High- and Low-Fat Dairy Intake, Recurrence, and Mortality After Breast Cancer Diagnosis
High- and Low-Fat Dairy Intake, Recurrence, and Mortality After Breast Cancer Diagnosis
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DOI：
10.1093/jnci/djt027
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发表时间：
2013-05-01
影响因子：
10.3
通讯作者：
Caan, Bette J.
中科院分区：
文献类型：
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作者：
Kroenke, Candyce H.;Kwan, Marilyn L.;Caan, Bette J.
背景乳制品中的膳食脂肪是雌激素的来源，可能与乳腺癌生存率降低有关。我们评估了高脂肪和低脂肪的乳制品摄入量，复发率和乳腺癌diagnosis.Methods后的死亡率之间的关联，我们包括1893名妇女从癌症后的生活流行病学研究诊断为早期浸润性乳腺癌，1997年至2000年，谁完成了弗雷德哈钦森癌症研究中心的食物频率问卷诊断后。共有349名妇女复发，372人在中位随访11.8年期间死亡，其中189人死于乳腺癌。我们使用延迟进入的考克斯比例风险回归来评估基线和5 - 6年后随访时乳脂累积平均值类别与后续结果之间的相关性。统计学显著性检验是双侧的。结果在多变量调整分析中，总体乳制品摄入量与乳腺癌的具体结果无关，尽管它与总体死亡率呈正相关。低脂乳制品摄入与复发或生存无关。然而，高脂肪乳制品摄入量与结果呈正相关。相较于参照（0至< 0.5份/天），那些消费大量高脂肪乳制品的人有更高的乳腺癌死亡率（0.5至< 1.0份/天：风险比[HR] = 1.20，95%置信区间[CI] = 0.82至1.77;以及>= 1.0份/天：HR = 1.49，95%CI = 1.00 - 2.24，P（趋势）= 0.05）、较高的全因死亡率（P（趋势）<0.001）和较高的非乳腺癌死亡率（P（趋势）= 0.007）;与乳腺癌复发呈正相关，但无统计学意义。不同类型的高脂肪乳制品的高风险出现一致。结论摄入高脂肪乳制品，但不是低脂乳制品，与乳腺癌诊断后的死亡率较高的风险。
Background Dietary fat in dairy is a source of estrogenic hormones and may be related to worse breast cancer survival. We evaluated associations between high-and low-fat dairy intake, recurrence, and mortality after breast cancer diagnosis.Methods We included 1893 women from the Life After Cancer Epidemiology study diagnosed with early-stage invasive breast cancer from 1997 to 2000, who completed the Fred Hutchinson Cancer Research Center Food Frequency Questionnaire after diagnosis. A total of 349 women had a recurrence and 372 died during a median follow-up of 11.8 years, with 189 deaths from breast cancer. We used delayed entry Cox proportional hazards regression to evaluate associations between categories of the cumulative average of dairy fat at baseline and at follow-up 5 to 6 years later and subsequent outcomes. Tests of statistical significance were two-sided.Results In multivariable-adjusted analyses, overall dairy intake was unrelated to breast cancer-specific outcomes, although it was positively related to overall mortality. Low-fat dairy intake was unrelated to recurrence or survival. However, high-fat dairy intake was positively associated with outcomes. Compared with the reference (0 to < 0.5 servings/day), those consuming larger amounts of high-fat dairy had higher breast cancer mortality (0.5 to < 1.0 servings/day: hazard ratio [HR] = 1.20, 95% confidence interval [CI] = 0.82 to 1.77; and >= 1.0 servings/day: HR = 1.49, 95% CI = 1.00 to 2.24, P (trend) = .05), higher all-cause mortality (P (trend) < .001), and higher non-breast cancer mortality (P (trend) = .007); the relationship with breast cancer recurrence was positive but not statistically significant. The higher risk appeared consistent across different types of high-fat dairy products.Conclusions Intake of high-fat dairy, but not low-fat dairy, was related to a higher risk of mortality after breast cancer diagnosis.