Follow-Up of Early Stage Breast Cancer Patients

Hebert, James

Abstract

Breast cancer is the most common malignancy among American women. Therefore, identification of factors affecting survival following a diagnosis of primary breast cancer is of major public health importance. Evidence for an effect of dietary factors such as fat and vitamin A intake on survival from breast cancer has come largely from animal models and observational studies of humans using indirect markers of dietary consumption. There have been few epidemiologic studies of specific nutrient effects on recurrence. The objective of the proposed study is to analyze follow-up data from a prospective cohort of 472 post-mastectomy women diagnosed with early stage breast cancer. This investigation is motivated by previous work with this cohort suggesting that obesity and dietary fat may influence breast cancer prognosis. Baseline medical histories and information on dietary intake and alcohol and tobacco use, were collected from 1982 to 1984 at Memorial Sloan-Kettering Cancer Center. Approximately one year after enrollment, diet was reassessed and serum cholesterol, height, and weight were measured. Data on survival on all the women in the study were collected at one, three and five years post-mastectomy. Overweight was found to be a negative prognostic indicator among the early stage patients. In order to re-examine the importance of this association and to examine the role of other factors in determining survival status, we now propose to collect all remaining vital status data for the period through 1992 and to analyze the information on site of recurrence and cause of death in relation to the baseline and one-year exposure data. This analysis will allow for the examination of the joint and independent effects of dietary intake, alcohol consumption, and prognostic indicators, such as family history, estrogen/progesterone receptor status, reproductive history, and type of therapy on breast cancer survival. This work with existing data can very efficiently contribute to the critical issue of identifying modifiable determinants of breast cancer recurrence and morbidity.