title: Dietary patterns and survival in German postmenopausal breast cancer survivors.
abstract: BACKGROUND
  Research on the association between dietary patterns and breast cancer survival is very limited.
  
  
  METHODS
  A prospective follow-up study was conducted in Germany, including 2522 postmenopausal breast cancer patients diagnosed in 2001-2005 with available food frequency questionnaire data. Vital status, causes of death, and recurrences were verified through the end of 2009. Principle component factor analysis was used to identify pre-diagnostic dietary patterns. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with Cox proportional hazards models.
  
  
  RESULTS
  Two major dietary patterns were identified: 'healthy' (high intakes of vegetables, fruits, vegetable oil, sauces/condiments, and soups/bouillons) and 'unhealthy' (high intakes of red meat, processed meat, and deep-frying fat). Increasing consumption of an 'unhealthy' dietary pattern was associated with an increased risk of non-breast cancer mortality (highest vs lowest quartile: HR, 3.69; 95% CI, 1.66-8.17; P-trend <0.001). No associations with breast cancer-specific mortality and breast cancer recurrence were found. The 'healthy' dietary pattern was inversely associated with overall mortality (HR, 0.74; 95% CI, 0.47-1.15; P-trend=0.02) and breast cancer recurrence (HR, 0.71; 95% CI, 0.48-1.06; P-trend=0.02) in stage I-IIIa patients only.
  
  
  CONCLUSIONS
  Increasing intake of an 'unhealthy' pre-diagnostic dietary pattern may increase the risk of non-breast cancer mortality, whereas increasing intake of a 'healthy' pattern may reduce the risk of overall mortality and breast cancer recurrence.
authors.affiliation: Unit of Genetic Epidemiology, Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Vrieling
authors.forename: K
authors.initials: K
authors.lastname: Buck
authors.forename: P
authors.initials: P
authors.lastname: Seibold
authors.forename: J
authors.initials: J
authors.lastname: Heinz
authors.forename: N
authors.initials: N
authors.lastname: Obi
authors.forename: D
authors.initials: D
authors.lastname: Flesch-Janys
authors.forename: J
authors.initials: J
authors.lastname: Chang-Claude
mesh_terms: D001943:Breast Neoplasms / Q000401:mortality; D004032:Diet; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit; D005858:Germany; D006801:Humans; D008460:Meat / Q000009:adverse effects; D017698:Postmenopause; D011446:Prospective Studies; D012008:Recurrence; D017741:Survivors; D014675:Vegetables