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Olive oil and risk of breast cancer: a systematic review and dose-response meta-analysis of observational studies.
Sealy, N, Hankinson, SE, Houghton, SC
The British journal of nutrition. 2021;(10):1148-1156
Abstract
Olive oil consumption has been suggested to be inversely associated with breast cancer risk, probably due to its high MUFA and polyphenol content. The purpose of this meta-analysis was to assess the association between olive oil and breast cancer risk, including assessing the potential for a dose-response association. We performed a systematic search of PubMed, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials through June 2020, identifying ten observational studies (two prospective studies and eight case-control studies) for meta-analysis. We estimated summary OR and 95 % CI for the highest v. lowest olive oil intake category across studies using random effect models and assessed the dose-response relationship between olive oil and breast cancer risk using restricted cubic splines. The summary OR comparing women with the highest intake to those with the lowest category of olive oil intake was 0·48 (95 % CI 0·09, 2·70) in prospective studies and 0·76 (95 % CI 0·54, 1·06) in case-control studies, with evidence of substantial study heterogeneity (prospective I2 = 89 %, case-control I2 = 82 %). There was no significant dose-response relationship for olive oil and breast cancer risk; the OR for a 14 g/d increment was 0·93 (95 % CI 0·83, 1·04). There may be a potential inverse association between olive oil intake and breast cancer; however, since the estimates are non-significant and the certainty level is very low, additional prospective studies with better assessment of olive oil intake are needed.
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Efficacy and Safety of Chinese Herbal Medicine on Treatment of Breast Cancer: A Meta-analysis of Randomized Controlled Trials.
Ho, VW, Tan, HY, Guo, W, Li, S, Wang, N, Meng, W, So, TH, Yu, EC, Feng, Y
The American journal of Chinese medicine. 2021;(7):1557-1575
Abstract
Breast cancer is currently the most common cancer in women, and it accounts for 11.6% of all cancer diagnoses in 2018. Breast cancer patients frequently resort to alternative medicine in addition to conventional Western therapy. This study is to evaluate clinical effectiveness of Chinese herbal medicine (CHM) on breast cancer by conducting meta-analyses on 81 randomized controlled trials (RCTs) with a total of 7215 subjects from eight databases. All RCTs compared patients using Western therapy alone and those using additional CHM therapy to evaluate the difference of primary (tumor response, mean time to progression (mTTP), overall survival (OS) and progression free survival (PFS)) and secondary outcome measures (tumor markers). Results showed that under the RECIST1.1 criteria, 52% patients with additional CHM therapy (67%, under WHO criteria) achieved either a complete response (CR) or a partial response (PR), compared to 38% patients with Western therapy alone (53%, under the WHO criteria). The risk ratio was 1.31 ([Formula: see text] < 0.00001, 95% CI = 1.15-1.50) for patients with CHM plus Western therapy and 1.25 ([Formula: see text] < 0.00001, 95% CI = 1.18-1.98) for those with Western therapy. Moreover, patients with complementary CHM therapy were associated with an mTTP of 2.79 months longer ([Formula: see text] < 0.00001) and an OS of 1.90 months longer ([Formula: see text] < 0.00001); they also had an increase in 3-year PFS ([Formula: see text]= 0.002), 2- ([Formula: see text]= 0.0002) and 5-year ([Formula: see text]= 0.006) OS rates. Therefore, complementary CHM therapy might demonstrate clinical benefits for breast cancer patients in terms of tumor response and survival. Clinical studies with further stratification of tumor stages and intervention types are highly warranted.
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Breast Cancer Risk From Modifiable and Non-Modifiable Risk Factors among Palestinian Women: A Systematic Review and Meta-Analysis.
