{"doi":"10.1093/jncics/pkae126","title":"Reply to Braillon","abstract":"We appreciate the correspondence from Dr. Braillon, MD, PhD, regarding our recently published review on lifestyle interventions in breast cancer survivors.1 Dr. Braillon raised several interesting points on clinical outcomes and screening. First, we fully agree that weight gain during and after treatment and its effect on recurrence and obesity-related co-morbidities has not attracted the concern it deserves. Currently, there is no evidence that 1 intervention decisively improves clinical outcomes related to obesity and related co-morbidities among breast cancer survivors. The rigor of the current trials, including design, sample size, and limited accessibility of interventions, may decrease the short- and long-term efficacy and adherence of these lifestyle behavioral approaches. Ensuring that future trials are randomized and controlled, include novel dietary or physical activity alternatives for daily calorie restriction, and consider participant burden would likely expand current knowledge and options for breast cancer survivors. Second, statistics from the United States were used for this manuscript from both the American Cancer Society2 and the National Institutes of Health.3 Current data in the United States state that 1 in 8 women in the United States will be diagnosed with breast cancer in their lifetime. This statistic is not intended to be used as a slogan for fearmongering, but instead emphasize the significant number of women who are affected by this disease. This review also states that 5-year survival is 90%,3 which is used to further emphasize the number of women in the survivorship period, post-acute treatment, who could potentially benefit physically and emotionally by efficacious lifestyle interventions to mitigate weight gain and cardiometabolic risk. Third, Dr. Braillon brings up multiple interesting points concerning optimal screening and implementation that are outside the scope of this manuscript and our expertise as nutrition scientists and Registered Dietitians. However, we may note that public health policy and health care may vary greatly between nations depending on access, insurance, and socialized healthcare. It is widely accepted that a healthy lifestyle comprising of a healthy diet including fruits and vegetables, whole grains, limited processed and red meats, being physically active, maintaining a healthy Body Mass Index (BMI), low alcohol intake, and not using tobacco products impacts the risk of breast cancer.4 Additionally, in a recent systematic review and meta-analysis, Armenta-Guirado et al.5 reported when using a healthy lifestyle index (including diet, physical activity, BMI, alcohol and tobacco consumption, supplements use, and breastfeeding), women in the highest category reduced breast cancer risk by 20% in prospective studies and decreased odds by 26% in retrospective studies even when stratified by menopausal status and cancer molecular subtype. Many behavioral and lifestyle interventions exist for reducing risk of breast cancer and we should continue to advocate for public health policies that support these healthy lifestyle changes. However, the World Health Organization reports that roughly half of breast cancers occur in women with no specific risk factors6 other than sex and age indicating the need for accessible, scalable, and easy to implement interventions to improve overall health after breast cancer occurs. Kaitlin Chakos, RD (Writing—review & editing), Lisa Tussing-Humphreys, MS, RD, PhD (Conceptualization), and Kelsey Gabel, PhD, RD (Conceptualization; Writing—original draft) This work was supported by National Institutes of Health R01CA250390 (L.T.-H.), R01CA204808 (L.T.-H.), K12HD101373 (K.G.), L30CA295383 (K.G.). None declared. Not applicable.","journal":"JNCI Cancer Spectrum","year":2024,"id":507806,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9518,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1258134,"name":"Lisa Tussing-Humphreys","orcid":"0009-0005-5727-9502","position":1,"is_corresponding":false},{"id":225431,"name":"Kelsey Gabel","orcid":"0000-0003-4613-8892","position":2,"is_corresponding":false},{"id":1041621,"name":"Kaitlin Chakos","orcid":"0009-0001-0887-4277","position":0,"is_corresponding":true}],"reference_count":3,"raw_metadata":null,"created_at":"2026-07-19T02:11:06.395600Z","pmid":"39705204","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}