Priorities for the primary prevention of breast cancer

Despite recent calls to intensify the search for new risk factors for breast cancer, acting on information that we already have could prevent thousands of cases each year. This article reviews breast cancer primary prevention strategies that are applicable to all women, discusses the underutilization of chemoprevention in high‐risk women, highlights the additional advances that could be made by including young women in prevention efforts, and comments on how the molecular heterogeneity of breast cancer affects prevention research and strategies. CA Cancer J Clin 2014;64:186–194. © 2014 American Cancer Society.

[1]  Kevin A. Henry,et al.  Annual Report to the Nation on the Status of Cancer, 1975-2011, Featuring Incidence of Breast Cancer Subtypes by Race/Ethnicity, Poverty, and State , 2015, Journal of the National Cancer Institute.

[2]  J. Manson,et al.  Nutrition and Physical Activity Cancer Prevention Guidelines, Cancer Risk, and Mortality in the Women's Health Initiative , 2014, Cancer Prevention Research.

[3]  S. Yao,et al.  Parity and breastfeeding among African-American women: differential effects on breast cancer risk by estrogen receptor status in the Women’s Circle of Health Study , 2013, Cancer Causes & Control.

[4]  V. Moyer.  Medications for Risk Reduction of Primary Breast Cancer in Women: U.S. Preventive Services Task Force Recommendation Statement , 2013, Annals of Internal Medicine.

[5]  G. Mills,et al.  Favorable modulation of benign breast tissue and serum risk biomarkers is associated with >10 % weight loss in postmenopausal women , 2013, Breast Cancer Research and Treatment.

[6]  S. Gapstur,et al.  Recreational Physical Activity and Leisure-Time Sitting in Relation to Postmenopausal Breast Cancer Risk , 2013, Cancer Epidemiology, Biomarkers & Prevention.

[7]  Karen R Fitzgerald.  Review of article: Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010 by Katherine M. Flegal, PhD; Margaret D. Carroll, MSPH; Brian K. Kit, MD; Cynthia L. Ogden, PhD (JAMA 2012;307:491-7). , 2013, Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing.

[8]  Brian Reid,et al.  Overdiagnosis and overtreatment in cancer: an opportunity for improvement. , 2013, JAMA.

[9]  W. Willett,et al.  Alcohol Intake Between Menarche and First Pregnancy: A Prospective Study of Breast Cancer Risk , 2013, Journal of the National Cancer Institute.

[10]  J. Cuzick,et al.  Use of pharmacologic interventions for breast cancer risk reduction: American Society of Clinical Oncology clinical practice guideline. , 2013, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[11]  K. Kinzler,et al.  Cancer Genome Landscapes , 2013, Science.

[12]  K. Jung,et al.  Prediction of Cancer Incidence and Mortality in Korea, 2013 , 2013, Cancer research and treatment : official journal of Korean Cancer Association.

[13]  W. Willett,et al.  Fruit and vegetable intake and risk of breast cancer by hormone receptor status. , 2013, Journal of the National Cancer Institute.

[14]  M. Wakefield,et al.  Population and age‐group trends in weekend sun protection and sunburn over two decades of the SunSmart programme in Melbourne, Australia , 2013, The British journal of dermatology.

[15]  Jacques Ferlay,et al.  GLOBOCAN 2012: Estimated cancer incidence, mortality and prevalence worldwide in 2012 , 2013 .

[16]  Steven J. M. Jones,et al.  Comprehensive molecular portraits of human breast tumours , 2013 .

[17]  Dongfeng Zhang,et al.  Physical activity and risk of breast cancer: a meta-analysis of prospective studies , 2013, Breast Cancer Research and Treatment.

[18]  J. Buring,et al.  Circulating carotenoids and risk of breast cancer: pooled analysis of eight prospective studies. , 2012, Journal of the National Cancer Institute.

[19]  Gretchen A. Stevens,et al.  National, regional, and global trends in adult overweight and obesity prevalences , 2012, Population Health Metrics.

[20]  P. Boyle,et al.  Triple-negative breast cancer: epidemiological considerations and recommendations. , 2012, Annals of oncology : official journal of the European Society for Medical Oncology.

[21]  S. Blair,et al.  Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy , 2012, BDJ.

[22]  Steven J. M. Jones,et al.  Comprehensive molecular portraits of human breast tumors , 2012, Nature.

[23]  Connie Lim,et al.  Youth risk behavior surveillance - United States, 2011. , 2012, Morbidity and mortality weekly report. Surveillance summaries.

[24]  Erika A. Waters,et al.  Use of tamoxifen and raloxifene for breast cancer chemoprevention in 2010 , 2012, Breast Cancer Research and Treatment.

[25]  W. Willett,et al.  Intakes of Alcohol and Folate During Adolescence and Risk of Proliferative Benign Breast Disease , 2012, Pediatrics.

[26]  Ahmedin Jemal,et al.  Annual Report to the Nation on the status of cancer, 1975‐2008, featuring cancers associated with excess weight and lack of sufficient physical activity , 2012, Cancer.

