Family History & Preventive Health Behaviors:BCa

#B135 Is Family History Related to Preventive Health Behaviors and Medical Management in Breast Cancer Patients?

Lisa Madlensky, Shirley Flatt, John P. Pierce,

University of California, San Diego, La Jolla, CA.

Background: Women who have been diagnosed with breast cancer who also have a family history of the disease are at increased risk of developing additional primary breast or ovarian cancers.

Medical management for such women may include increased breast screening, prophylactic surgery, and/or chemoprevention. However, preventive health behaviors such as following a healthy diet, exercising, and not smoking are rarely discussed in the context of potential risk reduction.

Newly diagnosed breast cancer patients have been found to make self-initiated changes in their health behaviors after diagnosis, however it is not known whether a family history (and therefore increased risk of additional cancer events) might affect the decision to make these behavior changes.

We sought to investigate whether a relationship exists between family history and health behaviors (both primary prevention and medical management) in a cross-sectional study of breast cancer patients.

Methods: Women participating in the Women’s Healthy Eating and Living (WHEL) study completed a detailed family history questionnaire at baseline, as well as questionnaires about their dietary patterns, exercise and smoking behaviors.

Data obtained from the medical record and self-report includes treatment, staging, hormone therapy, and prophylactic surgeries. Participants were defined as having a family history (FH+) if they met at least one of five family history criteria (n=195), and were compared with women having no family history (FH-) of breast cancer (n=1736).

Results: The mean age of breast cancer diagnosis was 51.2 for both groups, but FH+ women were more likely to be diagnosed before age 40. FH+ and FH- women had similar dietary patterns, alcohol intake, exercise patterns, body mass index and smoking histories.

However, FH+ women were more likely to have undergone prophylactic contralateral mastectomy (OR= 3.6, 95%CI= 2.2 - 6.2) and bilateral oophorectomy (OR= 1.6; 95%CI = 1.0 - 2.3) after adjusting for age and time since diagnosis.

The FH+ and FH- groups had similar patterns of anti-estrogen use and medical follow-up visit frequency.

Conclusions: Breast cancer patients who have a strong family history of breast cancer are more likely to undergo surgical preventive measures to reduce their risk of additional cancer, but do not undertake primary preventive behaviors such as diet and exercise any more than breast cancer patients without a family history.

Frontiers in Cancer Prevention Research, 2003 AACR

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