mutations in BRCA1/2 have a high lifetime penetrance of developing breast cancer and/or ovarian cancer. Genetic and/or environmental factors may influence BRCA penetrance, and identifying modifiable exposures might be valuable for prevention.PATIENTS AND METHODS: We implemented a multicenter prospective 2-arm (1:1) randomized controlled trial to investigate whether a Mediterranean dietary intervention with moderate protein restriction would reduce potential modulators of BRCA penetrance such as insulin-like growth factor 1 (IGF-1), body weight, and metabolic risk factors. We studied the baseline characteristics of women with BRCA-positive disease who joined the trial cohort, focusing on the relationships between selected lifestyle exposures, metabolic/anthropometric parameters, and BRCA-related cancer.RESULTS: A total of 502 women (304 with a previous diagnosis of breast cancer and/or ovarian cancer and 198 unaffected) with deleterious BRCA mutations, with or without a previous cancer, aged 18 to 70 years and without metastases were included. Late age at menarche and pregnancy were negatively associated with BRCA-related cancer, especially in women with BRCA1-positive disease. Higher fat mass and the presence of 4 or 5 metabolic risk factors were significantly associated with BRCA-related cancer (hazard ratio, 1.87, 95% confidence interval, 1.21-2.88; and hazard ratio, 1.87, 95% confidence interval, 1.11-3.19, respectively), with greater effect in BRCA2-positive women.CONCLUSIONS: Our findings confirm previous observations about reproductive factors in women with BRCA disease and suggest a potential impact of metabolic factors in BRCA-related cancer. The prospective follow-up of the trial cohort will enable us to study the environmental modulators of BRCA penetrance and their impact in relation to the history of BRCA-related cancer. [ClinicalTrials.gov NCT03066856].
KW - Adult
KW - Aged
KW - BRCA1 Protein
KW - BRCA2 Protein
KW - Body Mass Index
KW - Breast Neoplasms/genetics
KW - Cohort Studies
KW - Female
KW - Humans
KW - Italy
KW - Life Style
KW - Middle Aged
KW - Nutritional Status
KW - Physical Fitness
KW - Prospective Studies
U2 - 10.1016/j.clbc.2020.11.002
DO - 10.1016/j.clbc.2020.11.002
M3 - Article
C2 - 33357965
SN - 1526-8209
VL - 21
SP - e168-e176
JO - Clinical Breast Cancer
JF - Clinical Breast Cancer
IS - 3
ER -