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About the Health, Eating, Activity, & Lifestyle (HEAL) Study

This NCI study is designed to look at the associations among physical activity, eating habits, weight patterns, hormones, and prognostic factors for breast cancer. Participants with early stage breast cancer were recruited through three Surveillance, Epidemiology, and End Results (SEER) registries -- those at the Fred Hutchinson Cancer Research CenterExternal Web Site Policy in Seattle, WA, the University of New MexicoExternal Web Site Policy, and the University of Southern CaliforniaExternal Web Site Policy. Because each of these registries draws from a distinct racial and ethnic population mix, study investigators have a unique opportunity to examine the differences in these associations among whites, Hispanics, and African-Americans.

NCI is particularly interested in the interplay of these lifestyle factors because research suggests that women who are overweight, obese, or physically inactive have a poorer survival and increased breast cancer recurrence rate compared with lighter-weight and physically active women.1-4 Overweight, obesity, and adult weight gain also are risk factors for postmenopausal breast cancer.5 It is thought that reducing body fat and increasing physical activity may reduce hormone production, and may be one potential mechanism to improve prognosis for breast cancer patients.

Women with breast cancer are at particularly high risk of developing new primary, recurrent, disseminated, or fatal breast cancer.6,7 To date, women with breast cancer have had few options, besides Tamoxifen therapy, to reduce this risk in the long-term.8 By identifying prognostic factors, health behavior strategies can be developed to prevent new or recurrent disease and to prolong survival with high quality of life.


  1. Goodwin PJ, Boyd NF. Body size and breast cancer prognosis: a critical review of the evidence. Breast Cancer Res Treat 1990 Oct;16(3):205-14. [View Abstract]
  2. Senie RT, Rosen PP, Rhodes P, Lesser ML, Kinne DW. Obesity at diagnosis of breast carcinoma influences duration of disease-free survival. Ann Intern Med 1992 Jan 1;116(1):26-32. [View Abstract]
  3. Schapira DV, Kumar NB, Lyman GH, Cox CE. Obesity and body fat distribution and breast cancer prognosis. Cancer 1991 Jan 15;67(2):523-8. [View Abstract]
  4. Chlebowski RT, Aiello E, McTiernan A. Weight loss in breast cancer patient management. J Clin Oncol 2002 Feb 15;20(4):1128-43. [View Abstract]
  5. IARC Working Group on the Evaluation of Cancer-Preventive Strategies. Weight control and physical activity. In: Vainio H, Biachini F, editors. IARC Handbooks of Cancer Prevention. Volume 6. Lyon, France: IARC Press, 2002:1-315.
  6. Parker SL, Tong T, Bolden S, Wingo PA. Cancer statistics, 1996. CA Cancer J Clin 1996 Jan-Feb;46(1):5-27. [View Abstract]
  7. Kelsey JL, Horn-Ross PL. Breast cancer: magnitude of the problem and descriptive epidemiology. Epidemiol Rev 1993;15(1):7-16. [View Abstract]
  8. Zelen M, Gelman R. Assessment of adjuvant trials in breast cancer. NCI Monogr 1986;(1):11-7. [View Abstract]

Last Modified: 11 Apr 2014