Raadpleeg ook de literatuurlijst voedingstoffen en niet-toxische middelen en behandelingen specifiek bij borstkanker van arts-bioloog drs. Engelbert Valstar. Of specifiek bij chemo en/of bestraling. 

21 november 2020: Een eindanalyse bevestigt de resultaten zoals hieronder al beschreven: Association of Low-Fat Dietary Pattern With Breast Cancer Overall Survival

Overstappen naar een vetarm dieet met veel groenten en fruit doet de kans op overlijden aan borstkanker (en ook aan andere vormen van kanker) sterk verminderen. 

A Secondary Analysis of the Women’s Health Initiative Randomized Clinical Trial

14 december 2018: Bron: Journal of Clinical Oncology 2017 Sep 1; 35(25): 2919–2926

Wanneer vrouwen met borstkanker een leefstijl en voedingspatroon onder begeleiding gingen hanteren met vetarme voeding en veel groenten en fruit en regelmatig sporten en bewegen dan verminderen zij het risico op overlijden aan hun borstkanker aanzienlijk. Dit blijkt uit een 16,5 jarig onderzoek onder de vrouwen met borstkanker die uit de 48.835 deelnemende vrouwen werden gevolgd.

In de studie werden 48,835 postmenopauzale vrouwen (50 tot 70 jaar) met geen aantoonbare borstkanker en zonder eerder borstkanker te hebben gehad, gerandomiseerd ingedeeld in twee groepen.

1 groep kreeg onder begeleiding een dieet voorgeschreven met een vermindering van de vetinname tot 20% energie en een verhoogde inname van fruit, groenten en granen (40%, n = 19.541) De andere groep kreeg een gebruikelijk standaard dieet. (60%; n = 29.294)

De aanname van patienten gebeurde in de periode 1993 tot 1998. De studie werd uitgevoerd in 40 Amerikaanse ziekenhuizen.

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Object name is JCO.2016.72.0326f1.jpg
Fig 1.

Participant flow for analyses of deaths as a result of and after breast cancer during the 8.3- and 8.5-year (mean and median) dietary intervention period and during the 16.5- and 16.1-year (mean and median) cumulative follow-up period in analyses that incorporated all 48,835 randomly assigned participants. Vertical arrows indicate the span of conducted National Death Index searches. WHI, Women’s Health Initiative.

In de eerste 8,5 jaar kregen 1,764 vrouwen borstkanker. Van die 1765 vrouwen overleden binnen die 8,5 jaar minder mensen (27 vs. 61 doden) uit de groep vrouwen die een vetarm dieet met veel groenten en fruit plus extra beweging gebruikten in vergelijking met de groep vrouwen die hun standaard leefstijl en dieet volgden. (27 doden [0.016% per jaar] vs 61 doden [0.024% per jaar]; hazard ratio , 0.67; 95% CI, 0.43 to 1.06; P = .08).

In de daaropvolgende 8 jaar overleden uit die groep nog eens 134 vrouwen aan hun borstkanker, maar van die 134 doden waren dat er uit de dieetgroep veel minder dan uit de standaardgroep (40 doden [0.025% per jaar] versus 94 doden [0.038% per jaar]; HR, 0.65; 95% CI, 0.45 tot 0.94; P = .02).

Gedurende de totale studieduur van 16,1 jaar met totaal 3,030 vrouwen die borstkanker kregen (uit 48.835 vruwen) blijkt het aantal doden ten gevolge van borstkanker in de dieetgroep statistisch significant verminderd t.o.v. de standaard leefstijl met een standaard dieet. (234 doden [0.085% per jaar] vs 443 doden [0.11% per jaar]; HR, 0.82; 95% CI, 0.70 tot 0.96; P = .01).

Hier een grafiek uit het studierapport van het aantal sterfgevallen gerelateerd aan borstkanker:

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Fig 3.

Dietary modification influence on deaths as a result of and after breast cancer during the 8.5-year (median) dietary intervention period. (A) Kaplan-Meier cumulative hazard estimates for death as a result of breast cancer (breast cancer followed by death attributed to the cancer) during the 8.5-year (median) dietary intervention period and (B) Kaplan-Meier cumulative hazard estimates for death after breast cancer (breast cancer followed by death as a result of any cause) during the dietary intervention period among all 48,835 trial participants, with 1,764 breast cancers measured since random assignment. Summary statistics are from a Cox proportional hazards regression model stratified by age-group and random assignment in the hormone therapy trials. The P value corresponds to a two-sided score (log-rank test). HR, hazard ratio.

Arts-bioloog Engelbert Valstar merkte nog op dat als mensen vet gebruiken ze het beste voeding met goede vetten (Omega-3 vetzuren) moeten gebruiken. Dus regelmatig vette vis, noten enz. 

