This summary table contains detailed information about research studies. While viewing summary tables offers an informative glimpse at the science behind many breast cancer guidelines and recommendations, they should be viewed with some caution. There are a number of concepts you must understand to be able to successfully read and interpret research tables. To get some background information about understanding research tables, please see How to Read a Research Table.
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Introduction: Breast cancer survival rates vary from country to country. Many researchers have wondered whether the differences in survival may be due, in part, to differences in diet. Fat intake is of special interest. Studies have looked at whether low-fat diets improve survival, but findings are mixed.
Learn about the strengths and weaknesses of different types of studies.
Study selection criteria: Randomized controlled trials and prospective cohort studies with at least 150 participants. All studies measured fat intake after breast cancer diagnosis.
Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.
Study
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Study Population (number of participants)
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Follow-up (years)
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Fat Intake Before or After Diagnosis?
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Risk of Premature Death in Breast Cancer Survivors who Eat High Amounts of Total Fat Compared to Those who Eat Low Amounts, RR (95% CI)
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Randomized controlled trials
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Women's Healthy Eating and Living Study [1]
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3,088
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7.3
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After
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0.91 (0.72-1.15)*
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Women's Intervention Nutrition Study [2]
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2,347
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5
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After
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0.89 (0.65-1.21)†
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Prospective cohort studies
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Holmes et al. [3]
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3,846
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6.9
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After
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0.89 (0.61-1.28)
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Ewertz et al. [4]
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1,744
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5
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After
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0.96 (0.75-1.22)
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Borugian et al. [5]
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603
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10
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After
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4.8 (1.3-18.1) for premenopausal women
0.7 (0.2-2.2) for postmenopausal women
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Rohan et al. [6]
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412
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5.5
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After
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1.40 (0.66-2.96)
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Sig = Statistically significant
NS = Result not statistically significant
* Results also showed no significant difference in disease-free survival (RR = 0.96 (0.80-1.14)).
†Although results found no difference in overall survival, women randomized to a lower dietary fat intake intervention had significantly improved relapse-free survival compared to the control group.
References
1. Pierce JP, Natarajan L, Caan BJ, et al. Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women's Healthy Eating and Living (WHEL) randomized trial. JAMA. 298(3):289-98, 2007.
2. Chlebowski RT, Blackburn GL, Thomson CA, et al. Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women's Intervention Nutrition Study. J Natl Cancer Inst. 98(24):1767-76, 2006.
3. Holmes MD, Chen WY, Hankinson SE, Willett WC. Physical activity’s impact on the association of fat and fiber intake with survival after breast cancer. Am J Epidemiol. 170(10):1250-56, 2009.
4. Ewertz M, Gillanders S, Meyer L, et al. Survival of breast cancer patients in relation to factors which affect the risk of developing breast cancer. Int J Cancer. 49(4):526-30, 1991.
5. Borugian MJ, Sheps SB, Kim-Sing C, et al. Insulin, macronutrient intake, and physical activity: are potential indicators of insulin resistance associated with mortality from breast cancer? Cancer Epidemiol Biomarkers Prev. 13:1163-72, 2004.
6. Rohan TE, Hiller JE, McMichael AJ. Dietary factors and survival from breast cancer. Nutr Cancer. 20(2):167-77, 1993.
Updated 11/24/09