Dietary pattern influences breast cancer prognosis in women without hot flashes: the women's healthy eating and living trial.
OBJECTIVE
To determine whether a low-fat diet high in vegetables, fruit, and fiber differentially affects prognosis in breast cancer survivors with hot flashes (HF) or without HF after treatment.


METHODS
A secondary analysis was conducted on 2,967 breast cancer survivors, age 18 to 70 years, who were randomly assigned between 1995 and 2000 in a multicenter, controlled trial of a dietary intervention to prevent additional breast cancer events and observed through June 1, 2006. We compared the dietary intervention group with a group who received five-a-day dietary guidelines.


RESULTS
Independent of HF status, a substantial between-group difference among those who did and did not receive dietary guidelines was achieved and maintained at 4 years in intake of vegetable/fruit servings per day (54% higher; 10 v 6.5 servings/d, respectively), fiber (31% higher; 25.5 v 19.4 g/d, respectively), and percent energy from fat (14% lower; 26.9% v 31.3%, respectively). Adjusting for tumor characteristics and antiestrogen treatment, HF-negative women assigned to the intervention had 31% fewer events than HF-negative women assigned to the comparison group (hazard ratio [HR] = 0.69; 95% CI, 0.51 to 0.93; P = .02). The intervention did not affect prognosis in the women with baseline HFs. Furthermore, compared with HF-negative women assigned to the comparison group, HF-positive women had significantly fewer events in both the intervention (HR = 0.77; 95% CI, 0.59 to 1.00; P = .05) and comparison groups (HR = 0.65; 95% CI, 0.49 to 0.85; P = .002).


CONCLUSIONS
A diet with higher vegetable, fruit, and fiber and lower fat intakes than the five-a-day diet may reduce risk of additional events in HF-negative breast cancer survivors. This suggestive finding needs confirmation in a trial in which it is the primary hypothesis.
Gold
Ellen B
EB
Department of Public Health Sciences, University of California, Davis, Davis, CA, USA.
Pierce
John P
JP
Natarajan
Loki
L
Stefanick
Marcia L
ML
Laughlin
Gail A
GA
Caan
Bette J
BJ
Flatt
Shirley W
SW
Emond
Jennifer A
JA
Saquib
Nazmus
N
Madlensky
Lisa
L
Kealey
Sheila
S
Wasserman
Linda
L
Thomson
Cynthia A
CA
Rock
Cheryl L
CL
Parker
Barbara A
BA
Karanja
Njeri
N
Jones
Vicky
V
Hajek
Richard A
RA
Pu
Minya
M
Mortimer
Joanne E
JE
D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000178:diet therapy*; D018752:Diet, Fat-Restricted; D004043:Dietary Fiber / Q000008:administration & dosage; D005260:Female; D005638:Fruit; D019584:Hot Flashes; D006801:Humans; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014675:Vegetables