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Table 3 Diet/Weight/Physical Activity and Ovarian & Breast Cancer Risk in BRCA1/2 Pathogenic Germline Gene Variant Carriers

From: Diet, weight management, physical activity and Ovarian & Breast Cancer Risk in women with BRCA1/2 pathogenic Germline gene variants: systematic review

Cancer TypeEnergy Balance-Related FactorsMajor Findings
Ovarian CancerDietary Habits• 1 study; No association between regular coffee consumption and ovarian cancer risk in BRCA1(Gronwald, 2006)
Weight Status/Weight Change• 2 studies (McGee, 2012; Qian, 2019)
• No association between weight change in adulthood and ovarian cancer risk in BRCA1 & BRCA2(McGee, 2012)
• Significant association between higher BMI and premenopausal ovarian cancer risk BRCA1 & BRCA2(Qian, 2019)
Breast CancerDietary Habits• 12 studiesa
• Decreased Breast Cancer Risk:
o Significantly associated with higher intakes of caffeinated coffee in BRCA1/2 & BRCA2b,c (Nkondjock, Ghadirian, 2006)
o Significantly associated with higher intake of soybean foods in BRCA1/2 & BRCA2b,c (Ko, 2013)
o Significantly associated with higher diet quality in BRCA1/2b (Nkondjock A et al, 2007)
o Significantly associated with folic acid and B12 supplementation at specific doses in BRCA1/2d (Kim, 2019)
o Significantly associated with any folic acid containing supplement in BRCA1e (Kim, 2019)
• Increased Breast Cancer Risk:
o Significantly associated with higher intake of meat in BRCA1/2 & BRCA2b,c (Ko, 2013)
o Significantly associated with higher daily energy intake (> 2339 kcal/d) in BRCA1/2(Nkondjock, Robidoux, 2006)
• Evidence related to total coffee consumption (caffeinated and decaffeinated) is mixedf
• Evidence related to alcohol intake is mixedg
• No association between macro/micro-nutrient intake and breast cancer risk in BRCA1/2b(Nkondjock, Robidoux, 2006)
Weight Status/Weight Change• 7 studiesh
• Decreased Breast Cancer Risk:
o Significantly associated with ≥10-lb weight loss between 18 & 30 years in BRCA1/2b (Kotsopoulos, 2005)
o Significantly associated with higher BMI in young adulthood in BRCA1/2, BRCA1, BRCA2b,c,e, i, (Qian, 2019)
• Increased Breast Cancer Risk:
o Significantly associated with adulthood body weight ≥ 72 kg & postmenopausal breast cancer risk in BRCA1/2b (Manders, 2011)
• Evidence related to adulthood weight gain and breast cancer risk is mixedj
• Evidence related to overweight/obesity status in adulthood and breast cancer risk is mixedk
• No effect observed for BMI at 18 and BMI one year before diagnosis and breast cancer riskb (Moorman, 2010)
• For Ashkenazi Jewish women, normal weight status at menarche and age 21 associated with delayed onset of breast cancer(King, 2003)
Physical Activity• 4 studies
• Decreased Breast Cancer Risk:
o Significantly associated with activity during adolescence, high levels of activity before age 30, and lower levels of activity after age 30 in BRCA1/2b(Lammert, 2018; Pijpe, 2010)
• No association for activity two years before diagnosis and breast cancer risk in BRCA1/2b(Nkondjock,Robidoux, 2006)
• For Ashkenazi Jewish women, engagement in physical activity as teenager associated with delayed onset breast cancer(King, 2003)
  1. lb pound; BMI body mass index
  2. aSeven studies assessed alcohol intake (6 exclusive to alcohol, 1 included alcohol with nutrient intake), two assessed coffee intake, one assessed supplement use (folic acid, B6, B12), one assessed food group intake, one assessed nutrient intake (and included alcohol), one assessed diet quality
  3. bBoth BRCA1 and BRCA2 pathogenic germline gene variants combined in the analysis
  4. cOnly BRCA2 pathogenic germline gene variant in the analysis
  5. dFolic acid:8.56- ≤ 89.29mcg/d; B12:0.02- ≤ 0.34mcg/d
  6. eOnly BRCA1pathogenic germline gene variant in the analysis
  7. fOne study observed no association(Gronwald, 2006) and one study observed OR0.51(0.26,0.98) for total coffee consumption in relation to breast cancer risk(Nkondjock, Ghadirian, 2006)
  8. gThree studies observed no association between alcohol intake and breast cancer risk in BRCA1/2 variants collectively(Cybulski, 2015; Nkondjock, Robidoux, 2006; Lecarpentier 2011), one study observed an association in BRCA1 but not BRCA2 when tobacco use was included as an interaction(Lecarpentier, 2011), one study observed an association in BRCA1 but not BRCA2(Dennis, 2010), one study observed a weak effect of alcohol when comparing breast cancer survivors compared to survivors without BRCA, no effect was observed for BRCA2(Moorman, 2010), one study observed an association in BRCA2 but not BRCA1(McGuire, 2006), one study observed an effect for alcohol when comparing survivors with BRCA2 to survivors without BRCA, but an effect was not observed in BRCA1(Dennis, 2011)
  9. hOne study(King, 2003) assessed weight status and physical activity
  10. iAssociation applies to pre- and post-menopausal breast cancer risk
  11. jOne study observed a significant association with weight gain since age 18 and 30 and increased breast cancer risk for BRCA1/2 variants (Nkondjock, Robidoux 2006), one study did not observe a significant association with 10–20 or > 20 lb. weight gain between the ages of 18 and 30 for BRCA1/2 variants collectively and by variant, and when age at diagnosis was between 30 and 40 years or > 40 years (Kotsopoulos, 2005)
  12. kOne study observed a significant inverse association between breast cancer risk and self-reported adulthood overweight/obesity and genetically scored overweight/obesity (Qian, 2019), one study observed a significant positive association between breast cancer risk and adulthood overweight/obesity(Abba, 2019), one study observed a significant positive association between breast cancer risk and adulthood overweight/obesity beyond age 43(Nkondjock, Robidoux, 2006), one study observed a significant positive association with postmenopausal breast cancer risk and adulthood body weight ≥ 72 kg(Manders, 2011)