In the first study to evaluate reproductive factors and breast cancer risk in women with Li-Fraumeni Syndrome (LFS), NCI investigators report lifetime breastfeeding of at least seven months to be associated with a 43 percent reduction in breast cancer risk. NCI investigators analyzed questionnaire data from 152 women with confirmed germline TP53 variants enrolled in the NCI LFS study; 85 of whom had at least one breast cancer diagnosis. These results are an important contribution to the conversation between clinicians, genetic counselors, and patients about the medical benefits of breastfeeding in the context of cancer screening and prophylactic mastectomy for cancer prevention in women with LFS.
LFS Cancer Incidence
In August 2016, our LFS team reported on cancer incidence from our NCI cohort in the journal Cancer. Read the paper online: "Risks of first and subsequent cancers among TP53 mutation carriers in the National Cancer Institute Li-Fraumeni syndrome cohort."
In this publication, we presented our findings from 286 individuals with TP53 mutations who enrolled in our study since it opened in 2011. We examined the cancer risk by gender as well as by specific cancer site. We observed that by age 31, 50% of females had developed cancer; for males it was by age 36. By age 70, nearly 100% of both males and females had developed some type of cancer.
Approximately 49% of those with one cancer developed at least one other cancer after 10 years. Our findings confirm the cancer risk in TP53 mutation carriers is very high, but varies by age, sex, and cancer type. Further research is needed to better inform personalized risk management for these individuals.
Psychosocial Aspects of LFS
In November 2015, our LFS team published an article in the Journal of Genetic Counseling (JoGC). Read the epub version of the article: "Easing the Burden: Describing the Role of Social, Emotional and Spiritual Support in Research Families with Li-Fraumeni Syndrome."
This paper presents the findings from assessments of the social support and emotional status of the first 66 participants who attended the LFS clinic at the NIH Clinical Center. We saw patients with or without cancer, along with relatives and spouses. Most people did not indicate distress on a standardized measure. We found that reported friendships varied widely and were an important source of informational, tangible, emotional, and spiritual support. In some families, organized religion was a major source of coping. Confidantes tended to be best friends and/or spouses. Our results shed preliminary light on how some people in LFS families handle tremendous medical, social, and emotional challenges.
Physical Activity & Diet Pilot
In 2014, CGB launched a pilot study targeting Physical Activity and Diet (PAD) in LFS families. This is a first step towards evaluating the feasibility and practicality of collecting data of this kind from our study participants. The long-range goal of this effort is to determine whether there might be opportunities for modification of these important lifestyle variables toward reducing cancer risk and improving overall health and well-being in LFS families. A random sample of LFS study participants were invited to participate by providing information about their daily diet and physical activity using a web-based data collection tool.
LFS Family Interview Study
In 2012, CGB launched the Family Interview study as an extension of the psychosocial research conducted in the LFS study. The purpose of the family interviews is to explore and understand the ways in which members of families with LFS or LFL communicate with and support each other. A trained couples and family therapist conducts in-depth interviews with two or more family members during their visits to the Clinical Center. During the interviews, we explore the specific challenges that arise in navigating a wide range of individual and family issues that might be affected by the presence of LFS or LFL.