Arafat, HM, Omar, J, Muhamad, R, Al-Astani, TAD, Shafii, N, Al Laham, NA, Naser, I, Shamallakh, OM, Shamallakh, KM, Jebril, MAAR
Asian Pacific journal of cancer prevention : APJCP. 2021;(7):1987-1995
Abstract
OBJECTIVE Breast cancer (BC) is known as one of the deadliest forms of cancer, and it is increasing globally. Identifying risk factors for BC is a key point in developing preventive strategies to reduce its occurrence. Herein, we aimed to conduct a systematic review and meta-analysis focus on the risk factors for BC in Palestine. MATERIAL AND METHODS We performed a systematic search via PubMed, MEDLINE, SCOPUS, Science Direct, Cochrane library, Emerald Insight, and Google scholar for identifying studies published on BC risk factors up to March 2021. Pooled odds ratios (OR) are calculated using fixed and random-effect models. Data were processed using Review Manager 5.4 (RevMan 5.4). RESULTS From a total of 73 articles, seven case-control studies met the criteria for systematic review. Meta-analysis results showed that of the known modifiable risk factors for BC, diabetes mellitus (DM) had the highest odds ratio (OR = 4.97, 95% CI 3.00- 8.25) followed by hypertension (OR = 3.21, 95% CI 1.96-5.23), obesity (BMI >30 Kg/m2) (OR = 2.90, 95% CI 2.00- 4.21), and passive smoking (OR = 1.50, 95% CI 1.12- 2.02). Controversially, breastfeeding (OR = 0.37, 95% CI 0.23- 0.61) was protective factor in BC. Of non-modifiable risk factors for BC has reached menopause had the highest odds ratio (OR = 3.74, 95% CI 2.64- 5.29), followed by family history of BC (OR = 2.63, 95% CI 1.07-6.44) and age (≥ 40 years) (OR = 2.49, 95% CI 1.43-4.34). CONCLUSIONS The most significant predictors of BC in Palestine were DM, hypertension, passive smokers, age (>40), reached menopause, and family history of BC. Almost all these risk factors are consistent with known risk factors for breast cancer in other parts of the world.
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Association of C677T (rs1081133) and A1298C (rs1801131) Methylenetetrahydrofolate Reductase Variants with Breast Cancer Susceptibility Among Asians: A Systematic Review and Meta-Analysis.
Rezaee, M, Akbari, H, Momeni-Moghaddam, MA, Moazzen, F, Salahi, S, Jahankhah, R, Tahmasebi, S
Biochemical genetics. 2021;(2):367-397
Abstract
This systematic review and meta-analysis were conducted to investigate the association between methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C polymorphisms with breast cancer (BC) in Asians. Systematic searches were conducted in PubMed, EMBASE, Web of Science, and Scopus by May 2020. Inter-study heterogeneity was also assessed with a Q test, along with I2 statistics. Random-effects models were applied to pooled crude ORs with corresponding 95% CIs for the genetic models. A total of 1097 identified results, along with 36 qualified studies were included: for MTHFR C677T polymorphism, a total of 36 studies was comprised of 11,261 cases and 13,318 controls and for MTHFR A1298C polymorphism, a number of 19 studies contained 7424 cases and 8204 controls. Likewise, for C677T polymorphism, an increased risk of BC was seen for the allelic (OR 1.21, 95% CI 1.09-1.33, P < 0.01, I2 = 78.9%), dominant (OR 1.17, 95% CI 1.05-1.30, P < 0.01, I2 = 71.8%), recessive (OR 1.43, 95% CI 1.23-1.67, P < 0.01, I2 = 55.8%), and homozygous models (OR 1.48, 95% CI 1.25-1.75, P < 0.01, I2 59.9%) among BC patients compared to controls. Also, in terms of A1298C polymorphism, an association was found between the allelic (OR 1.15, 95% CI 1.04-1.28, P < 0.01, I2 70.4%) and homozygous models (OR 1.38, 95% CI 1.15-1.66, P < 0.01, I2 44.2%) with the risk of BC. In conclusion, findings revealed that MTHFR C677T variant might be a factor that predisposes BC in Asians. Furthermore, it was found that A1298C variant acts as a BC risk factor, particularly in a Western Asia population.
