Julius CenterFor Health Sciences and Primary Care

Julius CenterFor Health Sciences and Primary Care

Julius CenterFor Health Sciences and Primary Care

Julius CenterHealth Sciences and Primary Care

Julius CenterFor Health Sciences and Primary Care

Julius CenterFor Health Sciences and Primary Care

woordmerk�guren

woordmerk diapositief

2 pt

Julius CenterFor Health Sciences and Primary Care

Julius CenterFor Health Sciences and Primary Care

Julius CenterFor Health Sciences and Primary Care

Julius CenterHealth Sciences and Primary Care

Julius CenterFor Health Sciences and Primary Care

Julius CenterFor Health Sciences and Primary Care

woordmerk�guren

woordmerk diapositief

2 pt

Julius CenterFor Health Sciences and Primary Care

Julius CenterFor Health Sciences and Primary Care

Julius CenterFor Health Sciences and Primary Care

Julius CenterHealth Sciences and Primary Care

Julius CenterFor Health Sciences and Primary Care

Julius CenterFor Health Sciences and Primary Care

woordmerk�guren

woordmerk diapositief

2 pt

Research

Breast Cancer Epidemiology

IntroductionBreast Cancer Epidemiology is one of the disease-based research lines of the Julius Center. The research includes all topics from Causes, Early Disease Markers, Early Diagnosis and Early Treatment of Breast Cancer.Breast cancer is the most prevalent type of cancer in Dutch women (approximately 12.500 new diagnoses in 2007). A population-based nationwide mammographic screening programme resulted – in combination with new (hormonal) treatments - in a decline in breast cancer mortality. Nevertheless, 3300 women still died as a consequence of metasta-sized breast cancer in 2006.

Early Diagnosis of Breast Cancer Within this research theme there is a focus on further improvements of the screening pro-gramme. These include new ways to detect the disease in an early phase (imaging, mole-cular imaging, biomarkers in blood), specific in women who currently are not invited for screening (younger women) or in women for whom current screening methods are not appropriate (high risk women, women with dense breast tissue). Approximately 25% of all

breast tumours are diagnosed in women who did not reach the age-limit for screening yet (50 years) and about 20% of breast cancers in women who do participate in screening cancer is diagnosed bet-ween two consecutive screening examinations. These women do not benefit from early detection. The research aim is to develop and evaluate personalised screening programmes in these women.

Causes of Breast cancer Further improvement of screening programmes (such as intensified screening regimens or more sensitive imaging techniques in high risk groups) and in treatment may further improve survival from breast cancer, yet incidence of breast cancer is still rising. Approximately 80% of cases occur in women without any of the known risk factors for the disease. Knowledge about causes is essen-tial to find new ways for prevention and early detection aiming to decrease disease burden in the Dutch society. This research theme aims at finding causes of breast cancer in an international research consortium (EPIC). EPIC-nl (http://www.epicnl.eu) is a merge of the two Dutch on-going population-based cohorts (Prospect-EPIC and Morgen-EPIC) that both participate in the large on-going European Prospective Investigation into Cancer (EPIC) in close collaboration

UMC Utrecht

Julius Center

for Health Sciences and Primary Care

Breast Cancer Epidemiology

Address & Correspondence:

Heidelberglaan 100

3584 CX Utrecht

The Netherlands

P.O. Box 85.500

3508 GA Utrecht

The Netherlands

Phone : +31 (0)88 755 9301

Fax : +31 (0)88 755 5485

Email: P.H.M.Peeters@umcutrecht.nl

www.umcutrecht.nl

www.juliuscenter.nl

www.epicnl.eu

with researchers of the Imperial College in London, UK and 23 other cancer/research institutes in 10 European countries. Pre-diagnostic serum, plasma, erythrocyte and buffy-coat (DNA) samples are available of 8,000 breast cancer cases and large control groups. So far, important results include the causal role of high levels of endogeneous sex hormo-nes and hormones of the Insulin-like growth factor axis, and the overall null-effect of phytoestrogens and other nutritional factors in relation to breast cancer. Obesity, fat distribution and physical activity however are consistently associated with the disease. The aim is to further disentan-gle relations between hormones, nutrition, anthropometry and genes in the occurrence of breast cancer. New techniques include proteomics and metabolomics.

Rehabilitation in breast cancer patients.Survival of breast cancer is increasing, and the consequence is a high number of breast cancer survivors which will further increase due to ageing of the population. One of the important problems of cancer patients is fatigue. Over 60% of cancer patients report complaints of fatigue during or after cancer treatment. This is expected to affect quali-ty of life, to decrease activity levels and to increase sick leave and pro-duction loss. Cost effectiveness of physical exercise during cancer treat-ment has not been studied. The theme is to study efficacy and efficiency of physical activity and other rehabilitation programmes in cancer patients: the OncoRev and PACT studies are examples.