Influence of Obesity on Breast Density Reduction by Omega-3 Fatty Acids: Evidence from a Randomized Clinical Trial

• Published in: Cancer prevention research (Philadelphia, Pa.) Vol. 9; no. 4; pp. 275 - 282
• Main Authors: Sandhu, Narinder, Schetter, Susann E, Liao, Jason, Hartman, Terryl J, Richie, John P, McGinley, John, Thompson, Henry J, Prokopczyk, Bogdan, DuBrock, Cynthia, Signori, Carina, Hamilton, Christopher, Calcagnotto, Ana, Trushin, Neil, Aliaga, Cesar, Demers, Laurence M, El-Bayoumy, Karam, Manni, Andrea
• Format: Journal Article
• Language: English
• Published: United States 01.04.2016
• Subjects: Adult; Aged; Body Mass Index; Breast - diagnostic imaging; Breast - physiology; Breast Density; Breast Neoplasms - prevention & control; Docosahexaenoic Acids - administration & dosage; Docosahexaenoic Acids - blood; Docosahexaenoic Acids - therapeutic use; Drug Combinations; Drug Therapy, Combination; Eicosapentaenoic Acid - administration & dosage; Eicosapentaenoic Acid - blood; Eicosapentaenoic Acid - therapeutic use; Estrogen Antagonists - administration & dosage; Estrogen Antagonists - therapeutic use; Female; Follow-Up Studies; Humans; Mammography; Middle Aged; Obesity - metabolism; Obesity - physiopathology; Raloxifene Hydrochloride - administration & dosage; Raloxifene Hydrochloride - therapeutic use; Tamoxifen - therapeutic use
• ISSN: 1940-6207; 1940-6215
• DOI: 10.1158/1940-6207.CAPR-15-0235

Preclinical data indicate that omega-3 fatty acids (n-3FA) potentiate the chemopreventive effect of the antiestrogen (AE) tamoxifen against mammary carcinogenesis. The role of n-3FA in breast cancer prevention in humans is controversial. Preclinical and epidemiologic data suggest that n-3FA may be preferentially protective in obese subjects. To directly test the protective effect of n-3FA against breast cancer, we conducted a 2-year, open-label randomized clinical trial in 266 healthy postmenopausal women (50% normal weight, 30% overweight, 20% obese) with high breast density (BD; ≥25%) detected on their routine screening mammograms. Eligible women were randomized to one of the following five groups (i) no treatment, control; (ii) raloxifene 60 mg; (iii) raloxifene 30 mg; (iv) n-3FA lovaza 4 g; and (v) lovaza 4 g plus raloxifene 30 mg. The 2-year change in BD, a validated biomarker of breast cancer risk, was the primary endpoint of the study. In subset analysis, we tested the prespecified hypothesis that body mass index (BMI) influences the relationship between plasma n-3FA on BD. While none of the interventions affected BD in the intention-to-treat analysis, increase in plasma DHA was associated with a decrease in absolute breast density but only in participants with BMI >29. Our results suggest that obese women may preferentially experience breast cancer risk reduction from n-3FA administration.