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- Jernström, Helena
(författare)
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Joint effects of genes, body constitution, and lifestyle: exploring novel pathways to predict prognosis and response to therapy in breast cancer
- 2014
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Ingår i: Anticancer research. - 1791-7530. ; 34:10, s. 5974-5975
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Konferensbidrag (refereegranskat)abstract
- Breast cancer is the most common cancer among women in the Western world. In Sweden, 1 in 9 women will be diagnosed during their lifetime, amounting to >8,000 new breast cancers per year. Each year around 1,400 patients die from their disease. A comprehensive report entitled "highlighted several areas in need of more research", including how weight, alcohol consumption, smoking, host metabolism and inflammatory and immunological factors’ impact on cancer progression (1). Our group has assembled a populationbased cohort of primary breast cancer patients in Lund, Sweden since 2002. Our analyses have shown significantly shorter disease-free survival (DFS) for breast cancer patients with ER-positive tumors and large total breast volume (≥850 ml) regardless of age, WHR and BMI (2). Preoperative BMI was not significantly associated with DFS after postoperative weight change was taken into account. The response to endocrine therapy was associated with germline genotypes of the androgen receptor (3) and COX2 (4), while tamoxifen response was not associated with CYP2D6 genotypes (5). Instead, coffee intake was associated with significantly better response to tamoxifen treatment with less than half the risk of early breast cancer events in patients who consumed 2+ cups/day compared to 0-1 cups/day (6). This was not observed in patients treated with aromatase inhibitors. Further, a low to moderate alcohol intake was associated with significantly longer DFS but only in patients with node-positive disease (7). This may, in part, be mediated by the fact that patients with two out of the three clinical markers “low alcohol intake, current smoking and normal BMI” were significantly less likely to adhere to their endocrine treatment (8).Taken together, our data suggest that body constitution, lifestyle and genetic factors jointly impact on the prognosis and treatment response in breast cancer, stressing the importance of taking host factors into consideration.
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| 64. |
- Jernström, Helena, et al.
(författare)
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Plasma prolactin in relation to menstrual cycle phase, oral contraceptive use, arousal time and smoking habits
- 1992
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Ingår i: Contraception. - 0010-7824. ; 46:6, s. 543-548
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Tidskriftsartikel (refereegranskat)abstract
- The study was designed to investigate if modern low dosage combined oral contraceptives were associated with changes in plasma prolactin levels in healthy nulliparous women aged 19-25. Plasma prolactin was not significantly correlated to oral contraceptive use, nor to smoking habits. Plasma prolactin was, however, significantly negatively correlated to time since awakening. A significant two-way interaction on prolactin was also seen between smoking and present oral contraceptive use. In our material the mean values of plasma prolactin were higher in the follicular phase than in the luteal phase, although not significantly.
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- Jernström, Helena, et al.
(författare)
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Pregnancy and risk of early breast cancer in carriers of BRCA1 and BRCA2
- 1999
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Ingår i: The Lancet. - 1474-547X. ; 354:9193, s. 1846-1850
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Early age at first full-term pregnancy and increasing parity are associated with a reduced risk of breast cancer. However, whether pregnancy decreases the risk of early-onset hereditary breast cancer is unknown. There is concern that pregnancy may increase breast-cancer risk in carriers of BRCA1 and BRCA2 germline mutations. We aimed to establish whether pregnancy is a risk factor for hereditary breast cancer. METHODS: We did a matched case-control study of breast cancer in women who carry deleterious BRCA1 or BRCA2 mutations. Cases were carriers who developed breast cancer by age 40 years, and controls were carriers of the same age without breast cancer, or who were diagnosed with breast cancer after age 40 years. Women who had undergone preventive mastectomy, hysterectomy, or oophorectomy, or who were diagnosed with ovarian cancer before the age at which breast cancer was diagnosed in the matched case were excluded. Information about pregnancies and pregnancy outcome was derived from a questionnaire completed by women in the course of genetic counselling. FINDINGS: A higher proportion of cases than controls had had a full term pregnancy (173/236 vs 146/236; odds ratio 1.71 [95% CI 1.13-2.62], p=0.01). The mean number of births was also greater for cases than for controls (1.62 vs 1.38, p=0.04). The risk increased with the number of births and did not diminish with time since last pregnancy. There were no significant differences in age at first birth or age at last birth between cases and controls. INTERPRETATION: Carriers of the BRCA1 and BRCA2 mutations who have children are significantly more likely to develop breast cancer by age 40 than carriers who are nulliparous. Each pregnancy is associated with an increased cancer risk. An early first pregnancy does not confer protection for carriers of BRCA1 or BRCA2 mutations.
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