Melinda L. Irwin, PhD, MPH

Understanding how lifestyle factors such as weight and exercise impact the risk of breast cancer and outcomes of breast cancer treatment.

Impact

Obesity increases the risk of breast cancer in older women as well as the risk of breast cancer recurrence at any age of diagnosis. Given that lifestyle and physical activity are impacted most during the first year after a breast cancer diagnosis, intervening soon after diagnosis may have the biggest impact on breast cancer outcomes. Dr. Irwin is conducting bio-behavioral research investigating the impact of physical activity, diet, and weight loss on breast cancer survivorship. Specifically, her research focuses on exercise and nutrition-associated changes in breast cancer biomarkers, adherence to therapy, body composition, and quality of life in women diagnosed with breast cancer. recurrences and deaths. Her findings may inform the development of more personalized lifestyle prescriptions, which in turn may lead to a lower risk of recurrence and mortality while also improving quality of life.

Progress Thus Far

Dr. Irwin has shown that both weight loss and exercise favorably change biomarkers (measured in the blood and tissues) related to breast cancer, such as the inflammatory marker, C-reactive protein. In addition, exercise can reduce the side effects of aromatase inhibitor (an anti-estrogen medicine) treatment. Her team has also published clinically meaningful findings showing that a genetic predisposition to obesity does not modify one’s ability to lose weight by a nutrition and exercise intervention.  With BCRF funding, her team completed accrual into a clinical trial of nutrition and exercise in women receiving chemotherapy for breast cancer. Preliminary results demonstrated that a telephone/zoom-based diet and physical activity not only led to an improvement in both, but it also improved the response rate among patients receiving neoadjuvant chemotherapy. She and her team will continue to collect and analyze data from this trial.

What’s next

Dr. Irwin and her team will continue to examine the effects of diet and physical activity interventions on endocrine therapy adherence and patient-reported outcomes, biomarkers, and body composition parameters. These data will be collated when all participants in the study reach the 1-year timepoint. BCRF funding will also enable Dr. Irwin and her colleagues to extend follow-up studies to determine the effects of the interventions on long-term and late-side effects. Results could accelerate a paradigm shift in how breast cancer care is delivered, with personalized lifestyle prescriptions for patients including nutrition, exercise, and weight management services as a part of routine cancer care that starts at the time of diagnosis.