Abstract
In early 1994, a clinical trial has been initiated to definitively address, for the first time, whether a dietary fat intake reduction program can influence the clinical course of patients with breast cancer. This study, the Women’s Intervention Nutrition Study (WINS) is based on a hypothesis which is directly supported by laboratory, animal and epidemiological observations.1-3 In addition, the feasibility of prospectively testing this hypothesis has been established by a series of pilot clinical studies. 2,4-8 These results represent a culmination of over a decade of research activity and are outlined in more detail below.
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Chlebowski, R.T., D. Rose, I.M. Buzzard, G.L. Blackburn, W. Insull Jr., M. Grosvenor, R. Elashoff, and E.L. Wynder, Adjuvant dietary fat intake reduction in postmenopausal breast cancer management, Breast Cancer Res. Treat. 20:73 (1991).
Chlebowski, R.T., G.L. Blackburn, I.M. Buzzard, D.P. Rose, S. Martino, J.D. Khandekar, R.M. York, R.W. Jeffrey, R.M. Elashoff, and E.L. Wynder, For the Women’s Intervention Nutrition Study. Adherence to a dietary fat intake reduction program in postmenopausal women receiving therapy for early breast cancer, J. Clin. Oncol. 11:2072 (1993).
Cohen, L.A., D.P. Rose, and E.L. Wynder, A rationale for dietary intervention in the treatment of postmenopausal breast cancer patients: an update, Nutr. Cancer. 19:1 (1993).
Chlebowski, R.T., D.W. Nixon, G.L. Blackburn, P. Jochimsen, E.F. Scanlon, W. Insull Jr., I.M. Buzzard, R. Elashoff, R. Butrum, and E. L. Wynder, A breast cancer Nutrition Adjuvant Study (NAS): protocol design and initial patient adherence, Breast Cancer Res. Treat. 10:21 (1987).
Boyar, A.P., D.P. Rose, J. R. Loughridge, A. Engle, A. Palgi, K. Laakso, D. Kinne, and E.L. Wynder, Response to a diet low in total fat in women with postmenopausal breast cancer: a pilot study, Nutr. Cancer. 11:93 (1988).
Boyd, N.F., M. Cousins, and V. Kriukov, A randomized controlled trial of dietary fat reduction: the retention of subjects and characteristics of drop outs, J. Clin. Epidemiol. 45:31 (1992).
Holm, L.-E., E. Nordevang, E. Ikkala, L. Hallstrom, and E. Callmer, Dietary intervention as adjuvant therapy in breast cancer patients: a feasibility study, Breast Cancer Res. Treat. 16:103 (1990).
Kristal, A.R., E. White, A.L. Shattuck, S. Curry, G.L. Anderson, A. Fowler, and N. Urban, Long-term maintenance of a low-fat diet: durability of fat-related dietary habits in the Women’s Health Trial, J. Am. Diet. Assoc. 92:553 (1992).
Wynder, E.L., T. Kajitani, J. Kuno, J.C. Lucas Jr., A. de Palo, and J. Farrow, A comparison of survival rates between American and Japanese patients with breast cancer, Surg. Gynecoi Obstet. 117:196 (1963).
Sakamoto, G., H. Sugano, and W.H. Hartman, Stage-by-stage survival from breast cancer in the U.S. and Japan, Jpn. J. Cancer. 25:161 (1979).
Markka, M. and G. Sakamoto, Natural history of breast cancer among Japanese and Caucasian females, Gan To Kagaku Ryoho 17:1239 (1990).
Allen, D.S., R.D. Bulbrook, M.A. Chaudary, J.L. Hayward, M. Yoshida, S. Miura, and J.T. Murai, Recurrence and survival rates in British and Japanese women with breast cancer, Breast Cancer Res. Treat. 18:sl31 (1991).
Morrison, A.S., C.R. Lowe, B. MacMahon, B. Ravnihar, and S. Yuasa, Some international differences in treatment and survival in breast cancer, Int. J. Cancer 18:269 (1976).
Lands, W.E.M., T. Hamazaki, K. Yamazaki, H.Okuyama, K. Sakai, Y. Goto, and V.S. Hubbard, Changing dietary patterns, Am. J. Clin. Nutr. 51:991 (1990).
Nomura A.M.Y., L. Le Marchand, L.N. Kolonel, and J.H. Hankin, The effect of dietary fat on breast cancer survival among Caucasian and Japanese women in Hawaii}, Breast Cancer Res. Treat.} 18}:135s (1
Henderson, I.C., Rapporteur’s report — Treatment and response, Breast Cancer Res. Treat. 18:157s (1991).
Early Breast Cancer Trialists’ Collaborative Group, Systemic treatment of early breast cancer by hormonal cytotoxic or immune therapy, Lancet 339:1 (1992).
Willett, W.C., DJ. Hunter, M. Stampfer, G. Colditz, J.E. Manson, D. Spiegelman, B. Rosner, C.H. Hennekens, and F.E. Speizer, Dietary fat and fiber in relation to risk of breast cancer. An 8-year follow-up, JAMA 268:2037 (1992).
