Sm. Zhang et al., BETTER BREAST-CANCER SURVIVAL FOR POSTMENOPAUSAL WOMEN WHO ARE LESS OVERWEIGHT AND EAT LESS FAT - THE IOWA WOMENS HEALTH STUDY, Cancer, 76(2), 1995, pp. 275-283
Background. The authors sought to determine whether prediagnosis obesi
ty, body-fat distribution, and dietary intake of fats, antioxidants, a
nd fiber may be related to survival after the diagnosis of breast canc
er. Methods. The mortality rates of 698 postmenopausal patients with u
nilateral breast cancer in a large cohort study were analyzed. Body-ma
ss index, waist-to-hip ratio, and food-frequency data were collected b
y questionnaire within 6 years before breast cancer was diagnosed. Res
ults. Adjusted for age, women in the highest tertile of body mass inde
x had a 1.9-fold higher risk (95% confidence interval = 1.0-3.7) of dy
ing after breast cancer than those in the lowest tertile; adjusted for
other prognostic variables (age, smoking, education level, extent of
breast cancer, and tumor size), this relative risk was 1.5 (95% CI = 0
.7 to 2.9). Waist-to-hip ratio was not related to risk of dying nor wa
s intake of fiber or several dietary antioxidants, Independent of othe
r prognostic variables, risk of death after breast cancer was statisti
cally significantly elevated, with a relative risk greater than 2.0 fa
r the highest tertiles of total fat, saturated fat, and monounsaturate
d fat intake, expressed as grams per day. An adjustment for energy int
ake, which also was associated positively with fatality, weakened thes
e associations somewhat. Conclusions. Although clinical trials are req
uired, these findings support the hypothesis that a high fat intake is
associated with reduced survival of postmenopausal women with breast
cancer and suggest that women with breast cancer should consider limit
ing their intake of fat.