Abstract GS2-09: Diabetes risk reduction diet and survival following breast cancer

Abstract

Importance: Type 2 diabetes (T2D) is associated with poor breast cancer prognosis. Adherence to a dietary pattern associated with lower T2D risk may improve breast cancer outcomes. Objective: To evaluate the association between adherence to a diabetes risk reduction diet (DRRD) after diagnosis and survival outcomes following breast cancer. Method: We followed 8,320 women diagnosed with stage I-III breast cancer from two large prospective cohort studies, the Nurses’ Health Study (NHS; 1980-2014) and the NHSII (1991-2015). Information on diet and other covariates was repeatedly measured in validated follow-up questionnaires every two to four years. The DRRD adherence score includes 9 dietary components: higher intakes of cereal fiber, coffee, nuts, whole fruits and polyunsaturated:saturated fat ratio; and lower glycemic index of diet, lower intakes of trans fat, sugar-sweetened beverages/fruit juices, and red meat. Cumulative average DRRD score was calculated using repeated measures of diet after breast cancer diagnosis. Deaths were reported by family members or via the search of National Death Index, and cause of death was assigned by reviewing death certificates/medical records. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between DRRD score and breast cancer-specific and all-cause mortality were estimated using Cox proportional hazards models. Results: During a median of 16 years of follow-up after diagnosis, we ascertained 2,146 deaths, of which 948 were due to breast cancer. In the multivariable-adjusted models, women with higher post-diagnostic DRRD scores had a 17% lower risk of breast cancer-specific mortality (top vs. bottom quintile HR =0.83; 95%CI=0.67-1.02; p-trend=0.03) and 33% lower risk of all-cause mortality (HR =0.67; 95%CI=0.58-0.78; p-trend Conclusion: We found that greater adherence to the DRRD after breast cancer diagnosis was associated with better survival, suggesting dietary modification after diagnosis consistent with T2D prevention may be important to breast cancer survivors. Citation Format: Tengteng Wang, Maryam Farvid, Jae Hee Kang, Michelle Holmes, Bernard Rosner, Rulla Tamimi, Walter Willett, A. Heather Eliassen. Diabetes risk reduction diet and survival following breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr GS2-09.