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Resistance training in breast cancer patients undergoing primary treatment: a systematic review and meta-regression of exercise dosage.
Lopez, P, Galvão, DA, Taaffe, DR, Newton, RU, Souza, G, Trajano, GS, Pinto, RS
Breast cancer (Tokyo, Japan). 2021;(1):16-24
Abstract
BACKGROUND Exercise is recognised as an adjunct therapy for breast cancer patients; however, little is known about the resistance training dose-response. We conducted a systematic review and meta-regression to examine the resistance training dose-response (i.e., volume and intensity) in breast cancer patients undergoing primary treatment. METHODS Searches in MEDLINE, CINAHL, and SPORTDiscus were conducted for studies published up to November 2019. Experimental studies that evaluated resistance-based exercise interventions in women with breast cancer undergoing primary treatment were included. Information about resistance training components, average change and change per week, as well as standardised mean difference were extracted, and used for meta-regression analysis. Outcome measures were upper and lower body muscle strength and body composition. RESULTS 10 trials were included in the systematic review and 4 trials in the dose-response analysis. Resistance training weekly prescribed volume was inversely associated with increases in upper and lower body muscle strength (r2 = 98.1-100%; p = 0.009), although there was no relationship between resistance training intensity and strength gains. There was insufficient data for the dose-response analysis of body mass index, percent body fat, and lean mass. CONCLUSION Low volume resistance training might be a suitable exercise recommendation for breast cancer patients undergoing primary treatment producing superior benefits for muscle strength compared to higher volume training, regardless of the training intensity. Low volume resistance training may provide a conservative and appropriate approach for breast cancer patients, allowing gradual progression and modification throughout the exercise program.
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Dietary acrylamide intake and risk of women's cancers: a systematic review and meta-analysis of prospective cohort studies.
Benisi-Kohansal, S, Salari-Moghaddam, A, Seyed Rohani, Z, Esmaillzadeh, A
The British journal of nutrition. 2021;(9):1355-1363
Abstract
This systematic review and meta-analysis was done to review earlier publications on the association between dietary acrylamide intake and risk of breast, endometrial and ovarian cancers. We performed a systematic search in the online databases of PubMed, ISI Web of Science and Scopus for relevant publications up to August 2020. Prospective cohort studies that considered dietary acrylamide as the exposure variable and breast, endometrial or ovarian cancer as the main outcome variable or as one of the outcome variables were included in this systematic review and meta-analysis. A total of fourteen cohort studies were included in the meta-analysis. We found no significant association between dietary acrylamide intake and the risk of breast (relative risk (RR) 0·95; 95 % CI 0·90, 1·01), endometrial (RR 1·03; 95 % CI 0·89, 1·19) and ovarian cancers (RR 1·02; 95 % CI 0·84, 1·24). In addition, we observed no significant association between dietary acrylamide intake and the risk of breast, endometrial and ovarian cancers in different subgroup analyses by smoking status, menopausal status, BMI status and different types of breast cancer. In conclusion, no significant association was found between dietary acrylamide intake and the risk of breast, endometrial and ovarian cancers.
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Dairy foods, calcium, and risk of breast cancer overall and for subtypes defined by estrogen receptor status: a pooled analysis of 21 cohort studies.
