Abstract P4-10-08: Can a diagnosis of invasive breast cancer effectively motivate patients to follow healthy lifestyles?
Authors: Ellsworth RE , Costantino N , Toro AL , Shriver CD , Ellsworth DL 
Published: May 2016

Abstract
Background: Survival rates for patients diagnosed with invasive breast cancer have increased dramatically, yet survivors often face a host of adverse health effects. Factors such as obesity, physical inactivity and tobacco use may contribute to decreased survival and quality of life. Behavioral risk factors in patients with and without breast cancer were evaluated to determine whether a diagnosis of invasive disease was sufficient motivation to modify lifestyle choices.
Methods: The dataset included female patients diagnosed between 2001-2011with malignant (n=421) or benign (n=230) breast disease and who had baseline and &gt;1-year follow-up information available. Changes in body mass index (BMI), fat intake, exercise frequency, alcohol and tobacco use, caffeine consumption, hormone replacement therapy (HRT) use and frequency of breast self-exam (BSE) were assessed. Random coefficients models were used to examine longitudinal effects of an invasive diagnosis on healthy behaviors. P&lt;0.05 was used to define significance.
Results: At diagnosis, patients with invasive cancer were significantly older (59 years), more likely to consume &gt;7 glasses of alcohol/week (7%) but less likely to be using HRT (3%) than those with benign disease (50 years, 3% and 11%, respectively). At baseline, a majority of both invasive and benign patients were overweight, non (current) smokers, and consumed a high fat, highly caffeinated diet and exercised &lt;90 minutes/week, and &gt;50% of both groups performed BSE at least once/month. Exercise, BMI, and caffeine, alcohol and fat intake did not change over time in either invasive or benign groups. Smoking decreased to a similar extent in both invasive and benign patients. In contrast, compliance with monthly BSE increased and HRT use decreased significantly at each time point in the invasive patient group, with no corresponding changes in patients with benign disease.
Conclusions: These data support the critical importance of providing education and recommendations about engaging in healthy behaviors by the clinical staff. The two behaviors that improved significantly in patients with invasive breast cancer are both addressed by the clinical staff at Walter Reed National Military Medical Center at the time of diagnosis: with nurse navigators providing education about proper BSE and physicians recommending discontinuation of HRT. Failure to significantly change other behaviors suggests that a diagnosis of breast cancer is not a sufficient motivating factor for the patient to adopt healthier lifestyle choices without provision of education and resources. Our data suggest a need for increased health-related behavioral counseling and support systems to successfully modify personal behaviors, thus improving the health and quality of life of breast cancer survivors.
Citation Format: Ellsworth RE, Costantino N, Toro AL, Shriver CD, Ellsworth DL. Can a diagnosis of invasive breast cancer effectively motivate patients to follow healthy lifestyles?. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-10-08.