Michelle Harvie

Prevention of breast cancer in the context of a national breast screening programme.

Abstract.  Howell A, Astley S, Warwick J, Stavrinos P, Sahin S, Ingham S, McBurney H, Eckersley B, Harvie M, Wilson M, Beetles U, Warren R, Hufton A, Sergeant J, Newman W, Buchan I, Cuzick J, Evans DG (Genesis Prevention Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester; School of Cancer and Enabling Sciences, University of Manchester, Manchester; Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London; School of Community Based Medicine, University of Manchester, Manchester; Genetic Medicine, Manchester Academic Health Sciences Centre, University of Manchester and Central Manchester Foundation Trust, Manchester; and Cambridge Breast Unit, Addenbrooke’s Hospital, Cambridge; UK). Prevention of breast cancer in the context of a national breast screening programme (Review). J Intern Med 2012; 271: 321–330.

Prevention of Breast Cancer on the context of National Breast Screening Programme.

Abstract.  Howell A, Astley S, Warwick J, Stavrinos P, Sahin S, Ingham S, McBurney H, Eckersley B, Harvie M, Wilson M, Beetles U, Warren R, Hufton A, Sergeant J, Newman W, Buchan I, Cuzick J, Evans DG (Genesis Prevention Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester; School of Cancer and Enabling Sciences, University of Manchester, Manchester; Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London; School of Community Based Medicine, University of Manchester, Manchester; Genetic Medicine, Manchester Academic Health Sciences Centre, University of Manchester and Central Manchester Foundation Trust, Manchester; and Cambridge Breast Unit, Addenbrooke’s Hospital, Cambridge; UK). Prevention of breast cancer in the context of a national breast screening programme (Review). J Intern Med 2012; 271: 321–330.

Intermittent energy restriction for weight loss: spontaneous reduction of energy intake on unrestricted days

Abstract There is increasing interest for the use of intermittent energy restriction (IER) in weight management. However, there are concerns that IER could result in ‘rebound’ overconsumption of energy on unrestricted days. We studied self‐reported food records from participants in two trials of IER versus continuous energy restriction (Study 1; 44 women on IER for 6 months and Study 2; 72 women on two types of IER for 4 months). Energy intake was assessed on restricted and unrestricted days immediately before and after restricted days and on other unrestricted days. We assessed consistency of days of the week chosen as restricted days, and whether this was associated with greater weight loss. Reported energy intake was reduced on unrestricted days in Study 1 and 2 and was 19% lower compared with the allocated isoenergetic diet, and respectively 21% and 29% lower than their baseline reported daily intakes. Energy intake appeared to be similarly reduced the day immediately before and after restricted days and on other unrestricted days. Seventy percent of women in Study 1 and 79% in Study 2 undertook consistent days of restriction each week (>50% of restricted days on the same 2 days each week). When studies were combined percentage weight loss at 3 months was −5.8 (−6.7 to −4.7) % in the consistent group and −7.4 (−8.7 to −6.2) % in the non‐consistent group (p = .09). Food records from patients undertaking IER suggest a spontaneous reduction in energy intake below their baseline reported intakes and the prescribed isoenergetic diet during all unrestricted days including the days immediately before and after restricted days which contributes to the weight loss success with these diets. Consistency of restricted days was not associated with weight loss success. These findings need to be confirmed in larger groups of patients ideally using objective measures of energy balance.

P4-11-07: Feasibility and Acceptability of Offering Breast Cancer Risk Estimation in the Context of the UK National Health Service Breast Cancer Screening Programme: A New Paradigm for Cancer Prevention.

Background: Currently there are no real attempts internationally to tailor breast screening programmes to individual risk Methods: We have assessed the feasibility of collecting breast cancer risk information during routine mammographic screening in the National Health Service Breast Screening Programme (NHSBSP) in England, in order to consider, ultimately, adapting the screening interval to risk of breast cancer and introducing preventive strategies in women at high risk. The study Predicting Risk Of Cancer At Screening (PROCAS) aims to recruit 60,000 women over 3 years. Results: 26,000 women (June 8 th 2011) have so far given consent to join the study. Thirty six percent of the first 20,000 women in nineteen screening sites in Manchester consented to enter the study and completed a risk factor questionnaire. The median 10 year breast cancer risk was 2.65%, with 926 (9.26%) of the first 10,000 women having a 10 year risk of ≥5% and 92 (0.92%) having a 10 year risk of ≥8% (Tyrer-Cuzick), IQR:1.35. 832 (8.32%) women had a mammographic density of 60% or greater (Visual Analogue Scale). We collected saliva samples from 1019 women for genetic analysis and will extend this to 18% of participants. Of those who agreed to participate in the study, 94% indicated that they wished to know their breast cancer risk. Women with a 10-year risk of ≥8%, and women with a 10-year risk of ≥5% and mammographic density ≥60% were invited to attend or be telephoned to be counselled. To date 138 have accepted with 135, so far, having received risk counselling. Nineteen percent of the high-risk women identified subsequently decided to enter a randomised breast cancer prevention study with either a dietary or drug intervention (IBIS2, anastrazole vs placebo). Results from the first 1,000 women who provided DNA samples suggest that the risk information from the 18 validated SNPS may enhance existing risk models. Conclusion: This study demonstrates that it is feasible to determine individual breast cancer risk and offer women appropriate risk-reducing interventions within the context of a population-based mammographic screening programme. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-11-07.