Skip to main content
Log in

The effect of dietary exposures on recurrence and mortality in early stage breast cancer

  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

We studied the effect of diet and body weight on recurrence and death in 472 women diagnosed with early-stage breast cancer in 1982–1984. From Cox proportional hazards regression models we found that the strongest effects were observed in premenopausal women. For example, after accounting for disease stage and age, reported baseline consumption (times/day) of butter, margarine, and lard (risk ratio (RR)=1.67; 95% confidence interval (CI)=1.17–2.39) and beer (drinks/day) (RR=1.58; 95% CI=1.15–2.17) increased the risk of recurrence. There also appeared to be an increased risk associated with consumption of red meat, liver, and bacon, corresponding to about a doubling of risk for each time per day that foods in this category were consumed (RR=1.93; 95% CI=0.89–4.15). Relative body weight increased risk at the rate of 9% (RR=1.09; 95% CI=1.02–1.17) for each kg/m2 (equivalent to about 5.8 pounds for a woman 5′4″ tall). For death, the results were similar, but relative weight was more strongly associated, increasing risk by 12% per kg/m2 (RR=1.12; 95% CI=1.03–1.22).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Howson CP, Kinne D, Wynder EL: Body weight, serum cholesterol, and stage of primary breast cancer. Cancer 58: 2372–2381, 1986

    Google Scholar 

  2. Hebert JR, Augustine A, Barone J, Kabat GC, Kinne DW, Wynder EL: Weight, height and body mass in the prognosis of breast cancer: early results of a prospective study. Int J Cancer 42: 315–318, 1988

    Google Scholar 

  3. Engle A. Hebert JR, Reddy BS: Relationships between food consumption and dietary intake among healthy volunteers and implications for meeting dietary goals. J Am Diet Assoc 90: 526–533, 1990

    Google Scholar 

  4. US Dept of Agriculture: USDA nutrient data base for standard reference, release 5. USDA, Hyattsville, MD, 1985

    Google Scholar 

  5. Willett WC: Nutritional Epidemiology. Oxford University Press, Oxford, 1990

    Google Scholar 

  6. Bingham SA: The use of 24 hr urine samples and energy expenditure to validate dietary assessments. Am J Clin Nutr 59(suppl): 227S–231S, 1994

    Google Scholar 

  7. Howe GR, Miller AB, Jain M: Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 124: 157–159, 1986

    Google Scholar 

  8. National Center for Health Statistics: Division of Health Examination Statistics. Nutrient intakes of persons ages 1–74 years by age, sex and race: United States, 1891–1980, NCHS, Hyattsville, MD, 1983

    Google Scholar 

  9. Toporoff E, Hebert JR: A proxy approach to the determination of total coloric intake for use in cancer opidemiology. Nutr Cancer 13: 35–49, 1990

    Google Scholar 

  10. Kleiber M: Body size and metabolic rate. Physiol Rev 27: 511–541, 1947

    Google Scholar 

  11. Tukey JW: Exploratory Data Analysis. Addison-Wesley, Reading, MA, 1977

    Google Scholar 

  12. SAS: SAS User's Guide — Statistics Vers 6.11. SAS Institute, Cary, NC, 1997

    Google Scholar 

  13. National Center for Health Statistics, Carroll M, Abraham S. Dresser C: Source data: United States, Dietary intake 1976–80. Vital and Health Statistics. Series 11-No 231. DHH/s Pub No (PHS) 83-1681. USGPO, Washington. 1983

    Google Scholar 

  14. US Bureau of the Census: Statistical abstract of the United States: 1985. USGPO, Washington, 1984

    Google Scholar 

  15. Kabat GC, Howson CP, Wynder EL: Beer consumption and rectal cancer. Int J Epidemiol 15(4): 494–501, 1986

    Google Scholar 

  16. Kelsey JL: Breast cancer etiology: Summary and future directions. Epidemiol Rev 15(1): 256–262, 1993

    Google Scholar 

  17. Howe GR, Hirohata T, Hislop TG et al.: Dietary factors and risk of breast cancer: combined analysis of 12 case-control studies. JNCI 82: 561–569, 1990

    Google Scholar 

  18. Grodin JM, Siiteri PK, MacDonald PC: Source of estrogen production in postmenopausal women. J Clin Endocrinol Metab 36: 217–224, 1973