In het gratis toegankelijke studierapport: Low-Fat Dietary Pattern and Breast Cancer Mortality in the Women’s Health Initiative Randomized Controlled Trial worden nog drie andere grote studies genoemd die vergelijkbare resultaten laten zien. Ik vertaal dit niet maar klik op de nummers achter de zinnen voor de studierapporten:

The WHI dietary intervention findings can be compared with three randomized primary breast cancer prevention trials that evaluated tamoxifen.- In the P-1 trial in 13,388 participants, after a median 7 years of follow-up, tamoxifen reduced breast cancer incidence by 43%, but 10% more deaths occurred after breast cancer in the tamoxifen group (n = 240; not significant). In the Royal Marsden Prevention Trial in 2,471 participants, after a median 13 years of follow-up, breast cancer incidence was somewhat lower in the tamoxifen group (22% lower, P = .1), with 27 deaths after breast cancer in each randomly assigned group. In the International Breast Cancer Intervention Trial 1 in 7,154 participants, after a median 16 years follow-up, tamoxifen reduced breast cancer incidence by 29% (P < .001), but 19% more deaths occurred as a result of breast cancer (n = 57; P = .8) and 10% more deaths after breast cancer (n = 389; P = 0.4) in the tamoxifen group.

In deze studieanalyse van dezelfde studiegegevens: 

Association of Low-Fat Dietary Pattern With Breast Cancer Overall SurvivalA Secondary Analysis of the Women’s Health Initiative Randomized Clinical Trial gepubliceerd in JAMA blijkt ook dat de overall overleving verbeterde met het vetarme dieet. Met een 10-jaars overleving van resp. 78 procent versus 82 procent voor de vetarme dieet groep.

Results:

Of 1764 women diagnosed with breast cancer during the dietary intervention period, mean (SD) age at screening was 62.7 (6.7) years and age at diagnosis was 67.6 (6.9) years. With 516 total deaths, breast cancer overall survival was significantly greater for women in the dietary intervention group than in the usual-diet comparison group (10-year survival of 82% and 78%, respectively; hazard ratio , 0.78; 95% CI, 0.65-0.94; P = .01). In the dietary group there were fewer deaths from breast cancer (68 vs 120; HR, 0.86; 95% CI, 0.64-1.17), other cancers (36 vs 65; HR, 0.76; 95% CI, 0.50-1.17), and cardiovascular disease (27 vs 64; HR, 0.62; 95% CI, 0.39-0.99).

Conclusions and Relevance:

In women who received a diagnosis of breast cancer during the dietary intervention period, those in the dietary group had increased overall survival. The increase is due, in part, to better survival from several causes of death.

Trial Registration:

ClinicalTrials.gov Identifier: NCT00000611.

Hier het abstract van de WHI studie:  

Compared with a usual diet comparison group, a low-fat dietary pattern led to a lower incidence of deaths after breast cancer.

. 2017 Sep 1; 35(25): 2919–2926.
Published online 2017 Jun 27. doi:  [10.1200/JCO.2016.72.0326]
PMCID: PMC5578391
PMID: 28654363

Low-Fat Dietary Pattern and Breast Cancer Mortality in the Women’s Health Initiative Randomized Controlled Trial

Abstract

Purpose

Earlier Women’s Health Initiative Dietary Modification trial findings suggested that a low-fat eating pattern may reduce breast cancers with greater mortality. Therefore, as a primary outcome-related analysis from a randomized prevention trial, we examined the long-term influence of this intervention on deaths as a result of and after breast cancer during 8.5 years (median) of dietary intervention and cumulatively for all breast cancers diagnosed during 16.1 years (median) of follow-up.

Patients and Methods

The trial randomly assigned 48,835 postmenopausal women with normal mammograms and without prior breast cancer from 1993 to 1998 at 40 US clinical centers to a dietary intervention with goals of a reduction of fat intake to 20% of energy and an increased intake of fruits, vegetables, and grains (40%; n = 19,541) or to a usual diet comparison (60%; n = 29,294).

Results

In the dietary group, fat intake and body weight decreased (all P < .001). During the 8.5-year dietary intervention, with 1,764 incident breast cancers, fewer deaths occurred as a result of breast cancer in the dietary group, which was not statistically significant (27 deaths [0.016% per year] v 61 deaths [0.024% per year]; hazard ratio , 0.67; 95% CI, 0.43 to 1.06; P = .08). During the same period, deaths after breast cancer (n = 134) were significantly reduced (40 deaths [0.025% per year] v 94 deaths [0.038% per year]; HR, 0.65; 95% CI, 0.45 to 0.94; P = .02) by the dietary intervention. During the 16.1-year follow-up, with 3,030 incident breast cancers, deaths after breast cancer also were significantly reduced (234 deaths [0.085% per year] v 443 deaths [0.11% per year]; HR, 0.82; 95% CI, 0.70 to 0.96; P = .01) in the dietary group.

