Match!

Association of Low-Fat Dietary Pattern With Breast Cancer Overall Survival: A Secondary Analysis of the Women’s Health Initiative Randomized Clinical Trial

Published on Oct 11, 2018in JAMA Oncology22.42
· DOI :10.1001/jamaoncol.2018.1212
Rowan T. Chlebowski77
Estimated H-index: 77
(City of Hope National Medical Center),
Aaron K. Aragaki43
Estimated H-index: 43
(Fred Hutchinson Cancer Research Center)
+ 10 AuthorsRoss L. Prentice90
Estimated H-index: 90
(Fred Hutchinson Cancer Research Center)
Abstract
Importance In a randomized clinical trial, a low-fat eating pattern was associated with lower risk of death after breast cancer. However, the extent to which results were driven by dietary influence on survival after breast cancer diagnosis was unknown. Objective To determine the association of a low-fat dietary pattern with breast cancer overall survival (breast cancer followed by death from any cause measured from cancer diagnosis). Design, Setting, and Participants This is a secondary analysis of the Women’s Health Initiative randomized clinical trial that was conducted at 40 US clinical centers enrolling participants from 1993 through 1998. Participants were 48 835 postmenopausal women with no previous breast cancer and dietary fat intake of greater than 32% by food frequency questionnaire. Interventions Participants were randomized to a dietary intervention group (40%; n = 19 541) with goals to reduce fat intake to 20% of energy and increase fruit, vegetable, and grain intake or a usual-diet comparison group (60%; n = 29 294). Dietary group participants with incident breast cancers continued to participate in subsequent dietary intervention activities. Main Outcomes and Measures Breast cancer overall survival for incident breast cancers diagnosed during the 8.5-year (median) dietary intervention, examined in post hoc analyses after 11.5 years (median) postdiagnosis follow-up. Results Of 1764 women diagnosed with breast cancer during the dietary intervention period, mean (SD) age at screening was 62.7 (6.7) years and age at diagnosis was 67.6 (6.9) years. With 516 total deaths, breast cancer overall survival was significantly greater for women in the dietary intervention group than in the usual-diet comparison group (10-year survival of 82% and 78%, respectively; hazard ratio [HR], 0.78; 95% CI, 0.65-0.94; P  = .01). In the dietary group there were fewer deaths from breast cancer (68 vs 120; HR, 0.86; 95% CI, 0.64-1.17), other cancers (36 vs 65; HR, 0.76; 95% CI, 0.50-1.17), and cardiovascular disease (27 vs 64; HR, 0.62; 95% CI, 0.39-0.99). Conclusions and Relevance In women who received a diagnosis of breast cancer during the dietary intervention period, those in the dietary group had increased overall survival. The increase is due, in part, to better survival from several causes of death. Trial Registration ClinicalTrials.gov Identifier:NCT00000611
  • References (33)
  • Citations (2)
References33
Newest
#1Rowan T. Chlebowski (Los Angeles Biomedical Research Institute)H-Index: 77
#2Aaron K. Aragaki (Fred Hutchinson Cancer Research Center)H-Index: 43
Last.Dorothy S. Lane (SBU: Stony Brook University)H-Index: 48
view all 17 authors...
#1Sarah F. Brennan ('QUB': Queen's University Belfast)H-Index: 5
#2Jayne V. Woodside ('QUB': Queen's University Belfast)H-Index: 38
Last.Marie M. Cantwell ('QUB': Queen's University Belfast)H-Index: 31
view all 5 authors...
#1Ross L. Prentice (Fred Hutchinson Cancer Research Center)H-Index: 90
#2Aaron K. Aragaki (Fred Hutchinson Cancer Research Center)H-Index: 43
Last.Matthew A. Allison (UCSD: University of California, San Diego)H-Index: 59
view all 12 authors...
#1Paul E. Goss (Harvard University)H-Index: 70
#2J. N. Ingle (Mayo Clinic)H-Index: 25
Last.S. Rubin (Dal: Dalhousie University)H-Index: 1
view all 20 authors...
Cited By2
Newest
#1Ross L. Prentice (Fred Hutchinson Cancer Research Center)H-Index: 90
#2Aaron K. Aragaki (Fred Hutchinson Cancer Research Center)H-Index: 43
Last.Lewis E Kuller (University of Pittsburgh)
view all 14 authors...
#1Lai Xu (WashU: Washington University in St. Louis)
#2Lindsay L. Peterson (WashU: Washington University in St. Louis)H-Index: 5
#1Rowan T. Chlebowski (Los Angeles Biomedical Research Institute)H-Index: 77
#2Garnet L. Anderson (Fred Hutchinson Cancer Research Center)H-Index: 66
Last.Dorothy S. Lane (SBU: Stony Brook University)H-Index: 48
view all 18 authors...
View next paperAbstract CT043: Low-fat dietary pattern and breast cancer mortality in the Women's Health Initiative (WHI) randomized trial