    Google Scholar 

  19. Rebuffe-Scrive M, Lonnroth P, Marin P, Wesslau C, Bjorntorp P, Smith U: Regional adipose tissue metabolism in men and post-menopausal women. Int J Obesity 11: 347–355, 1987

    Google Scholar 

  20. Kaye SA, Folsom AR, Soler JT, Prineas RJ, Potter JD: Associations of body mass and fat distribution with sex hormone concentrations in postmenopausal women. Int J Epidemiol 20: 151–156, 1991

    Google Scholar 

  21. Tannebaum A: Genesis and growth of tumors III. Effects of a high-fat diet. Cancer Res 2: 468–475, 1942

    Google Scholar 

  22. Hebert JR, Rosen A: Nutritional, socioeconomic and reproductive factors in relation to breast cancer mortality: findings from a cross-national study, Cancer Detect Prev 20: 234–244, 1996

    Google Scholar 

  23. Verrcault R, Brison J, Deschenes L: Dietary fat in relation to prognostic indicators in breast cancer. J Natl Cancer Inst 80: 819–825, 1988

    Google Scholar 

  24. Hunter DJ, Spiegelman D, Adami HO et al.: Cohort studies of fat intake and the risk of breast cancer — a pooled analysis. N Engl J Med 334: 356–361, 1996

    Google Scholar 

  25. Prentice R, Pepe M, Self S: Dietary fat and breast cancer: A quantitative assessment of the epidemiological literature and a discussion of methodologic issues. Cancer Res 49: 3147–3156, 1989

    Google Scholar 

  26. Kushi LH, Sellers TA, Potter JD et al.: Dietary fat and postmenopausal breast cancer. JNCI 84: 1092–1099, 1992

    Google Scholar 

  27. Willett W, Stampfer M, Colditz G, Rosner B, Hennekens C, Spiezer F: Dietary fat and the risk of breast cancer. N Engl J Med 316: 22–28, 1987

    Google Scholar 

  28. Lund E: The search tide ebbs for the dietary fat hypothesis in breast cancer. Epidemiology 5: 387–388, 1995

    Google Scholar 

  29. Prentice R: Measurement error and results from analytic epidemiology: Dietary fat and breast cancer. JNCI 88(23): 1738–1747, 1996

    Google Scholar 

  30. Schatzkin A, Greenwald P, Byar DP, Clifford CK: The dietary fat — breast cancer hypothesis is alive. JAMA 261: 3284–3287, 1989

    Google Scholar 

  31. Jain M, Miller AB, To T: Premorbid diet and the prognosis of women with breast cancer. J Natl Cancer Inst 86: 1390–1397, 1994

    Google Scholar 

  32. Gregorio DI, Emerich LJ, Graham S, Marshall JR, Nemoto T: Dietary fat consumption and survival among women with breast cancer. J Natl Cancer Inst 75: 37–41, 1985

    Google Scholar 

  33. Holm L-E, Nordevang E, Jhalmar M-E, Lidbrink E, Callmer E, Nilsson B: Treatment Failure and Dietary Habits in Women with Breast Cancer. Karolinska Hospital, Stockholm, Sweden, 1993

    Google Scholar 

  34. Rohan TE, Hiller JE, McMichael AJ: Dietary lactors and survival from breast cancer. Nutr Cancer 20: 167–177, 1993

    Google Scholar 

  35. Kyogoku S, Hirohata T, Nomura Y, Shigematsu T, Takeshita S, Hirohata I: Diet and prognosis of breast cancer. Nutr Cancer 17: 271–277, 1992

    Google Scholar 

  36. Ewertz M, Gillanders S, Meyer L, Zedeler K: Survival of breast cancer patients in relation to factors which affect the risk of developing breast cancer. Int J Cancer 49: 526–530, 1991

    Google Scholar 

  37. Hebert JR, Wynder EL: Dietary fat and the risk of breast cancer, N Engl J Med 317: 165–166, 1987

    Google Scholar 

  38. Wynder EL, Hebert JR: Homogencity in nutritional exposure: An impediment in cancer epidemiology. J Natl Cancer Inst 79: 605–607, 1987

    Google Scholar 

  39. Hebert JR, Miller DR: Methodologic considerations for investigating the diet-cancer link. Am J Clin Nutr 47: 1068–1077, 1988

