Abstract
Simple SummaryWhile most systematic reviews have focused on the association between dietary factors and breast cancer incidence, this current study focuses on the association between comprehensive dietary factors and breast cancer prognosis among breast cancer survivors by systematic review and meta-analysis. We reviewed a total of 63 cohort studies to assess the association between dietary factors and breast cancer prognosis by subgroup analysis with prediagnostic or postdiagnostic dietary intake, menopausal status, and dietary or supplementary micronutrient intake. We found that unhealthy dietary patterns, including the intake of beer and saturated fat, exacerbated the risk of breast cancer prognosis; however, the supplementation of most vitamins was desirable for breast cancer prognosis. Therefore, this study’s systematic review and meta-analysis provide useful dietary information for the development of dietary guidelines/recommendations to improve prognosis among breast cancer survivors.Few studies have summarized the association between dietary factors and breast cancer (BC) prognosis among breast cancer survivors (BCS). Therefore, we carried out a systematic review and meta-analysis to determine the associations between dietary factors and BC prognosis among BCS. We performed a literature search in PubMed and Embase to investigate the association between dietary factors and BC prognosis. We applied a random-effects model to compute the hazard ratio/relative risk and their 95% confidence intervals and heterogeneity (Higgins I2) and to generate forest plots using STATA. Among the 2279 papers identified, 63 cohort studies were included in the systematic review and meta-analysis. Our main finding was that higher consumption of beer and saturated fat negatively affected BC prognosis. However, the intake of lignans, fiber, multivitamins, and antioxidants was negatively associated with the risk of mortality. Furthermore, we performed subgroup analyses by menopausal status and dietary or supplementary micronutrient intake. Most trends were similar to the main findings; in particular, the vitamin C, vitamin D, and vitamin E supplements decreased the risk of mortality. This study’s current systematic review and meta-analysis provide comprehensive dietary information for the development of dietary guidelines/recommendations to improve prognosis among BCS.
Highlights
Breast cancer (BC) is the most commonly diagnosed cancer among women worldwide and is the leading cause of cancer death, followed by colorectal cancer and lung cancer [1]
A recent continuous update project (CUP) report suggested that higher consumption of foods containing fiber [4,5,6,7,8,9,10] and soy [11,12,13,14] and physical activity [15,16,17,18,19,20,21,22,23] may reduce the risk of all-cause mortality among breast cancer survivors (BCS)
We investigated the association between dietary factors and BC prognosis by using adjusted hazard ratio (HR) or relative risk (RR) with 95% confidence intervals (CIs) for the main analysis
Summary
Breast cancer (BC) is the most commonly diagnosed cancer among women worldwide and is the leading cause of cancer death, followed by colorectal cancer and lung cancer [1]. With advances in the early detection of BC cases and improved surgery and treatment, BC survival rates have been improved [2] It is, important to investigate how lifestyle interventions, such as diet and physical activity, influence outcomes in cancer survivors [2]. A recent CUP report suggested that higher consumption of foods containing fiber [4,5,6,7,8,9,10] and soy [11,12,13,14] and physical activity [15,16,17,18,19,20,21,22,23] may reduce the risk of all-cause mortality among breast cancer survivors (BCS). As most observational studies have selection bias due to participant recruitment methods, nutritional epidemiological analyses generally prefer prospective cohort studies [26,27]
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