This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kroenke, C. H. Articles by Holmes, M. D. Search for Related Content PubMed PubMed Citation Articles by Kroenke, C. H. Articles by Holmes, M. D.

Dietary Patterns and Survival After Breast Cancer Diagnosis

From the University of California, Robert Wood Johnson Health and Society Scholars Program, San Francisco, CA; Simmons College; Department of Nutrition, Harvard School of Public Health; Channing Laboratory, Department of Medicine, Brigham & Women's Hospital; and Harvard Medical School, Boston, MA

Address reprint requests to Candyce Kroenke, ScD, University of California, 3333 California St, Suite 465, San Francisco, CA 94118; e-mail: ckroenke{at}berkeley.edu

PURPOSE: There is little prior study of major dietary patterns and breast cancer survival.

METHODS: Patients included 2,619 Nurses' Health Study participants who were diagnosed with invasive breast cancer between 1982 and 1998 and completed a dietary questionnaire more than 1 year after diagnosis. Participants were followed through 2002 (median = 9 years). During follow-up, 414 patients died of any cause, 242 patients died of breast cancer, and 172 patients died from causes other than breast cancer. Women with in situ or metastatic disease at diagnosis were excluded. We used Cox proportional hazards models to evaluate prospective associations of prudent and Western dietary patterns assessed both before and after diagnosis with time to event after diagnosis.

RESULTS: In multivariate-adjusted analyses assessed after diagnosis, the Western and prudent dietary patterns were unrelated to all-cause or breast cancer mortality. However, compared with women with the lowest intake of the prudent dietary pattern, the relative risks (and 95% CIs) of death from causes other than breast cancer were 0.85 (95% CI, 0.53 to 1.35), 0.74 (95% CI, 0.45 to 1.21), 0.70 (95% CI, 0.42 to 1.17), and 0.54 (95% CI, 0.31 to 0.95; P = .03, from lowest to highest quintile of intake). In contrast, the Western dietary pattern was positively associated with this outcome (P = .04). Results for the assessment of dietary patterns before diagnosis were similar, except the prudent dietary pattern was unrelated to mortality.

CONCLUSION: A higher intake of the prudent pattern and a lower intake of the Western pattern may protect against mortality from causes unrelated to breast cancer.

Supported by grant Nos. CA87969 and CA095589 from the National Cancer Institute, National Institutes of Health, Bethesda, MD.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

This article has been cited by other articles:

				J. P. Pierce, V. A. Newman, L. Natarajan, S. W. Flatt, W. K. Al-Delaimy, B. J. Caan, J. A. Emond, S. Faerber, E. B. Gold, R. A. Hajek, et al. Telephone Counseling Helps Maintain Long-Term Adherence to a High-Vegetable Dietary Pattern J. Nutr., October 1, 2007; 137(10): 2291 - 2296. [Abstract] [Full Text] [PDF]

				J. P. Pierce, L. Natarajan, B. J. Caan, B. A. Parker, E. R. Greenberg, S. W. Flatt, C. L. Rock, S. Kealey, W. K. Al-Delaimy, W. A. Bardwell, et al. Influence of a Diet Very High in Vegetables, Fruit, and Fiber and Low in Fat on Prognosis Following Treatment for Breast Cancer: The Women's Healthy Eating and Living (WHEL) Randomized Trial JAMA, July 18, 2007; 298(3): 289 - 298. [Abstract] [Full Text] [PDF]

				S. M. Gapstur and S. Khan Fat, Fruits, Vegetables, and Breast Cancer Survivorship JAMA, July 18, 2007; 298(3): 335 - 336. [Full Text] [PDF]

				J. P. Pierce, M. L. Stefanick, S. W. Flatt, L. Natarajan, B. Sternfeld, L. Madlensky, W. K. Al-Delaimy, C. A. Thomson, S. Kealey, R. Hajek, et al. Greater Survival After Breast Cancer in Physically Active Women With High Vegetable-Fruit Intake Regardless of Obesity J. Clin. Oncol., June 10, 2007; 25(17): 2345 - 2351. [Abstract] [Full Text] [PDF]

				R. Chlebowski Lifestyle Change Including Dietary Fat Reduction and Breast Cancer Outcome J. Nutr., January 1, 2007; 137(1): 233S - 235S. [Full Text] [PDF]

				A. C. M. Thiebaut, A. Schatzkin, R. Ballard-Barbash, and V. Kipnis Dietary Fat and Breast Cancer: Contributions From a Survival Trial J Natl Cancer Inst, December 20, 2006; 98(24): 1753 - 1755. [Full Text] [PDF]

				C. Doyle, L. H. Kushi, T. Byers, K. S. Courneya, W. Demark-Wahnefried, B. Grant, A. McTiernan, C. L. Rock, C. Thompson, T. Gansler, et al. Nutrition and Physical Activity During and After Cancer Treatment: An American Cancer Society Guide for Informed Choices CA Cancer J Clin, November 1, 2006; 56(6): 323 - 353. [Abstract] [Full Text] [PDF]