[27]  G. Colditz,et al.  Commentary: eight ways to prevent cancer: a framework for effective prevention messages for the public , 2012, Cancer Causes & Control.

[28]  Sabrina T. Wong,et al.  Willingness to use tamoxifen to prevent breast cancer among diverse women , 2012, Breast Cancer Research and Treatment.

[29]  Katherine M Flegal,et al.  Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. , 2012, JAMA.

[30]  P. Porter,et al.  Reproductive factors and risk of estrogen receptor positive, triple-negative, and HER2-neu overexpressing breast cancer among women 20–44 years of age , 2012, Breast Cancer Research and Treatment.

[31]  M. Thun,et al.  American Cancer Society guidelines on nutrition and physical activity for cancer prevention , 2002, CA: a cancer journal for clinicians.

[32]  W. Willett,et al.  Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk. , 2011, JAMA.

[33]  Jae Woo Lim,et al.  The changing trends in live birth statistics in Korea, 1970 to 2010 , 2011, Korean journal of pediatrics.

[34]  Karen A Gelmon,et al.  Exemestane for breast-cancer prevention in postmenopausal women. , 2011, The New England journal of medicine.

[35]  M. Gail,et al.  Benefit/risk assessment for breast cancer chemoprevention with raloxifene or tamoxifen for women age 50 years or older. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[36]  W. Ghali,et al.  Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis , 2011, BMJ : British Medical Journal.

[37]  Victoria L. Cafourek,et al.  Associations of breast cancer risk factors with tumor subtypes: a pooled analysis from the Breast Cancer Association Consortium studies. , 2011, Journal of the National Cancer Institute.

[38]  G. Colditz,et al.  Traditional breast cancer risk factors in relation to molecular subtypes of breast cancer , 2011, Breast Cancer Research and Treatment.

[39]  Brigid M Lynch,et al.  Physical activity and breast cancer prevention. , 2011, Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer.

[40]  W. Willett,et al.  Physical activity and risk of breast cancer among postmenopausal women. , 2010, Archives of internal medicine.

[41]  S. Carlson,et al.  Trend and prevalence estimates based on the 2008 Physical Activity Guidelines for Americans. , 2010, American journal of preventive medicine.

[42]  Chien-Jen Chen,et al.  Recent trends and patterns in breast cancer incidence among Eastern and Southeastern Asian women , 2010, Cancer Causes & Control.

[43]  Joseph P. Costantino,et al.  Update of the National Surgical Adjuvant Breast and Bowel Project Study of Tamoxifen and Raloxifene (STAR) P-2 Trial: Preventing Breast Cancer , 2010, Cancer Prevention Research.

[44]  W. Willett,et al.  Intake of fiber and nuts during adolescence and incidence of proliferative benign breast disease , 2010, Cancer Causes & Control.

[45]  W. Willett,et al.  Body fatness at young ages and risk of breast cancer throughout life. , 2008, American journal of epidemiology.

[46]  X. Shu,et al.  Adolescent and adult soy food intake and breast cancer risk: results from the Shanghai Women's Health Study. , 2009, The American journal of clinical nutrition.

[47]  M. Pike,et al.  Childhood Soy Intake and Breast Cancer Risk in Asian American Women , 2009, Cancer Epidemiology Biomarkers & Prevention.

[48]  Erika A. Waters,et al.  Explanations for side effect aversion in preventive medical treatment decisions. , 2009, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[49]  Susan M. Domchek,et al.  Meta-analysis of Risk Reduction Estimates Associated With Risk-Reducing Salpingo-oophorectomy in BRCA1 or BRCA2 Mutation Carriers , 2009, Journal of the National Cancer Institute.

[50]  G. Cho,et al.  Age at menarche in a Korean population: secular trends and influencing factors , 2009, European Journal of Pediatrics.

[51]  S. Bond.  OTHER STUDIES OF INTEREST TO MIDWIVES , 2008 .

[52]  W. Willett,et al.  A prospective study of age-specific physical activity and premenopausal breast cancer. , 2008, Journal of the National Cancer Institute.

[53]  M. Zwahlen,et al.  Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies , 2008, The Lancet.

[54]  C. Perou,et al.  Epidemiology of basal-like breast cancer , 2008, Breast Cancer Research and Treatment.

[55]  G. Colditz,et al.  Moving forward with breast cancer prevention , 2007, Cancer.

[56]  J. Cuzick,et al.  Long-term results of tamoxifen prophylaxis for breast cancer--96-month follow-up of the randomized IBIS-I trial. , 2007, Journal of the National Cancer Institute.

[57]  T. Powles,et al.  Twenty-year follow-up of the Royal Marsden randomized, double-blinded tamoxifen breast cancer prevention trial. , 2007, Journal of the National Cancer Institute.

[58]  W. Willett,et al.  Adult weight change and risk of postmenopausal breast cancer. , 2006, JAMA.

[59]  Connie Lim,et al.  Youth risk behavior surveillance--United States, 2005. , 2006, The Journal of school health.

