2024-SABCS-Takeaways - 15

should produce a more
robust and clinically
active immune response.
Early trials in colon
cancer support the
hypothesis with a 38%
reduction in adenoma
recurrence at three years.
Multiple trials in breast
cancer suggest potential
for success.
TAKEAWAY FOUR:
Genetic Composition
and Legacy Inequality
Designing new
approaches to prevention
and therapy is just the
beginning. Reducing
the impact of breast
cancer requires
understanding the
interaction of genetic and
environmental factors,
then getting the most
effective interventions
to the populations and
individuals who can
most benefit.
In the U.S., the rate of
developing and dying
from breast cancer
differs substantially
among racial/ethnic
groups. Black women
have a lower incidence
of breast cancer but a
higher risk of mortality
as a result of complex
interactions between
biology, environment,
structural barriers to
care, and exclusion from
trials. Gene expression
likely varies by ancestry,
and Black individuals
were less likely to receive
guideline concordant
care, leading to worse
overall survival. 
ON TREATMENT FOR OBESITY,
NOT TREATMENT FOR WEIGHT LOSS
" We have to think about treatment
for obesity, not treatment for weight
loss. And if we are treating obesity,
activity is going to affect some of those
downstream factors differently or
in an enhanced way compared to
just thinking about it from
a weight perspective. "
JOHN M. JAKICIC, PHD,
Professor, Department of Internal
Medicine, Division of Physical
Activity and Weight
Management, University
of Kansas Medical Center
December 10-13, 2024 | San Antonio, Texas
15
Top Clinical Pearls in
RISK REDUCTION,
DISPARITIES
AND MORE from
2024 SABCS®
» More weight loss is better for reducing
breast cancer risk. Aim for ≥10% loss from
baseline regardless of the method, calorie
restriction, bariatric surgery, or medical
therapy. Losing ≥10% baseline body weight
brings a 20-30% reduction in visceral fat.
» Incretin mimetics can bring significant weight
loss, but early data on breast cancer risk
reduction are unclear.
» Add exercise to weight loss to improve overall
health and reduce breast cancer-specific and
overall mortality. Both aerobic exercise and
resistance training are important.
» Tamoxifen is the only approved breast
cancer prevention drug for premenopausal
women, but the 20 mg/daily dose is not
acceptable to many women because of
adverse events.
» Moderate levels of physical activity,
particularly during adolescence, is associated
with higher overall survival and breast-cancer
specific survival.
» West African ancestry is associated with
increased risk for triple-negative breast
cancer, driven by dichotomous gene
expression associated with ancestry from
Sub-Saharan West Africa. A specific mutation
conferring resistance to malaria alters
expression of the DARC gene, which regulates
immune cell infiltration.
» Living in areas of the U.S. once subject to
redlining (a practice often associated with
racial discrimination that constitutes the
systematic denial of financial services based
on neighborhoods) is associated with a 1.6fold
increased risk of breast cancer mortality.
2024-SABCS-Takeaways

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