Matteo Di Maso1,2, Luigino Dal Maso3, Livia S A Augustin4, Antonella Puppo5, Fabio Falcini6,7, Carmen Stocco8, Veronica Mattioli3, Diego Serraino3, Jerry Polesel3. 1. Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry and Epidemiology G.A. Maccacaro, Università degli Studi di Milano, via A. Vanzetti 5, 20133 Milan, Italy. 2. Department of Public Health and Pediatric Sciences, Università degli Studi di Torino, CTO Hospital, via G. Zuretti 29, 10126 Turin, Italy. 3. Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano IRCCS, via Gallini 2, 33081 Aviano, Italy. 4. Unit of Epidemiology, Istituto Tumori Fondazione Pascale, IRCSS, via M. Semmola 1, 80131 Naples, Italy. 5. IRCCS Ospedale Policlinico San Martino, Liguria Cancer Registry, Largo R. Benzi 10, 16132 Genova, Italy. 6. Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, via P. Maroncelli 40, 47014 Meldola, Italy. 7. Azienda Usl Della Romagna, via della Rocca 19, 47121 Forlì, Italy. 8. Veneto Tumour Registry, Azienda Zero, via J. Avanzo 35, 35132 Padova, Italy.
Abstract
Adherence to Mediterranean diet has been consistently associated with a reduced mortality in the general population, but evidence for women with breast cancer is scanty. METHODS: A cohort of 1453 women with breast cancer diagnosed between 1991 and 1994 in northern Italy was followed-up for vital status for 15 years after diagnosis. The pre-diagnostic habitual diet was assessed through a structured questionnaire and adherence to the Mediterranean diet was evaluated through the Mediterranean Diet Score. Hazard ratios (HR) of death with confidence intervals (CI) were estimated using Cox model, adjusting for potential confounders. RESULTS: Compared to women who scarcely adhere to the Mediterranean diet (n = 332, 22.8%), those highly adherent (n = 500, 34.4%) reported higher intakes of carbohydrates, mono-unsaturated and poly-unsaturated fatty acids, vitamins, folate, and carotenoids, and lower intakes of cholesterol and animal proteins. Adherence to the Mediterranean diet was associated with a better prognosis: 15-year overall survival of 63.1% for high and 53.6% for low adherence, respectively (p = 0.013). HR for all-cause mortality was 0.72 (95% CI: 0.57-0.92) and HR for breast cancer mortality was 0.65 (95% CI: 0.43-0.98) for women 55 years and older. No significant association emerged for breast cancer mortality in the total cohort. CONCLUSIONS: Although dietary habits may have changed after breast cancer diagnosis, these findings indicate that women who ate according to the Mediterranean dietary pattern prior to their diagnosis may have greater chance of a favorable prognosis after breast cancer diagnosis compared to those who did not.
Adherence to Mediterranean diet has been consistently associated with a reduced mortality in the general population, but evidence for women with breast cancer is scanty. METHODS: A cohort of 1453 women with breast cancer diagnosed between 1991 and 1994 in northern Italy was followed-up for vital status for 15 years after diagnosis. The pre-diagnostic habitual diet was assessed through a structured questionnaire and adherence to the Mediterranean diet was evaluated through the Mediterranean Diet Score. Hazard ratios (HR) of death with confidence intervals (CI) were estimated using Cox model, adjusting for potential confounders. RESULTS: Compared to women who scarcely adhere to the Mediterranean diet (n = 332, 22.8%), those highly adherent (n = 500, 34.4%) reported higher intakes of carbohydrates, mono-unsaturated and poly-unsaturated fatty acids, vitamins, folate, and carotenoids, and lower intakes of cholesterol and animal proteins. Adherence to the Mediterranean diet was associated with a better prognosis: 15-year overall survival of 63.1% for high and 53.6% for low adherence, respectively (p = 0.013). HR for all-cause mortality was 0.72 (95% CI: 0.57-0.92) and HR for breast cancer mortality was 0.65 (95% CI: 0.43-0.98) for women 55 years and older. No significant association emerged for breast cancer mortality in the total cohort. CONCLUSIONS: Although dietary habits may have changed after breast cancer diagnosis, these findings indicate that women who ate according to the Mediterranean dietary pattern prior to their diagnosis may have greater chance of a favorable prognosis after breast cancer diagnosis compared to those who did not.
Entities:
Keywords:
Mediterranean diet; breast cancer; mortality; survival
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