Day 034 - 11 Oct 94 - Page 25
1 incorporate clinical and pathologic factors in the
2 analysis, to distinguish between sources of dietary fat
3 intake, and to ascertain dietary patterns subsequent to
4 breast cancer diagnosis was noted."
5
6 What briefly this study showed was that women,
7 particularly women with metastatic breast cancer --
8 cancer that has already spread at the time of diagnosis --
9 the higher the fat intake, the more likely the individual
10 was to have the disease to progress to the point of
11 fatality, and that every 1000 grammes of fat increased the
12 risk of death by about 40 per cent.
13
14 Now, 1000 grammes of fat can easily, over the course of a
15 month, can easily be the difference between a low fat diet
16 and a typical English or American diet. The study itself,
17 if I may read the first two or three paragraphs:
18
19 "The belief is widely held that altered hormone and
20 immune states may initiate or enhance the growth of breast
21 tumours"; perhaps it is worth emphasising the words
22 "widely held". "In particular, oestrogen, which
23 influences normal breast tissue development, is a
24 suspected risk factor in breast carcinogenesis";
25 carcinogenesis again meaning the beginnings of cancer,
26 including the causation of cancer: "Laboratory studies
27 show that tumour induction fails in ovariectomized mice"
28 -- these are mice who have had ovaries removed -- "and a
29 protective effect of artificial menopause in women has
30 been reported".
31
32 What the author is saying is that when women have had
33 their ovaries removed, typically in the course of a
34 hysterectomy, their breast cancer risk drops. This is
35 used by the author to support the increased risk with
36 increased oestrogen stimulation of the breast tissue.
37 "Conversely, persistent oestrogenic stimulation in women
38 increases their risk of disease."
39
40 I would want to highlight in that sentence, Dr. Gregorio
41 does not say "persistent oestrogenic stimulation in women
42 may increase" or "could increase"; he says that persistent
43 oestrogenic stimulation in women increases their risk of
44 disease. This will become important as the effects of
45 high fat diets and of obesity on oestrogen levels comes
46 into the discussion.
47
48 In the next sentence he says: "Indicators of potentially
49 abnormal endo-connect activity - such as early age at
50 menarche, low parity, late age at first pregnancy, and
51 late age at menopause - have been shown to increase a
52 woman's risk of developing breast cancer." Again,
53 I would note the absence of qualifiers such as "may be" or
54 "could have been"; he says "these indicators have been
55 shown to increase a woman's risk of developing breast
56 cancer".
57
58 "Circumstantial evidence points to the importance of
59 estrone in the etiology of the disease." Estrone is one
60 form of oestrogen.
