title: Postdiagnosis diet quality, the combination of diet quality and recreational physical activity, and prognosis after early-stage breast cancer.
abstract: OBJECTIVE
  To investigate, among women with breast cancer, how postdiagnosis diet quality and the combination of diet quality and recreational physical activity are associated with prognosis.
  
  
  METHODS
  This multiethnic, prospective observational cohort included 670 women diagnosed with local or regional breast cancer. Thirty months after diagnosis, women completed self-report assessments on diet and physical activity and were followed for 6 years. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals for death from any cause and breast cancer death.
  
  
  RESULTS
  Women consuming better-quality diets, as defined by higher Healthy Eating Index-2005 scores, had a 60% reduced risk of death from any cause (HR(Q4:Q1): 0.40, 95% CI: 0.17, 0.94) and an 88% reduced risk of death from breast cancer (HR(Q4:Q1): 0.12, 95% CI: 0.02, 0.99). Compared with inactive survivors consuming poor-quality diets, survivors engaging in any recreational physical activity and consuming better-quality diets had an 89% reduced risk of death from any cause (HR: 0.11, 95% CI: 0.04, 0.36) and a 91% reduced risk of death from breast cancer (HR: 0.09, 95% CI: 0.01, 0.89). Associations observed were independent of obesity status.
  
  
  CONCLUSIONS
  Women diagnosed with localized or regional breast cancer may improve prognosis by adopting better-quality dietary patterns and regular recreational physical activity. Lifestyle interventions emphasizing postdiagnosis behavior changes are advisable in breast cancer survivors.
authors.affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd., Suite 320, MSC 7232, Rockville, MD 20852, USA. materess@mail.nih.gov
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: George
authors.forename: Melinda L
authors.initials: ML
authors.lastname: Irwin
authors.forename: Ashley W
authors.initials: AW
authors.lastname: Smith
authors.forename: Marian L
authors.initials: ML
authors.lastname: Neuhouser
authors.forename: Jill
authors.initials: J
authors.lastname: Reedy
authors.forename: Anne
authors.initials: A
authors.lastname: McTiernan
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Alfano
authors.forename: Leslie
authors.initials: L
authors.lastname: Bernstein
authors.forename: Cornelia M
authors.initials: CM
authors.lastname: Ulrich
authors.forename: Kathy B
authors.initials: KB
authors.lastname: Baumgartner
authors.forename: Steven C
authors.initials: SC
authors.lastname: Moore
authors.forename: Demetrius
authors.initials: D
authors.lastname: Albanes
authors.forename: Susan T
authors.initials: ST
authors.lastname: Mayne
authors.forename: Mitchell H
authors.initials: MH
authors.lastname: Gail
authors.forename: Rachel
authors.initials: R
authors.lastname: Ballard-Barbash
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D002277:Carcinoma / Q000175:diagnosis* / Q000628:therapy*; D015331:Cohort Studies; D004032:Diet / Q000592:standards; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009367:Neoplasm Staging; D009749:Nutrition Surveys; D011379:Prognosis; D011786:Quality Control; D011788:Quality of Life; D011998:Recreation / Q000502:physiology*