Association of Healthy Diet and Physical Activity With Breast Cancer: Lifestyle Interventions and Oncology Education

Abstract

Global cancer statistics suggest that breast cancer (BC) is the most diagnosed cancer in women, with an estimated 2. 3 million new cases reported in 2020. Observational evidence shows a clear link between prevention and development of invasive BC and lifestyle-based interventions such as a healthy diet and physical activity. The recent findings reveal that even minimal amounts of daily exercise and a healthy diet reduced the risk of BC, mitigated the side effects of cancer treatment, and stopped the recurrence of cancer in the survivors. Despite the myriad benefits, the implementation of these lifestyle interventions in at-risk and survivor populations has been limited to date. Given the need to disseminate information about the role of physical activity and nutrition in BC reduction, the review aimed to present the recent scientific outreach and update on associations between the lifestyle interventions and BC outcomes to narrow the gap and strengthen the understanding more clearly. This review covers more direct, detailed, and updated scientific literature to respond to frequently asked questions related to the daily lifestyle-based interventions and their impact on BC risk and survivors. This review also highlights the importance of the oncology provider's job and how oncology education can reduce the BC burden.

Keywords: breast cancer; diet; lifestyle; oncology education; physical activity.

Figure 1

Possible mechanisms of polyphenol effect on the inhibition of BC cell proliferation. PI3K, phosphoinositide-3–kinase; TNF a, tumor necrosis alpha; ROS, radioactive oxide species; NF-κB, nuclear factor kappa light chain enhancer of activated B cells; DNMT, DNA methyltransferase; HAT, histone acetyltransferases; HMT, histone methyltransferases; HDAC, histone deacetylases; GLUT-2, glucose transporter-2; MeCP, methyl CpG binding protein; EZH2, enhancer of zeste homolog 2; BRCA1, 2, breast cancer 1, 2; HNF- 6, hepatocyte nuclear factor 6; FAK and paxillin, two focal adhesion–associated proteins.

Figure 2

Figurative description of dietary factors involved in BC incidence prevention and recurrence. BC, breast cancer.

Figure 3

Figures give the recommended standard approaches to therapy of metastatic BC as per the guideline of the American Cancer Society. These recommendations are adopted in (108) and are given as per the guidelines of the National Comprehensives Cancer Network (109). HR, Hormonal receptor; ERBB2, Epidermal growth factor-2; TNBC, Triple negative breast cancer; ILT, Initial line of therapy; LLT, Later line of therapy.

Figure 4

Available preferences of exercises for BC survivors in the form of (i) supervised exercise, (ii) group exercise, (iii) special program for BC survivors, (iv) enjoyment factors. BC, breast cancer.

BOX 1

For practices that do not have an in-house patient education department, according to the medical library association, there are several cancer patients' educational websites that provide in-house cancer guidelines for both patients and families.