title: Dietary intake of fish, polyunsaturated fatty acids, and survival after breast cancer: A population-based follow-up study on Long Island, New York.
abstract: BACKGROUND
  In laboratory experiments, ω-3 polyunsaturated fatty acids (PUFAs) have been found to reduce inflammatory eicosanoids resulting from ω-6 PUFA metabolism via competitive inhibition, and the ω-3-induced cytotoxic environment increases apoptosis and reduces cell growth in breast cancer cells. To the authors' knowledge, epidemiologic investigations regarding whether dietary ω-3 PUFA intake benefits survival after breast cancer are limited and inconsistent.
  
  
  METHODS
  The authors used resources from a population-based follow-up study conducted on Long Island, New York, among 1463 women newly diagnosed with first primary breast cancer who were interviewed an average of approximately 3 months after diagnosis to assess risk and prognostic factors, including dietary intake (using a food frequency questionnaire). Vital status was determined through 2011, yielding a median follow-up of 14.7 years and 485 deaths. Adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using Cox proportional hazards regression.
  
  
  RESULTS
  All-cause mortality was reduced among women with breast cancer reporting the highest quartile of intake (compared with never) for tuna (HR, 0.71; 95% CI, 0.55-0.92), other baked/broiled fish (HR, 0.75; 95% CI, 0.58-0.97), and the dietary long-chain ω-3 PUFAs docosahexaenoic acid (HR, 0.71; 95% CI, 0.55-0.92) and eicosapentaenoic acid (HR, 0.75; 95% CI, 0.58-0.97).
  
  
  CONCLUSIONS
  All-cause mortality was reduced by 16% to 34% among women with breast cancer who reported a high intake of fish and long-chain ω-3 PUFAs. Long-chain ω-3 PUFA intake from fish and other dietary sources may provide a potential strategy to improve survival after breast cancer.
authors: Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina.
authors: Nikhil K
authors: NK
authors: Khankari
authors: Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina.
authors: Patrick T
authors: PT
authors: Bradshaw
authors: Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina.
authors: Susan E
authors: SE
authors: Steck
authors: Department of Epidemiology and Biostatistics, Indiana University, Bloomington, Indiana.
authors: Ka
authors: K
authors: He
authors: Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina.
authors: Andrew F
authors: AF
authors: Olshan
authors: Department of Environmental Health, Columbia University, New York, New York.
authors: Jing
authors: J
authors: Shen
authors: Department of Population Health, New York University, New York, New York.|Department of Environmental Medicine, New York University, New York, New York.
authors: Jiyoung
authors: J
authors: Ahn
authors: Department of Population Health, New York University, New York, New York.|Department of Environmental Medicine, New York University, New York, New York.
authors: Yu
authors: Y
authors: Chen
authors: Department of Health Studies and Comprehensive Cancer Center, University of Chicago, Chicago, Illinois.
authors: Habibul
authors: H
authors: Ahsan
authors: Department of Epidemiology, Columbia University, New York, New York.
authors: Mary Beth
authors: MB
authors: Terry
authors: Department of Preventive Medicine, Mount Sinai School of Medicine, New York, New York.
authors: Susan L
authors: SL
authors: Teitelbaum
authors: Department of Epidemiology, Columbia University, New York, New York.|Department of Medicine, Columbia University, New York, New York.
authors: Alfred I
authors: AI
authors: Neugut
authors: Department of Environmental Health, Columbia University, New York, New York.
authors: Regina M
authors: RM
authors: Santella
authors: Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina.
authors: Marilie D
authors: MD
authors: Gammon
mesh_terms: D000818:Animals; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000401:mortality; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009518:New York / Q000453:epidemiology; D017747:Seafood; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D015525:Fatty Acids, Omega-3; D005231:Fatty Acids, Unsaturated
keywords: all-cause mortality; breast cancer; polyunsaturated fatty acids PUFAs; survival