Howe, G.R., T. Hirohata, T.G. Hislop, J.M. Iscovich, J.-M. Yuan, K. Katsouyanni, F. Lubin, E. Marubini, B. Modan, T. Rohan, P.T. Toniolo, and Y. Shunzhang, Dietary factors and risk of breast cancer: combined analysis of 12 case-control studies, J. Natl. Cancer Inst., 82:561 (1990).
Erickson, K.L. and N.E. Hubbard, Dietary fat and tumor metastasis, Nutr. Rev. 48:6 (1990).
Rose, D.P., J.M. Connolly, and CL. Meschter, Effect of dietary fat on human breast cancer growth and lung metastasis in nude mice, J. Natl. Cancer Inst. 83:1491 (1991).
Rose, D.P. and J.M. Connolly, Influence of dietary fat intake on local recurrence and progression of metastases arising from MDA-MB-435 human breast cancer cells in nude mice after excision of the primary tumor, Nutr. Cancer 18:113 (1992).
Longcope, C, Relationships of estrogen to breast cancer, of diet to breast cancer, and of diet to estradiol metabolism, J. Natl. Cancer Inst. 82:896 (1990).
Prentice, R., D. Thompson, C. Clifford, S. Gorbach, B. Goldin, and D. Byar, Dietary fat reduction and plasma estradiol concentration in healthy postmenopausal women, J. Natl. Cancer Inst. 82:129(1990).
Rose, D.P., A. Boyar, C. Cohen, and L.E. Strong, Effect of a low-fat diet on hormone levels in women with cystic breast disease. I. Serum steroids and gonadotropins, J. Natl. Cancer Inst. 78:623 (1987).
Rose, D.P., R.T. Chlebowski, J.M. Connolly, L.A. Jones, and E.L. Wynder, The effects of tamoxifen adjuvant therapy and a low-fat diet on serum binding proteins and estradiol bioavailability in postmenopausal breast cancer patients, Cancer Res. 52:5386 (1992).
Rose, D.P., J.M. Connolly, R.T. Chlebowski, I.M. Buzzard, and E.L. Wynder, The effects of a low-fat dietary intervention and tamoxifen adjuvant therapy on the serum estrogen and sex hormone-binding globulin concentrations of postmenopausal breast cancer patients, Breast Cancer Res. Treat. 27:253 (1993).
Shimizu, H., R.K. Ross, L. Bernstein, M.C. Pike, and B.E. Henderson, Serum oestrogen levels in postmenopausal women: comparison of American whites and Japanese in Japan, Br. J. Cancer. 62:451 (1990).
Wang, D.Y., T.J.A. Key, M.C. Pike, J. Boreham, and J. Chen, Serum hormone levels in British and rural Chinese females, Breast Cancer Res. Treat. 18:41 (1991).
Senie, R.T., P.P. Rosen, P. Rhodes, M.L. Lesser, and D.W. Kinne, Obesity at diagnosis of breast carcinoma influences duration of disease-free survival, Ann. Intern. Med. 116:26 (1992).
Bastarruchea, J., G.N. Hortobagyi, T.L. Smith, S.C. Kai, and A. U. Buydan, Obesity as an adverse prognostic factor for patients receiving adjuvant chemotherapy for breast cancer, Ann. Intern. Med. 119:18 (1993).
Camoriano, J.K., C.L. Loprinzi, J.N. Ingle, T.M. Therneau, J.E. Krook, and M.H. Veeder, Weight change in women treated with adjuvant therapy or observed following mastectomy for node-positive breast cancer, J. Clin. Oncol. 8:1327 (1990).
Chlebowski, R.T, J.M. Weiner, R. Reynolds, J. Luce, L. Bulcavage, and J.R. Bateman, Long term survival following relapse after 5-FU but not CMF adjuvant breast cancer therapy, Breast Cancer Res. Treat. 7:23 (1986).
Dixon, J., D.A. Moritz, and F.L. Baker, Breast cancer and weight gain: an unexpected finding, Oncol. Nurs. Forum 5:5 (1978).
Hoskin, P.J., S. Ashley, and J.R. Yarnold, Changes in body weight after treatment for breast cancer and the effect of tamoxifen, Br. J. Cancer 62(Suppl XI):26 (1990).
Denmark-Wahnefried, W, E.P. Winer, and B.K. Rimer, Why women gain weight with adjuvant chemotherapy for breast cancer, J. Clin. Oncol. 11:1418 (1993).
Heasman, K.Z., J.H. Sutherland, J.A. Campbell, T. Elhakim, and N.F. Boyd, Weight gain during adjuvant chemotherapy for breast cancer, Breast Cancer Res. Treat. 5:195 (1986).
Gregorio, D., L. Emrich, S. Graham, J. Marshall, and T. Nemoto, Dietary fat consumption and survival among women with breast cancer, J.Natl. Cancer Inst. 75:37 (1985).
Holm, L.-E., E. Callmer, M.-L. Hjalmar, E. Lidbrink, B. Nilsson, and L. Skoog, Dietary habits and prognostic factors in breast cancer, J. Natl. Cancer Inst. 81:1218 (1989).
