Holm L E, Nordevang E, Hjalmar M L, Lidbrink E, Callmer E, Nilsson B
Department of Cancer Prevention, Radiumhemmet, Karolinska Hospital, Stockholm, Sweden.
J Natl Cancer Inst. 1993 Jan 6;85(1):32-6. doi: 10.1093/jnci/85.1.32.
Epidemiological and experimental evidence suggests that breast cancer risk can be reduced by dietary measures. Study of the relationships between dietary habits and prognosis in patients with breast cancer is essential to the design of diet intervention trials.
Our purpose was to determine whether dietary habits are associated with disease-free survival in patients with breast cancer who have undergone treatment.
We interviewed 240 women about their dietary histories. These women were 50-65 years old and had pathological stage I-II breast cancer with subsequent follow-up for 4 years; 209 of these women were postmenopausal. Differences in dietary variables between groups of patients were analyzed with bivariate and multivariate statistical methods.
Cancers were classified as estrogen receptor (ER) rich (> or = 0.10 fmol/micrograms of DNA) in 149 patients and as ER poor (< 0.10 fmol/micrograms of DNA) in 71 patients. Fifty-two patients had treatment failure during follow-up. The 30 patients with ER-rich tumors who had treatment failure reported higher intakes of total fat, saturated fatty acids, and polyunsaturated fatty acids than did the 119 patients with ER-rich tumors who did not have treatment failure. The multiple-odds ratio (OR) for treatment failure in these women was 1.08 for each 1% increment in percentage of total energy (E%) from total fat. For treatment failure within the first 2 years, the OR was 1.19 for each 1-mg increase in vitamin E intake per 10 megajoules of energy. In women with treatment failure 2-4 years after diagnosis, ORs were 1.13 and 1.23 for each E% increment in total fat or saturated fatty acids, respectively. No association between dietary habits and treatment failure was found for women with ER-poor cancers. There was a tendency to a dose-response relationship (in quartiles) between intake of saturated fatty acids and disease-free survival, but the observed differences were not statistically significant.
Dietary habits at the time of diagnosis may affect prognosis, at least for patients with ER-rich breast cancers. Dietary fat may have an effect on growth or spread of breast cancer, both of which may vary according to type of fat. Total fat and saturated fatty acids were the dietary parameters most strongly associated with risk for treatment failure.
Dietary intervention might serve as an adjuvant treatment to improve breast cancer prognosis.
流行病学和实验证据表明，饮食措施可降低乳腺癌风险。研究饮食习惯与乳腺癌患者预后之间的关系对于饮食干预试验的设计至关重要。
我们的目的是确定饮食习惯是否与接受治疗的乳腺癌患者的无病生存期相关。
我们采访了240名女性的饮食史。这些女性年龄在50 - 65岁之间，患有病理分期为I - II期的乳腺癌，随后进行了4年的随访；其中209名女性已绝经。采用双变量和多变量统计方法分析患者组之间饮食变量的差异。
149例患者的癌症被分类为富含雌激素受体（ER）（≥0.10 fmol/微克DNA），71例患者的癌症被分类为ER缺乏（<0.10 fmol/微克DNA）。52例患者在随访期间出现治疗失败。30例ER丰富肿瘤且治疗失败的患者报告的总脂肪、饱和脂肪酸和多不饱和脂肪酸摄入量高于119例ER丰富肿瘤且未出现治疗失败的患者。这些女性治疗失败的多因素比值比（OR）为，总脂肪占总能量百分比（E%）每增加1%，OR为1.08。对于前2年内的治疗失败，每10兆焦耳能量中维生素E摄入量每增加1毫克，OR为1.19。在诊断后2 - 4年出现治疗失败的女性中，总脂肪或饱和脂肪酸E%每增加1%，OR分别为1.13和1.23。对于ER缺乏癌症的女性，未发现饮食习惯与治疗失败之间存在关联。饱和脂肪酸摄入量与无病生存期之间存在剂量反应关系趋势（四分位数），但观察到的差异无统计学意义。
诊断时的饮食习惯可能会影响预后，至少对于ER丰富的乳腺癌患者如此。膳食脂肪可能会影响乳腺癌的生长或扩散，两者可能因脂肪类型而异。总脂肪和饱和脂肪酸是与治疗失败风险最密切相关的饮食参数。
饮食干预可能作为辅助治疗来改善乳腺癌预后。