Conclusion

Compared with a usual diet comparison group, a low-fat dietary pattern led to a lower incidence of deaths after breast cancer.

ACKNOWLEDGMENT

The Women’s Health Initiative (WHI) Project Office at National Heart, Lung, and Blood Institute reviewed and approved the final manuscript but played no other role in the preparation of this report. We thank the WHI investigators, staff, and the trial participants for their outstanding dedication and commitment.

Appendix

Women’s Health Initiative Investigators

Program Office: (National Heart, Lung, and Blood Institute, Bethesda, MD) Jacques Roscoe, Shari Ludlum, Dale Burden, Joan McGowan, Leslie Ford, and Nancy Geller

Clinical Coordinating Center: (Fred Hutchinson Cancer Research Center, Seattle, WA) Garnet Anderson, Ross Prentice, Andrea LaCroix, and Charles Kopperberg)

Investigators and Academic Centers: (Brigham and Women's Hospital, Harvard Medical School, Boston, MA) JoAnn E. Manson, (MedStar Health Research Institute/Howard University, Washington, DC) Barbara V. Howard, (Stanford Prevention Research Center, Stanford, CA) Marcia L. Stefanick, (The Ohio State University, Columbus, OH) Rebecca Jackson, (University of Arizona, Tucson/Phoenix, AZ) Cynthia A. Thompson, (University at Buffalo, Buffalo, NY) Jean Wactawski-Wende, (University of Florida, Gainesville/Jacksonville, FL) Marian Limacher, (University of Iowa, Iowa City/Davenport, IA) Robert Wallace, (University of Pittsburgh, Pittsburgh, PA) Lewis Kuller, (Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA. Now at City of Hope National Medical Center, Duarte, CA) Rowan T. Chlebowski, (Wake Forest University School of Medicine, Winston-Salem, NC) Sally Shumaker

Women's Health Initiative Memory Study: (Wake Forest University School of Medicine, Winston Salem, NC) Sally Shumaker A full list of all the investigators who have contributed to Women's Health Initiative science appears at https://www.whi.org/researchers/Documents%20%20Write%20a%20Paper/WHI%20Investigator%20Long%20List.pdf.

