Survival analyses from the Women's Intervention Nutrition Study (WINS) evaluating dietary fat reduction and breast cancer outcome

Chlebowski, Rowan T.; Blackburn, George L.; Hoy, M. Katherine; Thomson, CA; Giuliano, Armando E.; McAndrew, Philomena F.; Hudis, C.; Butler, James R.G.; Shapiro, Amos; Elashoff, Robert M.; Study, Women's Intervention Nutrition

doi:10.1200/jco.2008.26.15_suppl.522

Cited by 36 publications

(22 citation statements)

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“…Furthermore, there is recent evidence of the efficacy of nonpharmacologic interventions that reduce insulin resistance in affecting breast cancer outcomes. For example, in the Women's Intervention Nutrition Study,24, 51 lower dietary fat intake and weight loss in the intervention group correlated with lower rates of disease recurrence (9.8% vs 12.4%) and death (7.5% vs 18.1%) compared with the control group. In the subgroup analyses, dietary fat reduction had a greater effect on RFS in women with ER‐negative breast tumors.…”

Section: Discussionmentioning

confidence: 96%

Effect of metformin on survival outcomes in diabetic patients with triple receptor‐negative breast cancer

Bayraktar

Hernadez-Aya

Lei

et al. 2011

Cancer

161

143

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Background Recent observational studies have shown that metformin use in diabetics decreases both cancer incidence and mortality. Metformin use is also independently predictive of pathologic complete response. We explored the association between metformin use and survival outcomes in patients with triple receptor-negative breast cancer (TNBC) receiving adjuvant chemotherapy. Methods The Breast Cancer Management System database of The University of Texas M.D. Anderson Cancer Center identified 1448 women who received adjuvant chemotherapy for TNBC between 1995 and 2007. Patients were categorized by diabetes status and metformin use. Kaplan-Meier product limit method was used to calculate distant metastasis-free survival (DMFS), recurrence-free survival (RFS), and overall survival (OS). Cox proportional hazards models were fit to determine the association between metformin use and survival outcomes. Results Our study cohort consisted of 63 diabetic patients taking metformin, 67 diabetic patients not taking metformin, and 1318 non-diabetic patients. Patients in the diabetic groups tended to be older (P=0.005); more diabetic patients were postmenopausal (P=0.0007), black (P=0.0001), and obese (P < 0.0001). At a median follow-up of 62 months, there were no significant differences in 5-year DMFS (P=0.23), RFS (P=0.38), and OS (P=0.58) between the three groups. Compared to the metformin group, patients who did not take metformin (Hazard ratio [HR]=1.63; 95% CI:0.87 to 3.06; P=0.13) and nondiabetics (HR=1.62; 95% CI:0.97 to 2.71; P=0.06) tended to have a higher risk of distant metastases. Conclusion Our findings suggest that metformin use during adjuvant chemotherapy does not significantly impact survival outcomes in diabetic patients with TNBC.

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Section: Discussionmentioning

confidence: 96%

Effect of metformin on survival outcomes in diabetic patients with triple receptor‐negative breast cancer

Bayraktar

Hernadez-Aya

Lei

et al. 2011

Cancer

161

143

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“…38 An analysis after a median follow-up of 9 years that was presented at ASCO showed that a low-fat diet conferred a statistically significant improvement in survival for women with ER-positive cancers. 39 In contrast, Women's Health Initiative Randomized Controlled Dietary Modification Trial (WHI-DMT) was a primary-prevention randomized trial of a low-fat diet in healthy postmenopausal women. 40 The groups did not differ in weight after the intervention, and no difference in breast cancer incidence was seen.…”

Section: Lifestyle Modificationmentioning

confidence: 99%

Risk Reduction Strategies for Ductal Carcinoma In Situ

Cohen

Ward

2010

J Natl Compr Canc Netw

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Ductal carcinoma in situ (DCIS) is a premalignant condition that, if left untreated, may progress to invasive breast cancer. After lumpectomy, DCIS can recur, and about half of recurrences are invasive. In 4 randomized trials, radiation has been shown to decrease the local recurrence rate by about half, though it does not change survival. Based on the results of 3 randomized trials, tamoxifen probably decreases cancer recurrence by about 30%, particularly in young women. Low fat diets, weight loss, and physical activity decrease invasive breast cancer recurrence and may be recommended to certain women with DCIS. Prognostic factors include age, extent of DCIS, margin status, grade, and presence of necrosis, although how these affect adjuvant therapy is unclear. Research evaluating other drugs to reduce recurrence risk and on different ways of delivering radiation continues.

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“…Cet essai s'est interrompu faute de financement avec un nombre d'é vé nements infé rieur aux hypothè ses initiales, et plusieurs critiques peuvent ê tre formulé es [29] concernant notamment le dé séquilibre dans le taux de traitements conservateurs entre les deux bras et le choix des autoquestionnaires. À cinq ans, on observe, lors de l'analyse intermé diaire, une ré duction du risque de rechute de 24 % dans le bras expé rimental avec un p = 0,034 (modè le de Cox, log-rank non significatif), mais plus aucune significativité n'est observé e dans la seconde analyse [7], sauf dans la population RH né gatifs. Si cela ouvre la voie à des straté gies d'intervention notamment chez les femmes atteintes de tumeurs « triples né gatives », l'inté rê t majeur de l'essai WINS est peut-ê tre simplement de monter que la modification du style de vie aprè s traitement du cancer du sein peut ê tre conduite avec succè s à grande é chelle.…”

Section: O N C O L O G I Eunclassified

Dietary interventions in cancer survivors: facts and fiction

Zelek

Escure

2008

Oncologie

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Survival analyses from the Women's Intervention Nutrition Study (WINS) evaluating dietary fat reduction and breast cancer outcome

Cited by 36 publications

References 0 publications

Effect of metformin on survival outcomes in diabetic patients with triple receptor‐negative breast cancer

Effect of metformin on survival outcomes in diabetic patients with triple receptor‐negative breast cancer

Risk Reduction Strategies for Ductal Carcinoma In Situ

Dietary interventions in cancer survivors: facts and fiction

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