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JNCI Journal of the National Cancer Institute 2007 99(11):899-900; doi:10.1093/jnci/djk205
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© The Author 2007. Published by Oxford University Press.

CORRESPONDENCE

Re: Dietary Fat Reduction and Breast Cancer Outcome: Interim Efficacy Results From the Women's Intervention Nutrition Study

Mevlut Kurt, Kadri Altundag

Affiliation of authors: Department of Medical Oncology, Hacettepe University Institute of Oncology, Ankara, Turkey

Correspondence to: Kadri Altundag, MD, Department of Medical Oncology, Hacettepe University Institute of Oncology, Sihhiye Ankara 06100, Turkey (e-mail: drkadri{at}usa.net).

We read with interest the article by Chlebowski et al. (1), in which the authors investigated the effect of a dietary intervention designed to reduce fat intake in women with resected early-stage breast cancer receiving conventional cancer management. After approximately 5 years of follow-up, women in the dietary intervention group had a 24% lower risk of relapse than those in the control group (hazard ratio = 0.76; 95% confidence interval = 0.60 to 0.98). Exploratory analyses suggested a differential effect of the dietary intervention based on hormonal receptor status such that there was a stronger effect for dietary fat reduction on breast cancer recurrence in women with hormone receptor–negative cancers than in women with hormone receptor–positive cancers. Saphner et al. (2) found that, when compared with estrogen receptor (ER)–negative status, a positive ER status was associated with a lower peak hazard of recurrence in the first 5 years but a higher hazard of recurrence from years 5–12. This means that the ER-negative recurrences occur more frequently in early follow-up and ER-positive recurrences occur more frequently in later follow-up. Because more recurrences are observed in ER-positive patients between 5 and 12 years, it seems possible that the differential effect of the dietary intervention on hormonal receptor status may be reduced after longer follow-up of these patients.

REFERENCES

(1) Chlebowski RT, Blackburn GL, Thomson CA, Nixon DW, Shapiro A, Hoy MK, et al. Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women's Intervention Nutrition Study. J Natl Cancer Inst (2006) 98:1767–76.[Abstract/Free Full Text]

(2) Saphner T, Tormey DC, Gray R. Annual hazard rates of recurrence for breast cancer after primary therapy. J Clin Oncol (1996) 14:2738–46.[Abstract/Free Full Text]


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Related Article in JNCI

Dietary Fat Reduction and Breast Cancer Outcome: Interim Efficacy Results From the Women's Intervention Nutrition Study
Rowan T. Chlebowski, George L. Blackburn, Cynthia A. Thomson, Daniel W. Nixon, Alice Shapiro, M. Katherine Hoy, Marc T. Goodman, Armando E. Giuliano, Njeri Karanja, Philomena McAndrew, Clifford Hudis, John Butler, Douglas Merkel, Alan Kristal, Bette Caan, Richard Michaelson, Vincent Vinciguerra, Salvatore Del Prete, Marion Winkler, Rayna Hall, Michael Simon, Barbara L. Winters, and Robert M. Elashoff
J Natl Cancer Inst 2006 98: 1767-1776. [Abstract] [Full Text] [PDF]

Response to this Correspondence

Response: Re: Dietary Fat Reduction and Breast Cancer Outcome: Interim Efficacy Results From the Women's Intervention Nutrition Study
Rowan T. Chlebowski and George L. Blackburn
J Natl Cancer Inst 2007 99: 900-901. [Extract] [Full Text] [PDF]



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