Original paper

Cancer Causes & Control

, Volume 22, Issue 4, pp 589-598

First online:

Postdiagnosis diet quality, the combination of diet quality and recreational physical activity, and prognosis after early-stage breast cancer

  • Stephanie M. GeorgeAffiliated withNutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer InstituteDivision of Chronic Disease Epidemiology, Yale School of Public Health Email author 
  • , Melinda L. IrwinAffiliated withDivision of Chronic Disease Epidemiology, Yale School of Public Health
  • , Ashley W. SmithAffiliated withApplied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute
  • , Marian L. NeuhouserAffiliated withDivision of Public Health Sciences, Fred Hutchinson Cancer Research Center
  • , Jill ReedyAffiliated withApplied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute
  • , Anne McTiernanAffiliated withDivision of Public Health Sciences, Fred Hutchinson Cancer Research Center
  • , Catherine M. AlfanoAffiliated withOffice of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute
  • , Leslie BernsteinAffiliated withDepartment of Population Sciences, City of Hope Medical Center and Beckman Research Center
  • , Cornelia M. UlrichAffiliated withDivision of Public Health Sciences, Fred Hutchinson Cancer Research CenterGerman Cancer Research Center and National Center for Tumor Diseases
    • , Kathy B. BaumgartnerAffiliated withDepartment of Epidemiology and Population Health, University of Louisville
    • , Steven C. MooreAffiliated withNutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute
    • , Demetrius AlbanesAffiliated withNutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute
    • , Susan T. MayneAffiliated withDivision of Chronic Disease Epidemiology, Yale School of Public Health
    • , Mitchell H. GailAffiliated withBiostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute
    • , Rachel Ballard-BarbashAffiliated withApplied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute

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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 (HRQ4:Q1: 0.40, 95% CI: 0.17, 0.94) and an 88% reduced risk of death from breast cancer (HRQ4: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.

Conclusion

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.

Keywords

Diet Exercise Breast neoplasm Prognosis