Originally published as JCO Early Release 10.1200/JCO.2008.19.4035 on December 29 2008

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Dietary Patterns and Breast Cancer Recurrence and Survival Among Women With Early-Stage Breast Cancer

From the Division of Research, Kaiser Permanente, Oakland, CA; and University of Utah, Salt Lake City, UT.

Corresponding author: Marilyn L. Kwan, PhD, 2000 Broadway, First Floor, Oakland, CA 94612; e-mail Marilyn.L.Kwan{at}kp.org.

Purpose To determine the association of dietary patterns with cancer recurrence and mortality of early-stage breast cancer survivors.

Patients and Methods Patients included 1,901 Life After Cancer Epidemiology Study participants diagnosed with early-stage breast cancer between 1997 and 2000 and recruited primarily from the Kaiser Permanente Northern California Cancer Registry. Diet was assessed at cohort entry using a food frequency questionnaire. Two dietary patterns were identified: prudent (high intakes of fruits, vegetables, whole grains, and poultry) and Western (high intakes of red and processed meats and refined grains). Two hundred sixty-eight breast cancer recurrences and 226 all-cause deaths (128 attributable to breast cancer) were ascertained. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs.

Results Increasing adherence to a prudent dietary pattern was associated with a statistically significant decreasing risk of overall death (P trend = .02; HR for highest quartile = 0.57; 95% CI, 0.36 to 0.90) and death from non–breast cancer causes (P trend = .003; HR for highest quartile = 0.35; 95% CI, 0.17 to 0.73). In contrast, increasing consumption of a Western dietary pattern was related to an increasing risk of overall death (P trend = .05) and death from non–breast cancer causes (P = .02). Neither dietary pattern was associated with risk of breast cancer recurrence or death from breast cancer. These observations were generally not modified by physical activity, being overweight, or smoking.

Conclusion Women diagnosed with early-stage breast cancer might improve overall prognosis and survival by adopting more healthful dietary patterns.

Supported by National Cancer Institute Grant No. R01 CA80027 and by Utah Cancer Registry Grant No. N01 PC67000, with additional support from the State of Utah Department of Health.

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

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