REFERENCES

1. Prentice RL, Caan B, Chlebowski RT, et al. : Low-fat dietary pattern and risk of invasive breast cancer: The Women’s Health Initiative randomized controlled dietary modification trial. JAMA 295:629-642, 2006 [PubMed]
2. Howard BV, Manson JE, Stefanick ML, et al. : Low-fat dietary pattern and weight change over 7 years: The Women’s Health Initiative Dietary Modification trial. JAMA 295:39-49, 2006 [PubMed]
3. Thomson CA, Van Horn L, Caan BJ, et al. : Cancer incidence and mortality during the intervention and postintervention periods of the Women’s Health Initiative Dietary Modification trial. Cancer Epidemiol Biomarkers Prev 23:2924-2935, 2014 [PMC free article] [PubMed]
4. The Women’s Health Initiative Study Group : Design of the Women’s Health Initiative clinical trial and observational study. Control Clin Trials 19:61-109, 1998 [PubMed]
5. Anderson GL, Manson J, Wallace R, et al. : Implementation of the Women’s Health Initiative study design. Ann Epidemiol 13S5-S17, 2003. (suppl 9) [PubMed]
6. Patterson RE, Kristal AR, Tinker LF, et al. : Measurement characteristics of the Women’s Health Initiative food frequency questionnaire. Ann Epidemiol 9:178-187, 1999 [PubMed]
7. Tinker LF, Burrows ER, Henry H, et al: Women’s Health Initiative: Overview of the nutrition component, in Kummel DA, Kris-Atherton PM (eds): Nutrition in Women’s Health. Gaithersburg, MD, Aspen, 1996, pp 510-542.
8. National Cancer Institute: Surveillance, Epidemiology, and End Results Program. https://seer.cancer.gov.
9. Reference deleted.
10. Cancello G, Maisonneuve P, Rotmensz N, et al. : Progesterone receptor loss identifies luminal B breast cancer subgroups at higher risk of relapse. Ann Oncol 24:661-668, 2013 [PubMed]
11. Colleoni M, Giobbie-Hurder A, Regan MM, et al. : Analyses adjusting for selective crossover show improved overall survival with adjuvant letrozole compared with tamoxifen in the BIG 1-98 study. J Clin Oncol 29:1117-1124, 2011 [PMC free article] [PubMed]
12. Perez EA, Romond EH, Suman VJ, et al. : Trastuzumab plus adjuvant chemotherapy for human epidermal growth factor receptor 2-positive breast cancer: Planned joint analysis of overall survival from NSABP B-31 and NCCTG N9831. J Clin Oncol 32:3744-3752, 2014 [PMC free article] [PubMed]
13. Jiralerspong S, Goodwin PJ: Obesity and breast cancer prognosis: Evidence, challenges, and opportunities. J Clin Oncol 34:4203-4216, 2016 [PubMed]
14. Centers for Disease Control and Prevention; National Center for Health Statistics: Diet/nutrition. https://www.cdc.gov/nchs/fastats/diet.htm.
15. Chlebowski RT: Nutrition and physical activity influence on breast cancer incidence and outcome. Breast 22: S30-S37, 2013 (suppl 2) [PubMed]
16. Brennan SF, Woodside JV, Lunny PM, et al: Dietary fat and breast cancer mortality: A systematic review and meta-analysis. Crit Rev Food Sci Nutr 57:1999-2008, 2017. [PubMed]
17. Cao Y, Hou L, Wang W: Dietary total fat and fatty acids intake, serum fatty acids and risk of breast cancer: A meta-analysis of prospective cohort studies. Int J Cancer 138:1894-1904, 2016 [PubMed]
18. Boeke CE, Eliassen AH, Chen WY, et al. : Dietary fat intake in relation to lethal breast cancer in two large prospective cohort studies. Breast Cancer Res Treat 146:383-392, 2014 [PMC free article] [PubMed]
19. Kroenke CH, Kwan ML, Sweeney C, et al. : High- and low-fat dairy intake, recurrence, and mortality after breast cancer diagnosis. J Natl Cancer Inst 105:616-623, 2013 [PMC free article] [PubMed]
20. Chlebowski RT, Aiello E, McTiernan A: Weight loss in breast cancer patient management. J Clin Oncol 20:1128-1143, 2002 [PubMed]
21. Chan DS, Vieira AR, Aune D, et al. : Body mass index and survival in women with breast cancer—systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol 25:1901-1914, 2014 [PMC free article] [PubMed]
22. Ligibel JA, Chlebowski RT: Lifestyle issues in breast cancer survivors, in Harris JR, Lippman ME, Morrow M, et al (eds): Diseases of the Breast (ed 5). Philadelphia, PA, Lippincott Williams & Wilkins, 2014, pp 676-681.
23. Santen RJ, Yue W, Heitjan DF: Occult breast tumor reservoir: Biological properties and clinical significance. Horm Cancer 4:195-207, 2013 [PubMed]
24. Neuhouser ML, Howard B, Lu J, et al: A low-fat dietary pattern and risk of metabolic syndrome in postmenopausal women: The Women’s Health Initiative. Metabolism 61:1572-1581, 2012. [PMC free article] [PubMed]
25. Allison MA, Aragaki AK, Ray RM, et al: A randomized trial of a low-fat dietary intervention on blood pressure and hypertension: Tertiary analyses of the WHI Dietary Modification trial. Am J Hypertens 29:959-968, 2016. [PMC free article] [PubMed]
26. Fisher B, Costantino JP, Wickerham DL, et al. : Tamoxifen for the prevention of breast cancer: Current status of the National Surgical Adjuvant Breast and Bowel Project P-1 study. J Natl Cancer Inst 97:1652-1662, 2005 [PubMed]
27. Powles TJ, Ashley S, Tidy A, et al. : Twenty-year follow-up of the Royal Marsden randomized, double-blinded tamoxifen breast cancer prevention trial. J Natl Cancer Inst 99:283-290, 2007 [PubMed]
28. Cuzick J, Sestak I, Cawthorn S, et al. : Tamoxifen for prevention of breast cancer: Extended long-term follow-up of the IBIS-I breast cancer prevention trial. Lancet Oncol 16:67-75, 2015 [PMC free article] [PubMed]
29. Chlebowski RT: IBIS-I tamoxifen update: Maturity brings questions. Lancet Oncol 16:7-9, 2015 [PubMed]
30. Martin LJ, Li Q, Melnichouk O, et al. : A randomized trial of dietary intervention for breast cancer prevention. Cancer Res 71:123-133, 2011 [PubMed]
31. Toledo E, Salas-Salvadó J, Donat-Vargas C, et al. : Mediterranean diet and invasive breast cancer risk among women at high cardiovascular risk in the PREDIMED trial: A randomized clinical trial. JAMA Intern Med 175:1752-1760, 2015 [PubMed]

Articles from Journal of Clinical Oncology are provided here courtesy of American Society of Clinical Oncology

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