Dear Colleagues,

Breast cancer (BC) is the leading cancer in women with over 2 million new cases globally in 2018, representing 25.4% of all female cancer incidence and the first cause of cancer death in women. BC survival rates in Europe have been estimated between 80% and 90% at 5 years; hence, there is still 10%–20% residual mortality within 5 years. This residual mortality is much higher in women with triple negative BC, which is a more aggressive type of BC affecting mostly younger women.

BC rates vary across countries, and population migration studies have observed a six-fold variation, suggesting that environmental factors, including diet, are important contributors. It has been estimated that approximately 35%–50% of BC deaths could be avoided by dietary modifications alone. Modifiable risk factors such as excess body weight, physical inactivity, alcohol consumption, and poor diet have been identified. Generally, high calorie diets as well as high consumption of red and processed meat and sugar-sweetened drinks are linked to increased cancer risk, whereas plant-based diets, including the traditional Mediterranean diet, may reduce BC risk. However, very little evidence is available in BC survivors.

An increasing number of BC survivors have been observed and more monitoring is expected in the next decades, mainly due to longer life expectancy and improved biomedical advances. Hence, targeting the potential health risks and strategies for the management of chronic conditions in cancer patients should be of public health relevance. BC survivors, regardless of age, are at a higher risk of a comorbid chronic condition (e.g., cardiovascular disease and diabetes) than the general population, either as a result of the cancer itself, the oncologic therapy, or the under-treatment of the comorbid conditions, which are often seen as secondary to the cancer itself. Chronic diseases negatively impact on quality of life and some conditions, such as metabolic syndrome and diabetes, may also increase the risk of BC recurrence. The impact on health economics is of concern; hence the need to reduce not only cancer recurrence but also the risk and management costs of chronic conditions in cancer survivors. Therefore, paying attention to lifestyle aspects, including a healthy diet and physical activity, that are known cost-effective methods to reduce chronic disease risk and complications becomes of major clinical and public health relevance.

This Special Issue will focus on disease recurrence and on comorbid chronic conditions of adult BC survivors that can be modified by lifestyle changes. It will specifically target the role of diet quality; macronutrients; dietary patterns, including the Mediterranean diet; and the components of plant-based diets, including soy foods, brassica vegetables, and fermented foods, in the management of BC survivors (taking into account molecular characteristics). The Special Issue will also cover recurrence risk and prognosis, cardiovascular disease (CVD) events and mortality, CVD risk factors, diabetes, obesity, and quality of life. Reviews, meta-analyses, observational studies, intervention trials, and mechanistic studies are all welcome.

Dr. Livia Silvia Augustin
Guest Editor

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• breast cancer survivors
• dietary macronutrients
• food groups
• Brassica vegetables
• soy foods
• dietary patterns
• plant-based diets
• diabetes
• cardiovascular disease risk factors
• quality of life