Background: Among women at high risk of breast cancer, there are limited data on the prevalence of use of lifestyle modifications and complementary and alternative medicine (CAM) for the purpose of breast cancer prevention. We examined use of lifestyle modifications and CAM in a diverse cohort of women at high breast cancer risk, including associations between the behaviors and perceived and model-based risk.
Methods: We used cross-sectional data from 810 non-Hispanic white and Hispanic women with no personal history of breast cancer enrolled in the Metropolitan New York Registry (MNYR) of Breast Cancer Families, one of six international sites of the National Cancer Institute's Breast Cancer Family Registry. Self-reported current lifestyle modifications (dietary change, exercise), use of CAM (multivitamins, herbal supplements, other dietary supplements, and prayer), perceived breast cancer risk, and breast cancer risk factors were assessed via a computer assisted telephone interview. The International Breast Cancer Intervention Study (IBIS) model, a validated breast cancer risk model for high-risk women, was used to estimate 10-year breast cancer risk. Relative risk regression models were used to examine associations between use of lifestyle modifications and CAM and perceived and model-based risk.
Results: The large majority of the sample (92.8%) reported current use of ≥1 lifestyle modification or CAM modality, and 16.4% reported using ≥1 specifically for breast cancer prevention. Among all women, 46.1 % used dietary change, 73.0% used exercise, 55.9% use multivitamins, 17.8% used herbal supplements, 51.5% used dietary supplements, and 44.7% used prayer. Non-Hispanic whites were more likely than Hispanics to use dietary change (p<0.001), exercise (p=0.002), other supplements (p=0.05), and prayer (p<0.001) specifically for breast cancer prevention. Hispanics were more likely than non-Hispanic whites to perceive their risk of breast cancer to be lower than the risk in the general population (p<0.0001). Model-based risk was significantly higher in non-Hispanic whites (7.1% ± 7.9% vs. 5.1% ± 6.5%; p<0.0001). In multivariable analyses, below average perceived risk of breast cancer was associated with prayer (RR: 1.43; 95% CI: 1.05, 1.96) and with the use of a higher number of lifestyle modifications and/or CAM modalities (RR: 1.23; 95% CI: 1.05-1.45) among non-Hispanic whites. Among Hispanics only, higher model-based risk was associated with current exercise (RR: 1.46; 95% CI: 1.02, 2.09). There was no association between perceived risk and current exercise, dietary change, and the use of multivitamins, herbal supplements or other supplements. Model-based risk did not appear to be a significant predictor of dietary change or use of herbal supplements, other supplements, or prayer.
Conclusions: Use of lifestyle modifications and CAM modalities is common among women at high risk for breast cancer, but patterns of use differed by ethnicity. Compared to non-Hispanic whites, Hispanic women were less likely to engage in breast cancer prevention behaviors, including dietary change and exercise, and were less likely to accurately perceive their breast cancer risk. Neither perceived risk nor model-based risk appear to be strong predictors of these behaviors. Future research should investigate motivations for the use of these modalities and awareness of evidence-based recommendations among women at high risk of breast cancer.
Citation Format: Cristina Valdovinos, Mary Beth Terry, Yuyan Liao, Ann Johnston, Heather Greenlee. Lifestyle modifications and use of complementary and alternative medicine in relation to perceived and model-based breast cancer risk among women at high risk of developing breast cancer. [abstract]. In: Proceedings of the Eleventh Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2012 Oct 16-19; Anaheim, CA. Philadelphia (PA): AACR; Cancer Prev Res 2012;5(11 Suppl):Abstract nr A07.