title: Dietary factors and the survival of women with breast carcinoma.
abstract: BACKGROUND
  Little is known regarding how specific dietary factors affect the survival of women with breast carcinoma.
  
  
  METHODS
  Female registered nurses were followed with biennial questionnaires in a prospective cohort with 18 years of follow-up. Participants were women with breast carcinoma (n = 1982) diagnosed between 1976-1990 who completed a food frequency questionnaire after diagnosis. The main outcome measure was time to death from any cause. Analysis was made by multivariate Cox proportional hazards models.
  
  
  RESULTS
  In multivariate analyses of diet after diagnosis, no apparent association was found between fat intake and mortality. The relative risk (and 95% confidence interval) of mortality comparing the highest with the lowest quintile of protein intake was 0.65 (0.47-0.88). There was no association between red meat and mortality. These associations were similar in analyses with breast carcinoma death as the outcome.
  
  
  CONCLUSIONS
  No survival advantage was found for a low fat diet after a diagnosis of breast carcinoma. However, increased survival was observed among women eating more protein, but not red meat. The findings suggest that differences in diet may affect survival after a diagnosis of breast carcinoma and should be examined in greater detail.
authors.affiliation: Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: M D
authors.initials: MD
authors.lastname: Holmes
authors.forename: M J
authors.initials: MJ
authors.lastname: Stampfer
authors.forename: G A
authors.initials: GA
authors.lastname: Colditz
authors.forename: B
authors.initials: B
authors.lastname: Rosner
authors.forename: D J
authors.initials: DJ
authors.lastname: Hunter
authors.forename: W C
authors.initials: WC
authors.lastname: Willett
mesh_terms: D001943:Breast Neoplasms / Q000401:mortality*; D004032:Diet; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk