Plant-Based Dietary Patterns and Breast Cancer Recurrence and Survival in the Pathways Study

Plant-based diets are recommended for cancer survivors, but their relationship with breast cancer outcomes has not been examined. We evaluated whether long-term concordance with plant-based diets reduced the risk of recurrence and mortality among a prospective cohort of 3646 women diagnosed with bre...

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Bibliographic Details
Published in:Nutrients 2021-09, Vol.13 (10), p.3374
Main Authors: Anyene, Ijeamaka C, Ergas, Isaac J, Kwan, Marilyn L, Roh, Janise M, Ambrosone, Christine B, Kushi, Lawrence H, Cespedes Feliciano, Elizabeth M
Format: Article
Language:English
Subjects:
Breast cancer
Breast Neoplasms - pathology
cancer survival
Cardiovascular disease
Confidence Intervals
Diet
Diet, Vegetarian
dietary patterns
Ethnicity
Feeding Behavior
Female
Food
Grain
Health hazards
Humans
Legumes
lifestyle
Middle Aged
Mortality
Neoplasm Recurrence, Local - pathology
plant-based diet
Questionnaires
recurrence
Statistical models
Survival
Survival Analysis
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Summary:Plant-based diets are recommended for cancer survivors, but their relationship with breast cancer outcomes has not been examined. We evaluated whether long-term concordance with plant-based diets reduced the risk of recurrence and mortality among a prospective cohort of 3646 women diagnosed with breast cancer from 2005 to 2013. Participants completed food frequency questionnaires at diagnosis and 6-, 25-, and 72-month follow-up, from which we derived plant-based diet indices, including overall (PDI), healthful (hPDI), and unhealthful (uPDI). We observed 461 recurrences and 653 deaths over a median follow-up of 9.51 years. Using multivariable-adjusted Cox proportional hazards models, we estimated hazard ratios (HR) and 95% confidence intervals for breast cancer recurrence and all-cause, breast-cancer-specific, and non-breast-cancer mortality. Increased concordance with hPDI was associated with a reduced hazard of all-cause (HR 0.93, 95% CI: 0.83-1.05) and non-breast-cancer mortality (HR 0.83, 95% CI: 0.71-0.98), whereas increased concordance with uPDI was associated with increased hazards (HR 1.07, 95% CI: 0.96-1.2 and HR 1.20, 95% CI: 1.02-1.41, respectively). No associations with recurrence or breast-cancer-specific mortality were observed. In conclusion, healthful vs. unhealthful plant-based dietary patterns had differing associations with mortality. To enhance overall survival, dietary recommendations for breast cancer patients should emphasize healthful plant foods.
ISSN:2072-6643
2072-6643
DOI:10.3390/nu13103374