BACKGROUND Lifestyle factors are important for cancer survival. However, empirical evidence regarding the effects of dietary changes on mortality in breast cancer survivors is sparse. OBJECTIVE The objective was to examine the associations of changes in overall diet quality, indicated by the Healthy Eating Index (HEI)-2010 score, with mortality in breast cancer survivors. DESIGN This was a prospective cohort study from September 1993 through September 30, 2015. PARTICIPANTS/SETTING This study included 2,295 postmenopausal women who were diagnosed with invasive breast cancer and completed a food frequency questionnaire both before and after the diagnosis of breast cancer in the Women's Health Initiative. MAIN OUTCOME MEASURES The HEI-2010 score (maximum score of 100) was calculated based on consumption of 12 dietary components. The outcomes were mortality from all causes, breast cancer, and causes other than breast cancer. STATISTICAL ANALYSES PERFORMED Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios of mortality from all causes, breast cancer, and other causes. RESULTS Over 12 years of follow-up, 763 deaths occurred. Compared with women with relatively stable diet quality (±14.9% change in HEI-2010 score), women who decreased diet quality (≥15% decrease in HEI-2010 score) had a higher risk of death from breast cancer (adjusted hazard ratio 1.66, 95% CI 1.09 to 2.52). Increased diet quality (≥15% increase in HEI-2010 score) was not significantly associated with lower risk of death. These associations persisted after additional adjustment for change in body mass index. CONCLUSIONS Among women with breast cancer, decreased diet quality after breast cancer diagnosis was associated with higher risk of death from breast cancer.

中文翻译：

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与绝经后乳腺癌妇女生存相关的整体饮食质量变化：妇女健康倡议的结果

背景生活方式因素对于癌症存活很重要。然而，关于饮食变化对乳腺癌幸存者死亡率影响的经验证据很少。目的 目的是检查由健康饮食指数 (HEI)-2010 得分表示的整体饮食质量变化与乳腺癌幸存者死亡率之间的关联。设计 这是一项从 1993 年 9 月到 2015 年 9 月 30 日的前瞻性队列研究。 参与者/设置 本研究包括 2,295 名被诊断患有浸润性乳腺癌的绝经后妇女，并在妇女的乳腺癌诊断前后完成了食物频率问卷调查。健康倡议。主要观察指标 HEI-2010 评分（最高 100 分）是根据 12 种膳食成分的消耗计算得出的。结果是全因死亡率、乳腺癌和非乳腺癌原因的死亡率。执行的统计分析 使用多变量 Cox 比例风险模型来估计所有原因、乳腺癌和其他原因导致的死亡率的调整风险比。结果 在 12 年的随访中，发生了 763 例死亡。与饮食质量相对稳定（HEI-2010 得分变化±14.9%）的女性相比，饮食质量下降（HEI-2010 得分降低≥15%）的女性死于乳腺癌的风险更高（调整后的风险比为 1.66） , 95% CI 1.09 至 2.52)。饮食质量的提高（HEI-2010 评分增加≥15%）与较低的死亡风险没有显着相关性。在对体重指数的变化进行额外调整后，这些关联仍然存在。结论 在患有乳腺癌的女性中，