Dietary Exposures and Other Factors of Possible Prognostic Significance in Relation to Tumour Size and Nodal Involvement in Early-Stage Breast Cancer

Abstract

In this case series study of 546 early-stage breast cancer patients we examined the relationship between tumour size and axillary nodal involvement separately in relation to other factors suggested to be of prognostic significance in breast cancer. Relationships were modelled using two-stage general linear models stratified by menopausal status. In stage I models, tumour size (diameter in cm) and nodal involvement, expressed as the loge (number of positive nodes total nodes examined), were regressed on an array of socio-demographic and reproduction-related variables as well as smoking and drinking. In stage II models we entered the same dependent variables, the linear predictor score from stage I modelling, estimated total calories consumed and calorie-adjusted fat, fibre and vitamin A intake, as well as serum cholesterol, body mass index, and oestrogen and progesterone receptor status. Using this very conservative analytical technique, we found that, among premenopausal women, for every gram increase in estimated calorie-adjusted daily fat intake there was a 0.09 mm increase in tumour diameter (T = 2.58, P = 0.01). Also among premenopausal women, we observed an inverse relationship between nodal involvement and fibre intake (g/d) and nodal involvement (B = -0.058, T = -2.11, P = 0.04). For postmenopausal women we observed an inverse relationship with serum cholesterol (mg/dl) (B = -0.005, T = -1.85, P = 0.07). Other findings of interest include the absence of background factor effects in premenopausal women, the lack of nutritional effects and the consistency of a protective effect of education among postmenopausal women, and a relationship between hormone receptor levels and tumour size among premenopausal women.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol Consumption and Breast Cancer Survival: A Metaanalysis of Cohort Studies

“…After reading full-texts, we excluded studies that were not cohort studies (n =61) and not about survival (n=61). Finally, 25 cohort studies (Hebert et al, 1989;Ewertz et al, 1991;Rohan et al, 1993;Fuchs et al, 1995;Zhang et al, 1995;Thun et al, 1997;Holmes et al, 1999;Saxe et al, 1999;Jain et al, 2000;McDonald et al, 2002;Borugian et al, 2004;Barnett et al, 2008;Dal Maso et al, 2008;Reding et al, 2008;Franceschi et al, 2009;Flatt et al, 2010;Hellmann et al, 2010;Kwan et al, 2010;Allemani et al, 2011;Beasley et al, 2011;Breslow et al, 2011;Harris et al, 2012;Vrieling et al, 2012;Holm et al, 2013;Kwan et al, 2013;Newcomb et al, 2013) (patients) were included ( Figure 1). …”

“…Pooling all data from highest versus lowest comparisons, alcohol DOI:http://dx.doi.org/10.7314/APJCP.2013.14.8.4785 Alcohol Consumption and Breast Cancer Survival: A Meta- (Figure 3). 15 studies (Hebert et al, 1989;Zhang et al, 1995;Thun et al, 1997;Saxe et al, 1999;Jain et al, 2000;Barnett et al, 2008;Reding et al, 2008;Franceschi et al, 2009;Hellmann et al, 2010;Allemani et al, 2011;Breslow et al, 2011;Harris et al, 2012;Vrieling et al, 2012;Holm et al, 2013;Newcomb et al, 2013) evaluated the relationship of post-diagnostic alcohol consumption with breast cancer mortality and three studies (Hebert et al, 1989;Saxe et al, 1999;Holm et al, 2013) evaluated the relationship of post-diagnostic alcohol consumption with breast cancer recurrence. And the meta-analysis results showed prediagnostic alcohol consumption was not associated with increased breast cancer mortality (HR1.05, 95%CI 0.93 1.19, I 2 =36%) ( Figure 2) and recurrence (HR1.24, 95%CI 0.89 1.73, I 2 =31%) (Figure 3).…”

“…All studies focused on breast cancer mortality and only five studies (Hebert et al, 1989;Saxe et al, 1999;Kwan et al, 2010;Holm et al, 2013;Kwan et al, 2013) focused on breast cancer recurrence. Of 25 studies, 14 were from USA, three were from Denmark, two were from Germany, and the rest were from Italy, Australia, Canada, France, Sweden and UK, separately.…”

“…However, the information on whether alcohol consumption is related to breast cancer survival is mixed (Hebert et al, 1989;Ewertz et al, 1991;Rohan et al, 1993;Fuchs et al, 1995;Zhang et al, 1995;Thun et al, 1997;Holmes et al, 1999;Saxe et al, 1999;Jain et al, 2000;McDonald et al, 2002;Borugian et al, 2004;Barnett et al, 2008;Reding et al, 2008;Franceschi et al, 2009;Flatt et al, 2010;Hellmann et al, 2010;Kwan et al, 2010;Allemani et al, 2011;Beasley et al, 2011;Breslow et al, 2011;Harris et al, 2012;Vrieling et al, 2012;Holm et al, 2013; Newcomb et al, 2013). Some studies reported that alcohol consumption was associated with reduced breast cancer mortality (Barnett et al, 2008;Reding et al, 2008;Flatt et al, 2010), while other studies revealed that alcohol consumption was associated with increased breast cancer mortality (Hebert et al, 1989;Fuchs et al, 1995;Jain et al, 2000;McDonald et al, 2002;Allemani et al, 2011;Vrieling et al, 2012). Even though, most studies found no relationship between alcohol consumption and breast cancer mortality (Ewertz et al, 1991;Rohan et al, 1993;Zhang et al, 1995;Thun et al, 1997;…”

“…Even though, most studies found no relationship between alcohol consumption and breast cancer mortality (Ewertz et al, 1991;Rohan et al, 1993;Zhang et al, 1995;Thun et al, 1997;Holmes et al, 1999;Saxe et al, 1999;Borugian et al, 2004;Franceschi et al, 2009;Hellmann et al, 2010;Kwan et al, 2010;Beasley et al, 2011;Breslow et al, 2011;Harris et al, 2012;Holm et al, 2013;Kwan et al, 2013;Newcomb et al, 2013). For the association of alcohol consumption with breast cancer recurrence, available evidence was also conflicted (Hebert et al, 1989;Saxe et al, 1999;Kwan et al, 2010;Holm et al, 2013;Kwan et al, 2013). So a meta-analysis is necessary to investigate the relationship of alcohol intake and breast cancer survival (mortality and recurrence).…”