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    Awarded Grants
    Influence of Diet and Lifestyle on Breast Cancer Outcome

    Scientific Abstract:
    Background - Little is known about the influence of modifiable risk factors on the odds of surviving breast cancer. Clearly, women diagnosed with breast cancer are eager to know ways in which they can improve both the quality of their lives and their odds of long-term survival. Hypothesis/Objectives – We propose to examine the risk of death following the diagnosis of breast cancer according to several modifiable exposures. We hypothesize that having 1) a diet high in specific nutrients (total protein, calcium, Omega-3 fatty acids) and foods (dairy, fish and vegetables), 2) increased physical activity, or 3) regular use of NSAIDS is associated with decreased second primaries and improved survival. We hypothesize that having 1) greater body mass index and weight gain or 2) use of psychoactive drugs is associated with new cancer diagnoses and decreased survival after a diagnosis. Aims – Using an established cohort of women diagnosed with breast cancer, we will examine diet, physical activity, and drug exposures as risk factors for mortality. Linkage with state cancer registries and the National Death Index (NDI) will be used to ascertain subsequent cancer diagnoses and death, respectively. Study Design - As an adjunct to a completed multicentered population-based case-control study of breast cancer sponsored by the NCI (1988-2002), we will follow a cohort of breast cancer cases (n=7,200). Following telephone interviews for the parent study, women with breast cancer completed a mailed questionnaire on post-diagnostic diet, energy balance, medication use, alternative therapies, quality of life, and other lifestyle choices. Based on subject responses, we will calculate food and nutrient values and metabolic equivalency scores for physical activity. We will search Massachusetts, New Hampshire, and Wisconsin cancer registries to identify breast cancer and other new primaries in this cohort. Finally, we will search NDI records to identify breast cancer deaths in our cohort. We expect to identify approximately 728 cancer diagnosis or deaths. Using life table methods and proportional hazards regression, we will investigate whether diet and other aspects of lifestyle after a breast cancer diagnosis are associated with subsequent incident cancers or death. Potential Outcomes - This will be the one of the first studies to address whether dietary and lifestyle modification may reduce deaths from breast cancer. Ultimately, the research may offer active choices for women to promote survival of a diagnosis of breast cancer.

    Lay Abstract:
    Background - Little is known about the influence of modifiable risk factors on the odds of surviving breast cancer. Clearly, women diagnosed with breast cancer are eager for ways in which they can improve both the quality of their lives and their odds of long-term survival. Hypothesis/Objectives – We propose to examine the risks of death and subsequent cancer following the diagnosis of breast cancer, according to several modifiable exposures. Specifically, a healthy diet, physical activity, and regular use of aspirin and other anti-inflammatory drugs may be associated with improved survival and a decreased risk of a subsequent cancer diagnosis, while weight, weight gain and use of antidepressants may be associated with reduced survival and an increased risk of subsequent cancer. Aims – Using data from a group of women who were diagnosed with breast cancer, we will examine diet, physical activity, and drug exposures as risk factors for mortality. Subsequent cancer diagnoses will be identified using state cancer registries, and deaths will be identified using death certificates. Study Design - We will use data from 7,200 women who were diagnosed with breast cancer between 1988 and 2002 and who participated in a previous population-based study in Massachusetts, New Hampshire and Wisconsin. These women have been interviewed regarding their post-diagnostic diet, body weight, medication use, alternative therapies, quality of life, and other lifestyle factors. We now propose to search state cancer registries to identify new breast cancer and other cancers, and national death certificate records to identify breast cancer deaths in this group. We expect to identify approximately 728 cancer diagnosis or deaths. We will investigate whether diet and other aspects of lifestyle after a breast cancer diagnosis are associated with subsequent cancers or death. Potential Outcomes - This will be one of the first studies to address whether dietary and lifestyle modification may reduce deaths from breast cancer. Ultimately, the research may offer active choices for women to promote survival after a diagnosis of breast cancer.