Dietary patterns and survival after breast cancer diagnosis
Dietary patterns and survival after breast cancer diagnosis
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DOI：
10.1200/jco.2005.02.0198
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发表时间：
2005-12-20
影响因子：
45.3
通讯作者：
Holmes, MD
中科院分区：
文献类型：
--
作者：
Kroenke, CH;Fung, TT;Holmes, MD
目的：主要饮食模式与乳腺癌生存之间的相关研究很少。方法纳入1982年至1998年间诊断为浸润性乳腺癌的2619名护士健康研究参与者，并在诊断后1年多完成饮食调查问卷。随访至2002年（中位数= 9年）。在随访期间，414名患者死于任何原因，242名患者死于乳腺癌，172名患者死于乳腺癌以外的原因。排除诊断时患有原位或转移性疾病的妇女。我们使用Cox比例风险模型来评估诊断前后谨慎饮食模式和西方饮食模式与诊断后事件发生时间的前瞻性关联。结果在诊断后评估的多变量调整分析中，西方和谨慎的饮食模式与全因或乳腺癌死亡率无关。然而，与摄入量最低的谨慎饮食模式的妇女相比，因乳腺癌以外原因死亡的相对风险（和95% Cls）分别为0.85 （95% Cl， 0.53至1.35）、0.74 （95% Cl， 0.45至1.21）、0.70 （95% Cl， 0.42至1.17）和0.54 （95% Cl， 0.31至0.95;P = 0.03，从摄入量最低到最高的五分位数）。相反，西方饮食模式与这一结果呈正相关（P = .04）。诊断前的饮食模式评估结果相似，除了谨慎的饮食模式与死亡率无关。结论：谨慎饮食模式的高摄入量和西方饮食模式的低摄入量可以预防与乳腺癌无关的死亡。
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% Cls) of death from causes other than breast cancer were 0.85 (95% Cl, 0.53 to 1.35), 0.74 (95% Cl, 0.45 to 1.21), 0.70 (95% Cl, 0.42 to 1.17), and 0.54 (95% Cl, 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.