Lifestyle Patterns and Survival following Breast Cancer in the Carolina Breast Cancer Study

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Citation

Parada, Humberto, Jr.; Sun, Xuezheng; Tse, Chiu-Kit J.; Olshan, Andrew F.; & Troester, Melissa A. (2019). Lifestyle Patterns and Survival following Breast Cancer in the Carolina Breast Cancer Study. Epidemiology, 30(1), 83-92. PMCID: PMC7451223

Abstract

BACKGROUND: Few studies have examined the impact of lifestyle patterns on survival following breast cancer. We aimed to identify distinct lifestyle patterns based on five behavior/dietary exposures among a population-based sample of women diagnosed with breast cancer, and to examine their association with subsequent survival.
METHODS: In the Carolina Breast Cancer Study Phases I/II, we interviewed 1,808 women aged 20-74 following diagnosis of invasive breast cancer. We determined using the National Death Index (717 deaths, 427 from breast cancer; median follow-up 13.56 years). We assessed lifestyle patterns using a latent class analysis based on five behavioral and dietary exposures: current versus never/former smokers; low versus high vegetable and fruit intake; high and low/moderate, versus no alcohol consumption; and no and low/moderate, vs. high regular physical activity. We used Cox regression to estimate covariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality, and cause-specific and subdistribution HRs for breast cancer-specific mortality within 5 years and 13 years post-diagnosis conditional on 5-year survival.
RESULTS: We identified three distinct lifestyle patterns: Healthy Behavior and Diet (n=916); Healthy Behavior and Unhealthy Diet (n=624); and Unhealthy Behavior and Diet (n=268). The Unhealthy (vs. Healthy) Behavior and Diet pattern was associated with a 13-year conditional all-cause mortality HR of 1.4 (95%CI=1.1-1.9) and with 13-year conditional breast cancer-specific and subdistribution HRs of 1.2 (95%CI=0.79-1.9) and 1.2 (95%CI=0.77-1.8), respectively.
CONCLUSIONS: Behavioral and dietary patterns can be used to identify lifestyle patterns that influence survival patterns following breast cancer diagnosis.

URL

http://dx.doi.org/10.1097/ede.0000000000000933

Reference Type

Journal Article

Year Published

2019

Journal Title

Epidemiology

Author(s)

Parada, Humberto, Jr.
Sun, Xuezheng
Tse, Chiu-Kit J.
Olshan, Andrew F.
Troester, Melissa A.

PMCID

PMC7451223

ORCiD

Olshan - 0000-0001-9115-5128