Wu, Y, Huang, R, Wang, M, Bernstein, L, Bethea, TN, Chen, C, Chen, Y, Eliassen, AH, Freedman, ND, Gaudet, MM, et al
The American journal of clinical nutrition. 2021;(2):450-461
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Abstract
BACKGROUND Epidemiologic studies examining the relations between dairy product and calcium intakes and breast cancer have been inconclusive, especially for tumor subtypes. OBJECTIVE To evaluate the associations between intakes of specific dairy products and calcium and risk of breast cancer overall and for subtypes defined by estrogen receptor (ER) status. METHOD We pooled the individual-level data of over 1 million women who were followed for a maximum of 8-20 years across studies. Associations were evaluated for dairy product and calcium intakes and risk of incident invasive breast cancer overall (n = 37,861 cases) and by subtypes defined by ER status. Study-specific multivariable hazard ratios (HRs) were estimated and then combined using random-effects models. RESULTS Overall, no clear association was observed between the consumption of specific dairy foods, dietary (from foods only) calcium, and total (from foods and supplements) calcium, and risk of overall breast cancer. Although each dairy product showed a null or very weak inverse association with risk of overall breast cancer (P, test for trend >0.05 for all), differences by ER status were suggested for yogurt and cottage/ricotta cheese with associations observed for ER-negative tumors only (pooled HR = 0.90, 95% CI: 0.83, 0.98 comparing ≥60 g/d with <1 g/d of yogurt and 0.85, 95% CI: 0.76, 0.95 comparing ≥25 g/d with <1 g/d of cottage/ricotta cheese). Dietary calcium intake was only weakly associated with breast cancer risk (pooled HR = 0.98, 95% CI: 0.97, 0.99 per 350 mg/d). CONCLUSION Our study shows that adult dairy or calcium consumption is unlikely to associate with a higher risk of breast cancer and that higher yogurt and cottage/ricotta cheese intakes were inversely associated with the risk of ER-negative breast cancer, a less hormonally dependent subtype with poor prognosis. Future studies on fermented dairy products, earlier life exposures, ER-negative breast cancer, and different racial/ethnic populations may further elucidate the relation.
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Effectiveness of diet and physical activity interventions amongst adults attending colorectal and breast cancer screening: a systematic review and meta-analysis.
Orange, ST, Hicks, KM, Saxton, JM
Cancer causes & control : CCC. 2021;(1):13-26
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Abstract
PURPOSE To estimate the effectiveness of tailored physical activity and dietary interventions amongst adults attending colorectal and breast cancer screening. METHODS Five literature databases were systematically searched to identify randomised controlled trials (RCTs) of tailored physical activity and/or dietary interventions with follow-up support initiated through colorectal and breast cancer screening programmes. Outcomes included markers of body fatness, physical activity, and dietary intake. Mean differences (MDs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using random effects models. RESULTS Five RCTs met the inclusion criteria encompassing a total of 722 participants. Diet and physical activity interventions led to statistically significant reductions in body mass (MD - 1.6 kg, 95% CI - 2.7 to - 0.39 kg; I2 = 81%; low quality evidence), body mass index (MD - 0.78 kg/m2, 95% CI - 1.1 to - 0.50 kg/m2; I2 = 21%; moderate quality evidence), and waist circumference (MD - 2.9 cm, 95% CI - 3.8 to - 1.91; I2 = 0%; moderate quality evidence), accompanied by an increase in physical activity (SMD 0.31, 95% CI 0.13 to 0.50; I2 = 0%; low quality evidence) and fruit and vegetable intake (SMD 0.33, 95% CI 0.01 to 0.64; I2 = 51%; low quality evidence). CONCLUSION There is low quality evidence that lifestyle interventions involving follow-up support lead to modest weight loss and increased physical activity and fruit and vegetable intake. Due to the modest intervention effects, low quality of evidence and small number of studies, further rigorously designed RCTs with long-term follow-up of modifiable risk factors and embedded cost-benefit analyses are warranted (PROSPERO ref: CRD42020179960).
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Diagnostic Values of 8 Different Imaging Modalities for Preoperative Detection of Axillary Lymph Node Metastasis of Breast Cancer: A Bayesian Network Meta-analysis.
