Dietary Pattern at 18-Month Post-Diagnosis and Outcomes of Breast Cancer Among Chinese Women with Early-Stage Breast Cancer

Abstract

Background Evidence of the association between dietary pattern and outcomes of breast cancer was limited in Asian women, including Chinese. Patients and Methods A prospective cohort study was initiated among Chinese breast cancer patients to investigate lifestyle habits and outcomes of breast cancer. At each follow-up, validated food frequency questionnaires (FFQ) were used to assess patients’ dietary intake. This study included 1226 patients with invasive early-stage breast cancer with detailed data at 18-month follow-up after cancer diagnosis. Factor analysis was used to derive dietary patterns, whereby two dietary patterns were identified. Cox proportional hazards models were used to investigate associations between dietary patterns and time to outcome, including breast cancer recurrence, overall mortality and breast cancer-specific mortality. Results With a median follow-up time of 54.1 months, 165 patients had breast cancer recurrence and 98 deaths occurred. Two dietary patterns were identified: “Western dietary pattern” characterized by high intake of refined grains and cakes, red and processed meat and oil; “healthy dietary pattern” characterized by high consumption of vegetables and fruits. Participants in the highest tertile of “Western dietary pattern” did not have a higher risk of breast cancer recurrence ( P trend = 0.89), overall mortality ( P trend = 0.48) and breast cancer-specific mortality ( P trend = 0.75). Similarly, a null association existed between “healthy dietary pattern” and outcomes of breast cancer. Conclusion Neither dietary pattern was associated with risk of breast cancer recurrence, all-causes death or death from breast cancer. Prospective follow-up is still needed to further confirm the association between specific dietary pattern and outcomes of breast cancer.

Dietary patterns and breast cancer risk, prognosis, and quality of life: A systematic review

“…The relationship between dietary patterns and BC prognosis has been studied in four countries, particularly focusing on healthy, Mediterranean, and DASH diets. Two studies on healthy eating patterns conducted in the United States found that this pattern had the potential to reduce patient mortality (64, 65), while two studies in China found no such relationship (66,67).…”

Postdiagnosis dietary factors, supplement use and breast cancer prognosis: Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis

“…The Prudent diet in the Life After Cancer Epidemiology study, and the Western diet in the Nurses' Health Study were negatively and positively associated, respectively, with all‐cause mortality, but not with breast cancer mortality 51,52 or recurrence 52 . Neither of these dietary patterns were associated with breast cancer prognosis in the Hong Kong NTEC‐KWC Breast Cancer Survival Study 53 …”

“…Tables S6 and S7 show the characteristics and main results of the studies identified investigating data driven or predefined dietary and lifestyle patterns 6,34‐56 …”

“…52 Neither of these dietary patterns were associated with breast cancer prognosis in the Hong Kong NTEC-KWC Breast Cancer Survival Study. 53 Twelve studies (16 publications 6,[34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] ) investigated high vs low categories of 18 predefined healthy dietary and lifestyle patterns (Figure 2). Results were generally consistent in the direction of an inverse association with all-cause mortality (only the Recommended Foods Score showed a RR > 1) and in eight (Healthy Eating Index-2005, 35,37,47 WCRF/AICR Cancer Prevention Recommendations, 41 Dietary Inflammatory Index, 39,44 low-fat, high-vegetables, fruit, and fibre diet, 42 Chinese Food Pagoda diet-2007, 43 Dietary Approaches to Stop Hypertension, 43 diabetes risk reduction diet 45 and endogenous acid production diet 48 ) out of 17 patterns showing inverse associations, the 95% CIs did not include 1.…”

“…Tables S6 and S7 show the characteristics and main results of the studies identified investigating data driven or predefined dietary and lifestyle patterns. 6, Three studies [51][52][53] investigated the Prudent (healthy) and Western (unhealthy) data-driven dietary patterns. The Prudent diet in the Life After Cancer Epidemiology study, and the Western diet in the Nurses' Health Study were negatively and positively associated, respectively, with all-cause mortality, but not with breast cancer mortality 51,52 or recurrence.…”