title: Dietary patterns and breast cancer recurrence and survival among women with early-stage breast cancer.
abstract: OBJECTIVE
  To determine the association of dietary patterns with cancer recurrence and mortality of early-stage breast cancer survivors.
  
  
  METHODS
  Patients included 1,901 Life After Cancer Epidemiology Study participants diagnosed with early-stage breast cancer between 1997 and 2000 and recruited primarily from the Kaiser Permanente Northern California Cancer Registry. Diet was assessed at cohort entry using a food frequency questionnaire. Two dietary patterns were identified: prudent (high intakes of fruits, vegetables, whole grains, and poultry) and Western (high intakes of red and processed meats and refined grains). Two hundred sixty-eight breast cancer recurrences and 226 all-cause deaths (128 attributable to breast cancer) were ascertained. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs.
  
  
  RESULTS
  Increasing adherence to a prudent dietary pattern was associated with a statistically significant decreasing risk of overall death (P trend = .02; HR for highest quartile = 0.57; 95% CI, 0.36 to 0.90) and death from non-breast cancer causes (P trend = .003; HR for highest quartile = 0.35; 95% CI, 0.17 to 0.73). In contrast, increasing consumption of a Western dietary pattern was related to an increasing risk of overall death (P trend = .05) and death from non-breast cancer causes (P = .02). Neither dietary pattern was associated with risk of breast cancer recurrence or death from breast cancer. These observations were generally not modified by physical activity, being overweight, or smoking.
  
  
  CONCLUSIONS
  Women diagnosed with early-stage breast cancer might improve overall prognosis and survival by adopting more healthful dietary patterns.
authors.affiliation: Division of Research, Kaiser Permanente, Oakland, CA, USA. Marilyn.L.Kwan@kp.org
authors.forename: Marilyn L
authors.initials: ML
authors.lastname: Kwan
authors.forename: Erin
authors.initials: E
authors.lastname: Weltzien
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Kushi
authors.forename: Adrienne
authors.initials: A
authors.lastname: Castillo
authors.forename: Martha L
authors.initials: ML
authors.lastname: Slattery
authors.forename: Bette J
authors.initials: BJ
authors.lastname: Caan
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology; D004032:Diet / Q000401:mortality*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality*; D011379:Prognosis; D016019:Survival Analysis