Diet Quality and Breast Cancer Recurrence and Survival: The Pathways Study
Menée aux Etats-Unis à partir de données portant sur 3 660 patientes atteintes d'un cancer du sein invasif, cette étude analyse l'association entre la qualité de l'alimentation dans la période du diagnostic, le risque de récidive de la maladie et la mortalité spécifique ou toutes causes confondues (durée de suivi : 40 888 personnes-années ; 461 cas de récidive, 655 décès)
Background : Prior research suggests a relationship between overall diet quality and breast cancer survival, though few studies have reported on this topic. We evaluated whether four dietary quality indices consistent with healthy eating recommendations around the time of breast cancer diagnosis were associated with risk of recurrence, cause-specific and all-cause mortality. Methods : A total of 3,660 women diagnosed with invasive breast cancer were included. Diet was assessed an average of 2.3 (range = 0.7–18.7) months after diagnosis, from which four dietary quality indices were derived: the American Cancer Society guidelines (ACS), the alternate Mediterranean Diet Index (aMED), the Dietary Approaches to Stop Hypertension (DASH) and the 2015 Healthy Eating Index (HEI). Over 40,888 person-years of follow-up, 461 breast cancer recurrences and 655 deaths were ascertained. Cox models were used to estimate hazards ratios (HRs) and 95% confidence intervals (CIs). Results : Adjusted comparisons between extreme quintiles showed all four dietary quality indices to be inversely associated with all-cause mortality, suggesting a 21%–27% lower risk (ACS HR = 0.73 [95%CI = 0.56–0.95], aMED HR = 0.79 [95%CI = 0.61–1.03], DASH HR = 0.76 [95%CI = 0.58–1.00], HEI HR = 0.77 [95%CI = 0.60–1.01]). Similar patterns were noted for non-breast cancer mortality (ACS HR = 0.69 [95%CI = 0.48–0.98], aMED HR = 0.73 [95%CI = 0.50–1.05], DASH HR = 0.55 [95%CI = 0.38–0.79], HEI HR = 0.67 [95%CI = 0.48–0.94]). None of the dietary quality indices were associated with recurrence or breast cancer-specific mortality. Conclusion : Food intake patterns concordant with dietary quality indices consistent with recommendations for healthy eating may be beneficial for women with breast cancer.
JNCI Cancer Spectrum 2021