Holm, L.-E., E. Nordevang, M.-L. Hjalmar, E. Lidbrink, E. Callmer, and B. Nilsson, Treatment failure and dietary habits in women with breast cancer, J. Natl. Cancer Inst. 85:32 (1993).
Tretli, S., T. Haldorsen, and L. Ottestad, The effect of pre-morbid height and weight on the survival of breast cancer patients, Br. J. Cancer 62:299 (1990).
Henderson, M.M., Role of intervention trials in research on nutrition and cancer, Cancer Res. 52:2030s (1992).
Ewertz, M., S. Gillanders, L. Meyer, and K. Zedeler, Survival of breast cancer patients in relation to factors which affect the risk of developing breast cancer, Int. J. Cancer 49:526 (1991).
Rohan, T., J. Hiller, and A. McMichael, Dietary factors and survival from breast cancer, Nutr. Cancer 20:167 (1993).
Newman, S.C., A.B. Miller, and G.R Howe, A study of the effect of weight and dietary fat on breast cancer survival time, Am. J. Epidemiol. 123:767 (1986).
Kyogoku, S., T. Hirohata, Y. Nomura, T. Shigematsu, S. Takeshita, and T. Hirohata, Diet and prognosis of breast cancer, Nutr. Cancer 17:271 (1992).
Nayfield, S.G., J.E. Karp, L.G. Ford, F.A. Dori, and B.S. Kramer, Potential role of tamoxi-fen in prevention of breast cancer, J. Natl. Cancer Inst. 83:1450 (1991).
Love, R.R., P.A. Newcomb, D.A. Wiebe, T.S. Surawicz, V.C. Jordan, P.P. Carbone, and D.L. DeMets, Effects of tamoxifen therapy on lipid and lipoprotein levels in postmeno-pausal patients with node-negative breast cancer, J. Natl. Cancer Inst. 82:1327 (1990).
Buzzard, I.M., E.H. Asp, R.T. Chlebowski, A.P. Boyar, R.W. Jeffrey, D.W. Nixon, G.L. Blackburn, P.R. Jochimsen, E.F. Scanlon, W. Insull Jr., R.M. Elashoff, R. Butrum, and E.L. Wynder, Diet intervention methods to reduce fat intake: nutrient and food group composition of self-selected low-fat diets, J. Am. Diet. Assoc. 90:42 (1990).
Chlebowski, R.T, D.P. Rose, I.M. Buzzard, G.L. Blackburn, M. York, W. Insull Jr., J. Khandekar, S. Martino, R.M. Elashoff, and E.L. Wynder, Dietary fat reduction in adjuvant breast cancer therapy: current rationale and feasibility issues,Adjuvant Ther. Cancer 6:357 (1990).
Nordevang, E., E. Dckala, E. Callmer, L. Hallstrom, and L.-E. Holm, Dietary intervention in breast cancer patients: effects on dietary habits and nutrient intake, Eur. J. Clin. Nutr. 44:681 (1990).
Nordevang, E., E. Callmer, A. Marmur, and L.-E. Holm, Dietary intervention in breast cancer patients: effects on food choice, Eur. J. Clin. Nutr. 46:387 (1992).
Gorbach, S.L., A. Morrill-LaBrode, M.N. Woods, J.T. Dwyer, W.D. Selles, M. Henderson, W. Insull Jr., S. Goldman, D. Thompson, C. Clifford, and L. Sheppard, Changes in food patterns during a low-fat dietary intervention in women, J. Am. Diet. Assoc. 90:802 (1990).
Henderson, M.M., L.H. Kushi, DJ. Thompson, S.L. Gorbach, C.K. Clifford, W. Insull Jr., M. Moskowitz, and R.S. Thompson, Feasibility of a randomized trial of a low-fat diet for the prevention of breast cancer: dietary compliance in the Women’s Health Trial Vanguard Study, Prev. Med. 19:115 (1990).
Hillner, B.E. and T.J. Smith, Efficacy and cost-effectiveness of adjuvant chemotherapy in women with node-negative breast cancer: a decision-analysis model, N. Engl. J. Med. 324:160(1991).
Food and Nutrition Board: Recommended Dietary Allowances (10th rev ed.). Washington, D.C., National Academy of Sciences, 1989.
Chlebowski, R.T., G. Blackburn, J.P. Richie, and E. Wynder, Unanticipated effect of dietary fat intake reduction on HDL cholesterol in postmenopausal women receiving tamoxifen, Proc. Am. Soc. Clin. Oncol. 12:214 (1994).
Howat, P.M., R. Mohan, C. Champagne, C. Monlezun, P. Wozniak, and G.A. Bray, Validity and reliability of reported dietary intake data,J. Am. Diet. Assoc. 94:169 (1994).
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Chlebowski, R.T. (1994). Dietary Fat Intake Reduction for Patients with Resected Breast Cancer. In: Weisburger, E.K. (eds) Diet and Breast Cancer. Advances in Experimental Medicine and Biology, vol 364. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-2510-3_2
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DOI: https://doi.org/10.1007/978-1-4615-2510-3_2
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