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Postdiagnosis diet quality, the combination of diet quality and recreational physical activity, and prognosis after early-stage breast cancer

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Abstract

Objective

To investigate, among women with breast cancer, how postdiagnosis diet quality and the combination of diet quality and recreational physical activity are associated with prognosis.

Methods

This multiethnic, prospective observational cohort included 670 women diagnosed with local or regional breast cancer. Thirty months after diagnosis, women completed self-report assessments on diet and physical activity and were followed for 6 years. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals for death from any cause and breast cancer death.

Results

Women consuming better-quality diets, as defined by higher Healthy Eating Index-2005 scores, had a 60% reduced risk of death from any cause (HRQ4:Q1: 0.40, 95% CI: 0.17, 0.94) and an 88% reduced risk of death from breast cancer (HRQ4:Q1: 0.12, 95% CI: 0.02, 0.99). Compared with inactive survivors consuming poor-quality diets, survivors engaging in any recreational physical activity and consuming better-quality diets had an 89% reduced risk of death from any cause (HR: 0.11, 95% CI: 0.04, 0.36) and a 91% reduced risk of death from breast cancer (HR: 0.09, 95% CI: 0.01, 0.89). Associations observed were independent of obesity status.

Conclusion

Women diagnosed with localized or regional breast cancer may improve prognosis by adopting better-quality dietary patterns and regular recreational physical activity. Lifestyle interventions emphasizing postdiagnosis behavior changes are advisable in breast cancer survivors.

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Acknowledgments

We would like to thank Dr. Charles L. Wiggins, HEAL Study managers, Eric Meier of the Fred Hutchinson Cancer Research Center Nutrition Assessment Shared Resource, Todd Gibson of Information Management Systems, and the HEAL Study participants. This study is supported by National Cancer Institute Grants: N01-CN-75036-20, NO1-CN-05228, NO1-PC-67010, and T32 CA105666.

Conflicts of interest

No conflicts of interest or disclaimers to report.

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Authors and Affiliations

  1. Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd., Suite 320, MSC 7232, Rockville, MD, 20852, USA

    Stephanie M. George, Steven C. Moore & Demetrius Albanes

  2. Division of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA

    Stephanie M. George, Melinda L. Irwin & Susan T. Mayne

  3. Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA

    Ashley W. Smith, Jill Reedy & Rachel Ballard-Barbash

  4. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Marian L. Neuhouser, Anne McTiernan & Cornelia M. Ulrich

  5. Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA

    Catherine M. Alfano

  6. Department of Population Sciences, City of Hope Medical Center and Beckman Research Center, Duarte, CA, USA

    Leslie Bernstein

  7. German Cancer Research Center and National Center for Tumor Diseases, Heidelberg, Germany

    Cornelia M. Ulrich

  8. Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, USA

    Kathy B. Baumgartner

  9. Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA

    Mitchell H. Gail

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  1. Stephanie M. George
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  2. Melinda L. Irwin
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  3. Ashley W. Smith
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  8. Leslie Bernstein
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  10. Kathy B. Baumgartner
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  11. Steven C. Moore
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  14. Mitchell H. Gail
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  15. Rachel Ballard-Barbash
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Corresponding author

Correspondence to Stephanie M. George.

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George, S.M., Irwin, M.L., Smith, A.W. et al. Postdiagnosis diet quality, the combination of diet quality and recreational physical activity, and prognosis after early-stage breast cancer. Cancer Causes Control 22, 589–598 (2011). https://doi.org/10.1007/s10552-011-9732-9

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  • DOI: https://doi.org/10.1007/s10552-011-9732-9

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