Association between the Dietary Inflammatory Index and Risk for Cancer Recurrence and Mortality among Patients with Breast Cancer.

Hyeonjeong Jang, Min Sung Chung, Shin Sook Kang, Yongsoon Park

Journal: Nutrients 2018;10(8):1095

PMID: 30111758

Plain Language Summary

There is evidence of a role for inflammation in cancer, and certain dietary factors may promote inflammation in the body. The dietary inflammatory index (DII) is a tool for assessing the inflammatory potential of a diet, where a lower DII score indicates a higher consumption of anti-inflammatory foods, and a higher DII score shows a higher consumption of pro-inflammatory foods. This study aimed to investigate the association between DII and the risk for cancer recurrence and death rate among patients with breast cancer in Korea. Out of 511 women, average age 52, who underwent breast cancer surgery, 88 had cancer recurrence, and 44 died during the follow–up period of 18 years. The DII was significantly higher in patients with recurrence than those without recurrence, and women with the highest DIIs were 2.3 more likely to have recurrence and 3 times more likely to die than those with the lowest DIIs. The association was significant in patients aged under 50 years, who were premenopausal, had a BMI ≥25 kg/m2, hormone receptor positive (HR+) breast cancer, tumour size >2 cm, and where the cancer had spread to the lymph nodes. The authors concluded that pro-inflammatory diets may be associated with the risk of cancer recurrence and death rate in patients with breast cancer. However, further studies must be conducted to investigate whether dietary intervention that is focused on inflammation could reduce the risk of cancer recurrence and death.

Abstract

The dietary inflammatory index (DII) has been associated with breast cancer incidence and survival. However, the association between DII and cancer recurrence and mortality among patients with breast cancer has not been investigated. Therefore, the present study aimed to investigate whether DII was positively associated with risk for cancer recurrence and overall mortality among patients with breast cancer. Among 511 women (51.9 ± 10.7 years; stage 0⁻3) who underwent breast cancer surgery, 88 had cancer recurrence, and 44 died during follow⁻up until 213 months (average disease free survival of 84.3 ± 42.4 months and overall survival of 69.3 ± 38.9 months). The DII assessed after surgery (5.4 ± 5.2 months after diagnosis) was significantly higher in patients with recurrence than those without recurrence, and Cox proportional hazards regression analysis showed that it was positively associated with the risk for cancer recurrence (hazard ratio (HR) 2.347, confidence interval (CI) 1.17⁻4.71) and overall mortality (HR 3.049, CI 1.08⁻8.83) after adjusting for confounding factors. Disease-free survival and overall survival rates were significantly lower in patients with higher DII scores. In addition, the DII was positively associated with the risk for cancer recurrence according to prognostic factors, such as age (<50 years), premenopausal status, body mass index (≥25 kg/m²), HR+, tumor size (>2 cm), and presence of lymph node metastasis. The present study showed that anti-inflammatory diets may decrease the risk of cancer recurrence and overall mortality in patients with breast cancer, particularly those with prognostic factors, such as younger age, premenopausal status, obesity, HR+ breast cancer, tumor size >2 cm, and presence of lymph node metastasis.

Address: Department of Food and Nutrition, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea. [email protected].; Department of Surgery, College of Medicine, Hanyang University, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea. [email protected].; Department of Dietetics and Nutrition Service, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. [email protected].; Department of Food and Nutrition, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea. [email protected].

DOI: 10.3390/nu10081095