Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, CA, USA.
JNCI Cancer Spectr. 2021 Mar 2;5(2). doi: 10.1093/jncics/pkab019. eCollection 2021 Apr.
Prior research suggests a relationship between overall diet quality and breast cancer survival, although few studies have reported on this topic. We evaluated whether 4 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.
A total of 3660 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 4 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).
Adjusted comparisons between extreme quintiles showed all 4 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 to 0.95; aMED HR = 0.79, 95% CI = 0.61 to 1.03; DASH HR = 0.76, 95% CI = 0.58 to 1.00; HEI HR = 0.77, 95% CI = 0.60 to 1.01). Similar patterns were noted for non-breast cancer mortality (ACS HR = 0.69, 95% CI = 0.48 to 0.98; aMED HR = 0.73, 95% CI = 0.50 to 1.05; DASH HR = 0.55, 95% CI = 0.38 to 0.79; HEI HR = 0.67, 95% CI = 0.48 to 0.94). None of the dietary quality indices were associated with recurrence or breast cancer-specific mortality.
Food intake patterns concordant with dietary quality indices consistent with recommendations for healthy eating may be beneficial for women with breast cancer.
先前的研究表明，整体饮食质量与乳腺癌生存之间存在关联，尽管很少有研究报道过这一主题。我们评估了在乳腺癌诊断时符合健康饮食建议的 4 种饮食质量指数是否与复发风险、特定原因和全因死亡率相关。
共纳入 3660 名诊断为浸润性乳腺癌的女性。饮食评估平均在诊断后 2.3 个月（范围=0.7-18.7）进行，由此得出 4 种饮食质量指数：美国癌症协会指南（ACS）、替代地中海饮食指数（aMED）、饮食方法停止高血压（DASH）和 2015 年健康饮食指数（HEI）。在超过 40888 人年的随访中，确定了 461 例乳腺癌复发和 655 例死亡。使用 Cox 模型估计风险比（HRs）和 95%置信区间（CIs）。
在极端五分位组之间的调整比较表明，所有 4 种饮食质量指数均与全因死亡率呈负相关，表明风险降低 21%-27%（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）。非乳腺癌死亡率也呈现出类似的模式（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）。没有一种饮食质量指数与复发或乳腺癌特异性死亡率相关。
与健康饮食建议一致的饮食质量指数一致的食物摄入模式可能对乳腺癌女性有益。
