Summary
To evaluate the feasibility of using a low-fat diet (i.e. 20–25% of energy (E%) as fat) as a component of adjuvant therapy for breast cancer patients, 240 females aged 50–65 years and operated for a stage I-II breast cancer were entered into a randomized study. The intervention group (n = 121) was to reduce dietary fat intake to 20–25 E% and to increase the intake of carbohydrates. Dietary counselling complemented other adjuvant treatments and the patients were followed for two years. No dietary advice was given to patients in the control group (n = 119).
There was no significant difference between the groups in terms of base-line nutrient intake except for higher energy intake in the control group (p < 0.05). Only 52% of the patients in the intervention group followed through with the dietary regimen for two years, and 89% of the patients in the control group had a two-year follow-up. Energy intake decreased in both groups after two years, and the difference between the two groups remained (p < 0.01). Total fat intake decreased from 36.2 E% to 22.2 E% after one year in the intervention group and remained at that level after two years. Total fat intake in the control group decreased by 3.6 E% after two years.
The low compliance raises concern about the protocol design. The study nevertheless indicates that a long-term reduction of dietary fat intake can be implemented in breast cancer patients.
This is a preview of subscription content, log in via an institution to check access.
References
Armstrong B, Doll R: Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. Int J Cancer 15: 617–631, 1975
Rose DP, Boyar AP, Wynder EL: International comparison of mortality rates for cancer of the breast, ovary, prostate, and colon, and per capita food consumption. Cancer 58: 2363–2371, 1986
National Academy of Sciences. Diet, Nutrition, and Cancer. Committee on Diet, Nutrition, and Cancer. Assembly of Life Sciences, National Research Council. National Academy Press, Washington DC, 1982
Goodwin PJ, Boyd NF: Critical appraisal of the evidence that dietary fat intake is related to breast cancer risk in humans. J Natl Cancer Inst 79: 473–485, 1987
Greenwald P, Sondik E (eds.): Cancer control objectives for the nation: 1985–2000. NCI Monogr 2: 1–105, 1986
Welsch CW: Enhancement of mammary tumorigenesis by dietary fat: review of potential mechanisms. Am J Clin Nutr 45: 192–202, 1987
Morrison AS, Lowe CR, MacMahon B, Ravnikar B, Yuasa S: Some international differences in treatment and survival of breast cancer. Eur J Cancer 18: 269–273, 1976
Boyd NF, Campbell JE, Germanson T, Thomson DB, Sutherland DJ, Meakin JW: Body weight and prognosis in breast cancer. J Natl Cancer Inst 67: 785–789, 1981
Newman SC, Miller AB, Howe GR: A study of the effect of weight and dietary fat on breast cancer survival time. Am J Epidem 123: 767–773, 1986
Gregorio DI, Emrich LJ, Graham S, Marshall JR, Nemoto T: Dietary fat consumption and survival among women with breast cancer. J Natl Cancer Inst 75: 37–41, 1985
Papatestas AE, Knitle J, Lesnick G, Fagerstrom R, Mulvihill MN: Effect of dietary habits and lipids on prognosis in breast cancer. In: 3rd ECO Symposium, Aarhus, Denmark. Preresa, Brussels, European Organization for Cooperation in Cancer Prevention Studies, 1985, pp 66–67
Verreault R, Brisson J, Deschenes I, Naud F, Meyer F, Belanger L: Dietary fat in relation to prognostic indicators in breast cancer. J Natl Cancer Inst 80: 819–825, 1988
Wynder EL, Cohen LA: A rationale for dietary intervention in the treatment of postmenopausal breast cancer patients. (editorial). Nutr Cancer 3: 195–199, 1982
Chlebowski RT, Nixon DW, Blackburn GL, Jochimsen P, Scanlon EF, Insull W Jr, Buzzard IM, Elashoff R, Butrum R, Wynder EL: A breast cancer nutrition adjuvant study (NAS): protocol design and initial patient adherence. Breast Cancer Res Treat 10: 21–29, 1987
Boyar AP, Rose DP, Loughridge JR, Engle A, Palge A, Laakso K, Kinne D, Wynder EL: Response to a diet low in total fat in women with postmenopausal breast cancer: A pilot study. Nutr Cancer 11: 93–99, 1988
Boyd NF, McGuire V, Shannon P, Cousins M, Kriukow V, Mahoney L, Fish E, Lickley L, Lockwood G, Tritchler D: Effect of a low-fat, high-carbohydrate diet on symptoms of cyclical mastopathy. Lancet ii: 128–132, 1988
Boyd NF, Cousins M, Beaton M, Han L, McGuire V: Methodological issues in clinical trials of dietary fat reduction in patients with breast dysplasia. In: Ip C et al (eds.). Dietary Fat and Cancer. Allan R Liss, New York, 1986, pp 117–124.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Holm, LE., Nordevang, E., Ikkala, E. et al. Dietary intervention as adjuvant therapy in breast cancer patients — a feasibility study. Breast Cancer Res Tr 16, 103–109 (1990). https://doi.org/10.1007/BF01809294
Issue Date:
DOI: https://doi.org/10.1007/BF01809294