    Google Scholar 

  40. Wynder EL, Taioli E, Rose DP: Breast cancer — the optimal diet. Adv Exp Med Biol 322: 143–153, 1992

    Google Scholar 

  41. Nutrition and Your Health: Dietary Guidelines for Americans. 4th ed. Home and Garden Bulletin No. 232. US Depts of Agriculture and Health and Human Services, Washington, DC, 1995

    Google Scholar 

  42. Cohen LA, Choi K, Weisburger JH, Rose DP: Effect of varying proportions of dietary fat on the development of N-ni-trosomethylurea-induced rat mammary tumors. Anticancer Res 6: 215–218, 1986

    Google Scholar 

  43. Woods MN, Barnett JB, Spiegelman D et al.: Hormone levels during dietary change in premenopausal African-American women. J Natl Cancer Inst 88: 1369–1374, 1996

    Google Scholar 

  44. Taioli E, Nicolosi A, Wynder EL: Dietary habits and breast cancer: A comparative study of United States and Italian data. Nutr Cancer 16: 259–265, 1991

    Google Scholar 

  45. O'Connell DL, Hulka BS, Chambless LE: Cigarette smoking, alcohol consumption, and breast cancer risk. J Natl Cancer Inst 78: 229–234, 1987

    Google Scholar 

  46. Van't Veer P, Kok FJ, Hermus RJJ, Sturmans F: Alcohol dose, frequency and age at first exposure in relation to the risk of breast cancer. Int J Epidemiol 18: 511–517, 1989

    Google Scholar 

  47. Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Hennekens CH, Speizer FE: Moderate alcohol consumption and the risk of breast cancer. N Engl J Med 316: 1174–1180, 1987

    Google Scholar 

  48. Hiatt RA, Klatsky AL, Armstrong MA: Alcohol consumption and the risk of breast cancer in a prepaid health plan. Cancer Res 48: 2284–2287, 1988

    Google Scholar 

  49. Lawton ME: Alcohol in breast milk, Aust NZ J Obstet Gynaecol 25: 71–73, 1985

    Google Scholar 

  50. Harvey EB, Schairer C, Brinton LA, Hoover RN, Fraumeni JF: Alcohol consumption and breast cancer. J Natl Cancer Inst 78: 657–661, 1987

    Google Scholar 

  51. Gapstur SM, Potter JD, Sellers TA, Folsom AR: Increased risk of breast cancer with alcohol consumption in postmenopausal women. Am J Epidemiol 136: 1221–1231, 1992

    Google Scholar 

  52. Jain M, Miller AB: Tumor characteristics and survival of breast cancer patients in relation to premorbid diet and body size. Breast Cancer Res Treat 42: 43–55, 1997

    Google Scholar 

  53. Goodwin PJ, Boyd NF: Body size and breast cancer prognosis: a critical review of the evidence. Breast Cancer Res Treat 16: 205–214, 1990

    Google Scholar 

  54. Boyd NF, Campbell JE, Germanson T, Thomason DB, Sutherland DJ, Meakin JW: Body weight and prognosis in breast cancer. J Natl Cancer Inst 67: 785–789, 1981

    Google Scholar 

  55. Newman SC, Miller AB, Howe GR: A study of the effect of weight and dietary fat on breast cancer survival time. Am J Epldemiol 123: 767–774, 1986

    Google Scholar 

  56. Albanes D: Total calories, body weight, and tumor incidence in mice. Cancer Res 47: 1987–1992, 1987

    Google Scholar 

  57. Zhang S, Folson AR, Sellers TA, Kushi LH, Potter JD: Better breast cancer survival for postmenopausal women who are less overweight and cat less fat. Cancer 76: 275–283, 1995

    Google Scholar 

  58. Wu AH, Ziegler RG, Horn-Ross PL et al.: Tofu and risk of breast cancer in Asian-American women. Cancer Epidemiol Biomark Prevent 5: 901–906, 1996

    Google Scholar 

  59. Kosary CL, Ries LAG, Miller BA, Hankey BF, Harras A, Edwards BK: SEER Cancer Statistics Review, 1973–1992 National Cancer Institute, Bethesda, MD, 1995

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hebert, J.R., Hurley, T.G. & Ma, Y. The effect of dietary exposures on recurrence and mortality in early stage breast cancer. Breast Cancer Res Treat 51, 17–28 (1998). https://doi.org/10.1023/A:1006056915001

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1006056915001

Navigation