ORCID Profile
0000-0002-8664-2172
Current Organisation
Brigham and Women's Hospital
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Publisher: Wiley
Date: 09-1999
DOI: 10.1002/(SICI)1097-0142(19990901)86:5<826::AID-CNCR19>3.0.CO;2-0
Abstract: Little is known regarding how specific dietary factors affect the survival of women with breast carcinoma. Female registered nurses were followed with biennial questionnaires in a prospective cohort with 18 years of follow-up. Participants were women with breast carcinoma (n = 1982) diagnosed between 1976-1990 who completed a food frequency questionnaire after diagnosis. The main outcome measure was time to death from any cause. Analysis was made by multivariate Cox proportional hazards models. In multivariate analyses of diet after diagnosis, no apparent association was found between fat intake and mortality. The relative risk (and 95% confidence interval) of mortality comparing the highest with the lowest quintile of protein intake was 0.65 (0.47-0.88). There was no association between red meat and mortality. These associations were similar in analyses with breast carcinoma death as the outcome. No survival advantage was found for a low fat diet after a diagnosis of breast carcinoma. However, increased survival was observed among women eating more protein, but not red meat. The findings suggest that differences in diet may affect survival after a diagnosis of breast carcinoma and should be examined in greater detail.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2005
Publisher: American Association for Cancer Research (AACR)
Date: 02-06-2022
DOI: 10.1158/1055-9965.EPI-21-1471
Abstract: Identifying risk factors for aggressive forms of breast cancer is important. Tumor factors (e.g., stage) are important predictors of prognosis, but may be intermediates between prediagnosis risk factors and mortality. Typically, separate models are fit for incidence and mortality postdiagnosis. These models have not been previously integrated to identify risk factors for lethal breast cancer in cancer-free women. We combined models for breast cancer incidence and breast cancer–specific mortality among cases into a multi-state survival model for lethal breast cancer. We derived the model from cancer-free postmenopausal Nurses’ Health Study women in 1990 using baseline risk factors. A total of 4,391 invasive breast cancer cases were diagnosed from 1990 to 2014 of which 549 died because of breast cancer over the same period. Some established risk factors (e.g., family history, estrogen plus progestin therapy) were not associated with lethal breast cancer. Controlling for age, the strongest risk factors for lethal breast cancer were weight gain since age 18: & 30 kg versus ± 5 kg, RR = 1.94 [95% confidence interval (CI) = 1.38–2.74], nulliparity versus age at first birth (AAFB) & 25, RR = 1.60 (95% CI = 1.16–2.22), and current smoking ≥ 15 cigarettes/day versus never, RR = 1.42 (95% CI = 1.07–1.89). Some breast cancer incidence risk factors are not associated with lethal breast cancer other risk factors for lethal breast cancer are not associated with disease incidence. This multi-state survival model may be useful for identifying prediagnosis factors that lead to more aggressive and ultimately lethal breast cancer.
Publisher: American Medical Association (AMA)
Date: 25-05-2005
Abstract: Physical activity has been shown to decrease the incidence of breast cancer, but the effect on recurrence or survival after a breast cancer diagnosis is not known. To determine whether physical activity among women with breast cancer decreases their risk of death from breast cancer compared with more sedentary women. Prospective observational study based on responses from 2987 female registered nurses in the Nurses' Health Study who were diagnosed with stage I, II, or III breast cancer between 1984 and 1998 and who were followed up until death or June 2002, whichever came first. Breast cancer mortality risk according to physical activity category ( or =24 metabolic equivalent task [MET] hours per week). Compared with women who engaged in less than 3 MET-hours per week of physical activity, the adjusted relative risk (RR) of death from breast cancer was 0.80 (95% confidence interval [CI], 0.60-1.06) for 3 to 8.9 MET-hours per week 0.50 (95% CI, 0.31-0.82) for 9 to 14.9 MET-hours per week 0.56 (95% CI, 0.38-0.84) for 15 to 23.9 MET-hours per week and 0.60 (95% CI, 0.40-0.89) for 24 or more MET-hours per week (P for trend = .004). Three MET-hours is equivalent to walking at average pace of 2 to 2.9 mph for 1 hour. The benefit of physical activity was particularly apparent among women with hormone-responsive tumors. The RR of breast cancer death for women with hormone-responsive tumors who engaged in 9 or more MET-hours per week of activity compared with women with hormone-responsive tumors who engaged in less than 9 MET-hours per week was 0.50 (95% CI, 0.34-0.74). Compared with women who engaged in less than 3 MET-hours per week of activity, the absolute unadjusted mortality risk reduction was 6% at 10 years for women who engaged in 9 or more MET-hours per week. Physical activity after a breast cancer diagnosis may reduce the risk of death from this disease. The greatest benefit occurred in women who performed the equivalent of walking 3 to 5 hours per week at an average pace, with little evidence of a correlation between increased benefit and greater energy expenditure. Women with breast cancer who follow US physical activity recommendations may improve their survival.
Publisher: Wiley
Date: 10-04-2007
DOI: 10.1002/IJC.22575
Abstract: We examined whether a history of smoking is associated with an increased risk of death from any cause or from breast cancer, among women diagnosed with breast cancer. This was a prospective observational study among 5,056 women from the Nurses' Health Study with Stages I-III invasive breast cancer diagnosed between 1978 and 2002 and for whom we had information on smoking, and who were followed until January 2002 or death, whichever came first. Subjects were classified as current, former or never smokers based upon smoking status at the biennial questionnaire immediately preceding the breast cancer diagnosis. In multivariate-adjusted analyses, compared with never smokers, women who were current smokers had a 43% increased adjusted relative risk (RR) [95% confidence interval (95% CI): 1.24-1.65] of death from any cause. A strong linear gradient was observed with the number of cigarettes per day smoked, p-trend <0.0001 the RR (95% CI) for 1-14, 15-24 and 25 or more cigarettes per day was 1.27 (1.01-1.61), 1.30 (1.08-1.57) and 1.79 (1.47-2.19). In contrast, there was no association with current smoking and breast cancer death the RR (95% CI) was 1.00 (0.83-1.19). Current and past smokers were more likely than never smokers to die from primary lung cancer, chronic obstructive pulmonary disease and other lung diseases. We conclude that a history of smoking increased mortality following diagnosis with breast cancer, but did not increase mortality from breast cancer.
No related grants have been discovered for Michelle Holmes.