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Article

Plant-Based Dietary Patterns and Breast Cancer Recurrence and Survival in the Pathways Study

1
Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
2
Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
*
Author to whom correspondence should be addressed.
Academic Editors: Wendy Demark-Wahnefried and Christina Dieli-Conwright
Nutrients 2021, 13(10), 3374; https://doi.org/10.3390/nu13103374
Received: 21 July 2021 / Revised: 21 September 2021 / Accepted: 22 September 2021 / Published: 25 September 2021
(This article belongs to the Special Issue Effect of Diet and Physical Activity on Cancer Prevention and Control)
Plant-based diets are recommended for cancer survivors, but their relationship with breast cancer outcomes has not been examined. We evaluated whether long-term concordance with plant-based diets reduced the risk of recurrence and mortality among a prospective cohort of 3646 women diagnosed with breast cancer from 2005 to 2013. Participants completed food frequency questionnaires at diagnosis and 6-, 25-, and 72-month follow-up, from which we derived plant-based diet indices, including overall (PDI), healthful (hPDI), and unhealthful (uPDI). We observed 461 recurrences and 653 deaths over a median follow-up of 9.51 years. Using multivariable-adjusted Cox proportional hazards models, we estimated hazard ratios (HR) and 95% confidence intervals for breast cancer recurrence and all-cause, breast-cancer-specific, and non-breast-cancer mortality. Increased concordance with hPDI was associated with a reduced hazard of all-cause (HR 0.93, 95% CI: 0.83–1.05) and non-breast-cancer mortality (HR 0.83, 95% CI: 0.71–0.98), whereas increased concordance with uPDI was associated with increased hazards (HR 1.07, 95% CI: 0.96–1.2 and HR 1.20, 95% CI: 1.02–1.41, respectively). No associations with recurrence or breast-cancer-specific mortality were observed. In conclusion, healthful vs. unhealthful plant-based dietary patterns had differing associations with mortality. To enhance overall survival, dietary recommendations for breast cancer patients should emphasize healthful plant foods. View Full-Text
Keywords: plant-based diet; dietary patterns; breast cancer; cancer survival; recurrence; lifestyle; survivorship plant-based diet; dietary patterns; breast cancer; cancer survival; recurrence; lifestyle; survivorship
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MDPI and ACS Style

Anyene, I.C.; Ergas, I.J.; Kwan, M.L.; Roh, J.M.; Ambrosone, C.B.; Kushi, L.H.; Cespedes Feliciano, E.M. Plant-Based Dietary Patterns and Breast Cancer Recurrence and Survival in the Pathways Study. Nutrients 2021, 13, 3374. https://doi.org/10.3390/nu13103374

AMA Style

Anyene IC, Ergas IJ, Kwan ML, Roh JM, Ambrosone CB, Kushi LH, Cespedes Feliciano EM. Plant-Based Dietary Patterns and Breast Cancer Recurrence and Survival in the Pathways Study. Nutrients. 2021; 13(10):3374. https://doi.org/10.3390/nu13103374

Chicago/Turabian Style

Anyene, Ijeamaka C., Isaac J. Ergas, Marilyn L. Kwan, Janise M. Roh, Christine B. Ambrosone, Lawrence H. Kushi, and Elizabeth M. Cespedes Feliciano. 2021. "Plant-Based Dietary Patterns and Breast Cancer Recurrence and Survival in the Pathways Study" Nutrients 13, no. 10: 3374. https://doi.org/10.3390/nu13103374

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