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. 

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.

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

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