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Can a Low-Fat Diet Reduce Breast Cancer Mortality? | Cancer Network
The WHI DM trial was conducted at 40 centers in the United States. A total of 48,835 postmenopausal women aged 50 to 79 years with no history of breast cancer and a 32% or higher dietary fat intake were enrolled in the study. Participants were randomized to either a usual diet or dietary intervention group, which aimed to reduce fat to 20% of total energy intake and increase consumption of vegetables, fruits, and grains.

Compared with the usual diet group, those in the low-fat diet group successfully increased fruit, vegetable, and grain intake, and averaged a small weight loss of 3% (all P < .001). The intervention lasted a total of 8.5 years, and the researchers noted 8% fewer breast cancers in this group compared with those who did not alter their diet.

In earlier reports, deaths from breast cancer trended lower, but did not reach statistical significance. However, in this study, all-cause mortality after breast cancer diagnosis decreased during intervention (hazard ratio [HR], 0.65; 95% CI, 0.45–0.95), as well as over a median follow-up of 16.1 years.

The latest data—which increased long-term follow-up to a median of 19.6 years, with a total of 3,374 breast cancer cases recorded—confirms the reduction in all-cause mortality after diagnosis (HR, 0.85; 95% CI, 0.74–0.96). It also showed, for the first time, a reduction in mortality attributed to breast cancer (HR, 0.79; 95% CI, 0.64–0.97).

Ganz attributed the potential mechanism behind these effects to primarily to weight loss, or at least weight maintenance in the face of the metabolic slowdown that can cause women to put on a few extra pounds each year once they reach menopause. “For older women, weight gain is a risk factor for breast cancer,” she said.
breastcancer  diet 
11 days ago by cnk
ASCO: Can Changes in Diet Reduce Deaths From Breast Cancer? | Cancer Network
“To our review, this is the only study providing randomized clinical trial evidence that an intervention can reduce a woman’s risk of dying from breast cancer,” wrote Rowan T. Chlebowski, MD, PhD, FASCO, of the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, in a press release.

Data were from the Women’s Health Initiative (WHI) clinical trial, looking at dietary modification in 48,835 postmenopausal women with no previous history of breast cancer. After long-term follow-up (median, 19.6 years), 3,374 breast cancers were diagnosed. Women who followed a balanced diet that was low in fat and included daily servings of fruits, vegetables, and grains had a 21% lower risk for death from breast cancer compared with women who continued their normal diet (hazard ratio [HR], 0.79; 95% CI, 0.64–0.97).

In addition, there was a 15% reduction in deaths after breast cancer from any cause (HR, 0.85; 95% CI, 0.74–0.96).

“The important thing here is that it is worth us sticking to the message of prevention that what we eat matters,” said Lidia Schapira, MD, FASCO, an ASCO expert on breast cancer. “Postmenopausal women who take the time to think about and plan their diets will be taking an important step toward prevention and improving their health.”

The study included women age 50 to 79 years. From 1993 to 1998, they were randomly assigned to continue their normal diet (60% of patients), in which fat accounted for 32% or more of their daily calories, or a diet with a goal of reducing fat consumption to 20% of energy and which increased vegetable, fruit, and grain intake (40%).

Women assigned to the dietary intervention significantly reduced their fat intake (P < .001), and increased their fruit, vegetable, and grain intake (P < .001), all with a modest weight loss (3%).

“This is a dietary change that we think can be achievable by many because it represents dietary moderation,” Chlebowski said, noting that the diet was even more moderate than originally planned because the majority of patients in the intervention arm did not reach the 20% goal for fat consumption.
diet  breastcancer  cancer 
5 weeks ago by cnk
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BreastCancer  NotToday  from twitter
8 weeks ago by krishnau
Which Breast Cancer Risk Models Are Most Accurate? | Cancer Network
A number of breast cancer risk models are currently in use, so researchers conducted a validation study of four of these models: the International Breast Cancer Intervention Study model (IBIS); the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm model (BOADICEA); the BRCAPRO model; and the Breast Cancer Risk Assessment Tool (BCRAT, also referred to as the Gail model). They used data from the 18,856 women included in the Breast Cancer Prospective Family Study Cohort; the results were published in Lancet Oncology.

After a total median follow-up period of 11.1 years, 619 of 15,732 included women were diagnosed with breast cancer (4%). Both the IBIS and BOADICEA models were well calibrated, with a ratio of expected cases to observed cases of 1.03 and 1.05, respectively. Meanwhile, the BRCAPRO and BCRAT models underestimated the risk, with ratios of 0.59 and 0.79, respectively. The estimated C-statistics for the IBIS, BOADICEA, BRCAPRO, and BCRAT models were 0.71, 0.70, 0.68, and 0.60, respectively.

In a subanalysis based on BRCA mutation status, the BOADICEA, IBIS, and BCRAT models were similar, with ratios close to 1 for BRCA-negative women, while the ratio of expected to observed cases with the BRCAPRO model was 0.53. In BRCA-positive women, BOADICEA and IBIS again performed best.

“Our results suggest that models that include multigenerational family history, such as BOADICEA and IBIS, have better ability to predict breast cancer risk, even for women at average or below-average risk of breast cancer,” the authors concluded. “Our study shows that even though some pedigree models are well calibrated, they overpredict risk for women in the upper quantiles of familial risk and underpredict risk for those in the lower quantiles.”
breastcancer  statistics  modeling 
march 2019 by cnk
Do Fat Levels Alter Breast Cancer Risk Even Among Women With Normal BMI? | Cancer Network
Higher levels of body fat were associated with an increased risk of invasive breast cancer in an analysis of data from the Women’s Health Initiative (WHI), specifically among postmenopausal women with normal body mass index (BMI). The findings suggest that BMI may be an inadequate marker for increasing risk.


“The recognition of obesity as a risk factor for several cancers is largely based on the use of anthropometric indices, such as BMI,” wrote study authors led by Neil M. Iyengar, MD, of Memorial Sloan Kettering Cancer Center in New York. “However, BMI is a crude measure of body size that does not discriminate between adiposity and muscle.” Some recent research has suggested that elevated body fat may be a more appropriate marker for cancer risk.
breastcancer 
january 2019 by cnk

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