The Lombardi Comprehensive Cancer Center hosted a presentation on the importance of exercise and weight loss in breast cancer prevention on Feb. 1. 

The event, part of a monthly Grand Rounds lecture series that allows experts to share knowledge about research in family medicine, was hosted by Chiranjeev Dash, an associate professor of oncology and biostatistics at the Georgetown University School of Medicine. Dash offered insight into his recent study, called F.I.E.R.C.E. (Focused Intervention on Exercise to Reduce Cancer), which sought to identify potential limiting factors for breast cancer and bridge racial disparities in the field.

During the webinar, Dash discussed his research on physical activity interventions to improve the metabolic health in Black women who are at high risk for breast cancer.

In the District of Columbia, reports have shown that the breast cancer mortality rate is over two times higher for Black women than for white women, with the most deaths occurring in Wards 7 and 8.

According to Dash, since Black women have a higher proportion of residence in Wards 7 and 8, this statistic reflects a trend of disparity in breast cancer mortality between Black women and white women in the District and nationally.

“We know some of the reasons why we have cancer health disparities across the United States, and it’s multifactorial,” Dash said at the event. “It’s not just race or ethnicity, it’s not just differences in diet or physical activity, all this comes together with environmental and behavioral factors as well as biological and genetic factors.”

One independent risk factor that contributes to this increased prevalence of breast cancer is metabolic syndrome, a group of conditions including high blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol levels.

According to Dash, while previous research has demonstrated that exercise helps to reduce metabolic syndrome, these studies have not included a diverse sample of participants.

“What we don’t have much data on is inclusion of African American women, especially those who we would put at the highest risk in terms of obesity and sedentary behavior,” Dash said. 

This lack of data led Dash and his team to investigate whether exercise interventions in postmenopausal, metabolically unhealthy Black women would reduce components of metabolic syndrome as well as biomarkers, or molecules found in the blood, that are a sign of breast cancer.

F.I.E.R.C.E observed one group of women who completed supervised workouts, one that completed workouts at home and a control group who made no changes to diet or exercise. The study was funded by the National Institute on Minority Health and Health Disparities and had 213 participants.

After six months, the researchers did not find significant changes in waist circumference, body mass index or fat mass between the control group and two other groups. However, Dash explained that while women across all three groups lost weight on average, the home-based and supervised groups had significant changes in terms of prevalence of metabolic syndrome compared to the control group. 

“The exercise groups gained something more than just weight loss,” Dash said. “Our home-based exercise and supervised exercise resulted in reductions in metabolic syndrome.” 

Additionally, blood pressure and biomarker measurements suggested that the metabolic profile improved in both the supervised and home-based groups. Dash said that based on this, he concluded that short-term exercise regimens can improve metabolic profile and thus reduce the risk of breast cancer in metabolically-unhealthy Black women with a high cancer risk. 

Two years after the study was published, about 60% of the women returned for a follow-up assessment, and Dash found that women in the home-based exercise group had the most long-term success. 

“The home-based group was more likely to keep it up, so there was a more reduced rate but more consistent rate in weight loss,” Dash said.

F.I.E.R.C.E. research participants were recruited to engage with the mission of Georgetown’s Office of Minority Health & Health Disparities Research, which conducts research to reduce cancer disparities among underserved and ethnic minorities in D.C. According to Dash, such research addresses social deterrents of health and cancer health disparities in local communities while emphasizing cultural and relational sensitivity in patient interactions.

He said he celebrates Georgetown’s commitment to the diverse D.C. community that makes it possible to conduct impactful studies. 

“Part of the reason we can do these real life community-based studies is we have a community-based center, Georgetown in southeast D.C., and we have outreach staff who reflect the diversity we see in the community we serve,” Dash said.