Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA 92093-0901, USA.
Maturitas. 2010 May;66(1):5-15. doi: 10.1016/j.maturitas.2010.01.004. Epub 2010 Jan 25.
Given the increasing numbers of long-term survivors of breast cancer, research specific to prevention of recurrence, new breast cancer events, and mortality is of considerable public health importance. The objective of this report is to present a review of the published epidemiologic research on lifestyle and breast cancer outcomes among women with a history of breast cancer. This review focused on physical activity, diet, and adiposity; and the primary outcomes were additional breast cancer events and mortality. The most consistent finding from observational studies was that adiposity was associated with a 30% increased risk of mortality. Although the observational data were not as consistent (or abundant), physical activity appeared to be associated with a 30% decreased risk of mortality. These data do not indicate that alcoholic drinks are a risk factor. Based only on the observational studies, total dietary fat appeared to be a risk factor, fiber was protective, and information on micronutrients and specific foods was sparse. However, the null results of 2 dietary intervention trials in survivors suggests that lowering fat intake or increasing consumption of fruits, vegetables, and fiber will not lead to improved prognosis in breast cancer survivors. Given that a high proportion of breast cancer patients appear to be both sedentary and obese/overweight, clinical trials are needed to investigate whether the combination of increased physical activity and reduced adiposity can improve breast cancer prognosis.
鉴于乳腺癌长期幸存者的数量不断增加，针对预防复发、新乳腺癌事件和死亡率的研究具有相当重要的公共卫生意义。本报告的目的是对已发表的关于乳腺癌病史女性的生活方式与乳腺癌结局的流行病学研究进行综述。本综述重点关注了身体活动、饮食和肥胖；主要结局是乳腺癌复发和死亡率。观察性研究中最一致的发现是肥胖与 30%的死亡率增加有关。尽管观察性数据并不一致（或丰富），但身体活动似乎与 30%的死亡率降低有关。这些数据并不表明酒精饮料是一个危险因素。仅基于观察性研究，总膳食脂肪似乎是一个危险因素，纤维具有保护作用，而关于微量营养素和特定食物的信息则很少。然而，2 项针对幸存者的饮食干预试验的阴性结果表明，降低脂肪摄入或增加水果、蔬菜和纤维的摄入不会改善乳腺癌幸存者的预后。鉴于很大一部分乳腺癌患者似乎久坐不动且肥胖/超重，需要进行临床试验来研究增加身体活动和减少肥胖是否可以改善乳腺癌的预后。
