Abstract 5890: The effect of healthy eating on breast cancer-specific outcomes: A systematic review and meta-analysis

Abstract

Abstract Background: Breast cancer (BC) survivors attempt to change their diet after diagnosis to improve cancer-specific outcomes; however, there are many sets of guidelines available, and cancer survivors are not sure which ones are best to follow. Therefore, we examined the effect of different dietary quality indices on BC-specific outcomes in BC survivors. Methods: Web of Science and EBSCOhost were searched for relevant publications using the key terms in June 2021. Covidence software was then used for the screening and extraction of these publications. Characteristics for the included studies such as, participants, and dietary quality index were examined, and summary effect sizes were estimated for BC recurrence and BC-specific mortality using a random-effects model. Results: Across the 10 included studies (9 BC-specific mortality and 1 Recurrence; 8 Post-diagnosis and 3 pre-diagnosis diet studies), a total of 25,194 BC survivors were included in the meta-analysis, and 2,550 BC-specific deaths and 461 recurrences were observed over a follow up period of 6-17.2 years. The dietary indices evaluated were ACS (n=2), CHFP (n=2), MDS (n=2), DASH (n=3), HEI (n=8), DQIR (n=1), and RFS (n=1). Meta-analysis showed that adhering to dietary guidelines after diagnosis was associated a 4~36% reduction in BC-specific mortality with varying degrees of significance: ACS (HR=0.96, 95% CI=0.72-1.29), CHFP (HR=0.64, 95% CI=0.49-0.83), MDS (HR=0.93, 95% CI=0.70-1.24), DASH (HR=0.79, 95% CI=0.64-0.98), and HEI (HR=0.93, 95% CI=0.70-1.24). Subgroup analysis with DASH guidelines showed that the strength of the association was greater for those with ER-positive, PR-negative, or HER2-positive cancer, physically active, and older survivors compared to their respective counterparts. Only one study evaluated BC recurrence, which was insufficient to perform meta-analysis, and pre-diagnosis adherence to dietary guidelines was not associated with BC-specific mortality (HR=0.98, 95% CI=0.81-1.17). Conclusions: Healthcare providers may find it best to encourage BC survivors to comply with the DASH or CHFP dietary guidelines to improve cancer-specific mortality. Additional research should be performed to strengthen the relationship found between adherence to dietary indices and breast cancer-specific outcomes. Keywords: dietary guidelines, diet quality, breast cancer mortality, DASH, meta-analysis Citation Format: Eric Han, Vanessa Kady, Kayla Montan, Marjona Normuminova, Soomin Eum, Michael Rovito, Eunkyung Lee. The effect of healthy eating on breast cancer-specific outcomes: A systematic review and meta-analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5890.