[60]  M. Thun,et al.  American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer With Healthy Food Choices and Physical Activity , 2002, CA: a cancer journal for clinicians.

[61]  T. Sellers,et al.  Epidemiology — identifying the causes and preventability of cancer? , 2006, Nature Reviews Cancer.

[62]  L. Ford,et al.  Tamoxifen for the prevention of breast cancer: current status of the National Surgical Adjuvant Breast and Bowel Project P-1 study. , 2005, Journal of the National Cancer Institute.

[63]  J. Berlin,et al.  Lifetime recreational exercise activity and breast cancer risk among black women and white women. , 2005, Journal of the National Cancer Institute.

[64]  S. Gregorich,et al.  Factors affecting breast cancer risk reduction practices among California physicians. , 2005, Preventive medicine.

[65]  K. Taguchi,et al.  Tamoxifen For Breast Cancer Chemoprevention: Low Uptake by High-Risk Women After Evaluation of a Breast Lump , 2005, The Annals of Family Medicine.

[66]  S. Cummings,et al.  Continuing outcomes relevant to Evista: breast cancer incidence in postmenopausal osteoporotic women in a randomized trial of raloxifene. , 2004, Journal of the National Cancer Institute.

[67]  G. Colditz,et al.  Sugar-added beverages and adolescent weight change. , 2004, Obesity research.

[68]  S. Cummings,et al.  Body mass index, serum sex hormones, and breast cancer risk in postmenopausal women. , 2003, Journal of the National Cancer Institute.

[69]  N. Kerse,et al.  Effectiveness of counselling patients on physical activity in general practice: cluster randomised controlled trial , 2003, BMJ : British Medical Journal.

[70]  Sowmya R. Rao,et al.  Estimates of the number of US women who could benefit from tamoxifen for breast cancer chemoprevention. , 2003, Journal of the National Cancer Institute.

[71]  C. Land,et al.  Incidence of female breast cancer among atomic bomb survivors, Hiroshima and Nagasaki, 1950-1990. , 1987, Radiation research.

[72]  M. C. Leske,et al.  Alcohol, tobacco and breast cancer – collaborative reanalysis of individual data from 53 epidemiological studies, including 58 515 women with breast cancer and 95 067 women without the disease , 2002, British Journal of Cancer.

[73]  J. Ranstam,et al.  Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50 302 women with breast cancer and 96 973 women without the disease , 2002, The Lancet.

[74]  C. T. Orleans,et al.  Evaluating primary care behavioral counseling interventions: an evidence-based approach. , 2002, American journal of preventive medicine.

[75]  T. Key,et al.  Endogenous sex hormones and breast cancer in postmenopausal women: reanalysis of nine prospective studies. , 2002, Journal of the National Cancer Institute.

[76]  R. Tibshirani,et al.  Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications , 2001, Proceedings of the National Academy of Sciences of the United States of America.

[77]  C. Matthews,et al.  Lifetime physical activity and breast cancer risk in the Shanghai Breast Cancer Study , 2001, British Journal of Cancer.

[78]  G. Colditz,et al.  Cumulative risk of breast cancer to age 70 years according to risk factor status: data from the Nurses' Health Study. , 2000, American journal of epidemiology.

[79]  Christian A. Rees,et al.  Molecular portraits of human breast tumours , 2000, Nature.

[80]  M H Gail,et al.  Weighing the risks and benefits of tamoxifen treatment for preventing breast cancer. , 1999, Journal of the National Cancer Institute.

[81]  G. Colditz,et al.  Adolescence and breast carcinoma risk , 1999, Cancer.

[82]  C K Redmond,et al.  Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. , 1999, Journal of the National Cancer Institute.

[83]  F. Speizer,et al.  Alcohol and breast cancer in women: a pooled analysis of cohort studies. , 1998, JAMA.

[84]  Alan D. Lopez,et al.  Alcohol consumption and mortality among middle-aged and elderly U.S. adults. , 1997, The New England journal of medicine.

[85]  G. Colditz,et al.  From public health science to prevention policy: placing science in its social and political contexts. , 1997, American journal of public health.

[86]  G. Colditz,et al.  Models of breast cancer show that risk is set by events of early life: prevention efforts must shift focus. , 1995, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[87]  J L Collins,et al.  Youth risk behavior surveillance--United States, 1993. , 1995, The Journal of school health.

[88]  B. Henderson,et al.  Physical exercise and reduced risk of breast cancer in young women. , 1994, Journal of the National Cancer Institute.

[89]  A M Nomura,et al.  Migration patterns and breast cancer risk in Asian-American women. , 1993, Journal of the National Cancer Institute.

[90]  G. Colditz,et al.  A prospective study of benign breast disease and the risk of breast cancer , 1992, JAMA.

[91]  H. Bartsch,et al.  International Agency for Research on Cancer. , 1969, WHO chronicle.

[92]  Rascon.  [The National Cancer Institute]. , 1953, Boletin cultural e informativo - Consejo General de Colegios Medicos de Espana.