Kim, K, Shim, SR, Kim, SJ
American journal of clinical oncology. 2021;(7):331-339
Abstract
OBJECTIVE This study aimed to compare diagnostic performances of 8 different imaging modalities for preoperative detection of axillary lymph node (LN) metastasis in patients with breast cancer by performing a network meta-analysis (NMA) using direct comparison studies with 2 or more imaging techniques. MATERIALS AND METHODS PubMed, Cochrane, and Embase were searched for the studies evaluating the performances of 8 different imaging modalities for preoperative axillary LN staging in patients with breast cancer. The NMA was performed in patient-based analyses. The consistency was evaluated by examining the agreement between direct and indirect treatment effects, and publication bias was assessed by funnel plot asymmetry tests. The surface under the cumulative ranking curve (SUCRA) values were obtained to calculate the probability of each imaging modality being the most effective diagnostic method. RESULTS A total of 2197 patients from 22 direct comparison studies using 8 different imaging modalities for preoperative detection of axillary LN metastasis in patients with breast cancer were included. For preoperative detection of axillary LN metastasis of breast cancer, elastography showed the highest SUCRA values of sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and diagnostic odds ratio. In addition, fluorine-18 fluorodeoxyglucose positron emission tomography (PET) or PET/computed tomography, fluorine-18 fluorodeoxyglucose PET/magnetic resonance, and contrast-enhanced computed tomography showed high SUCRA values. CONCLUSION Elastography showed the highest SUCRA values. Seven imaging modalities showed the complementary diagnostic roles for preoperative detection of axillary LN metastasis in patients with breast cancer, except mammography.
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Virtual screening of the multi-gene regulatory molecular mechanism of Si-Wu-tang against non-triple-negative breast cancer based on network pharmacology combined with experimental validation.
Zhang, Z, Liu, J, Liu, Y, Shi, D, He, Y, Zhao, P
Journal of ethnopharmacology. 2021;:113696
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Si-Wu-Tang (SWT), a prestigious herbal formula from China, has been extensively used for centuries for female-related diseases. It has been documented that SWT has a significant inhibitory effect on non-triple-negative breast cancer (non-TNBC) cells. However, there has been limited comprehensive analysis of the targeted effects of the anticancer components of SWT and its exact biological mechanism. AIM OF THE STUDY This study aims to uncover the mechanism by which SWT treats non-TNBC by applying a network pharmacological method combined with experimental validation. MATERIALS AND METHODS First, SWT compounds were collected from the Traditional Chinese Medicines Systems Pharmacology database (TCMSP) and The Encyclopedia of Traditional Chinese Medicine (ETCM), and then the targets related to SWT were obtained from the TCMSP and SwissTarget databases. Second, a target data set of non-TNBC proteins was established by using the Online Mendelian Inheritance in Man (OMIM), GeneCards and Gene Expression Omnibus (GEO) databases. Third, based on the overlap of targets between SWT and non-TNBC, a protein-protein interaction (PPI) network was built to analyse the interactions among these targets, which focused on screening for hub targets by topology. On these hub genes, we conducted a meta-analysis and survival analysis to screen the best match targets, ESR1, PPARG, CAT, and PTGS2, which had a strong correlation with the ingredients of SWT in our verification by molecular docking. In vitro experiments further proved the reliability of the network pharmacology findings. Finally, FunRich software and the ClusterProfiler package were utilized for the enrichment analysis of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) data. RESULTS A total of 141 active ingredients and 116 targets of SWT were selected. GO enrichment analysis showed that the biological processes through which SWT acted against non-TNBC (FDR<0.01) mainly involved modulating energy metabolism and apoptosis. According to RT-qPCR and Western blotting, the mRNA and protein expression of ESR1, PPARG and PTGS2 were upregulated (P < 0.01), and the mRNA and protein levels of CAT were downregulated (P < 0.01), suggesting a multi-gene regulatory molecular mechanism of SWT against non-triple-negative breast cancer. CONCLUSIONS This research explored the multi-gene pharmacological mechanism of action of SWT against non-TNBC through network pharmacology and in vitro experiments. The findings provide new ideas for research on the mechanism of action of Chinese medicine against breast cancer.