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Diet and Breast Cancer Recurrence—Reply
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In Reply: Over the last decade, the National Cancer Institute funded 2 large randomized trials on the effect of diet on recurrent breast cancer events (WHEL and WINS). These studies enrolled different populations and studied different dietary patterns. Nevertheless, both interventions aimed to reduce dietary fat intake. The WHEL intervention initially reduced fat intake and maintained a significant between-group difference over 4 years.1 However, the intervention did not influence breast cancer outcomes, and results did not suggest a differential benefit depending on baseline dietary fat intake. This finding is at odds with the WINS interim analysis, in which a reduction in fat intake approached statistical significance on breast cancer outcomes using the appropriate a priori test.2 The question is how to interpret this apparent inconsistency.
One explanation could be that the reduction in dietary fat intake in the WHEL study was not of sufficient magnitude to promote change in the . . . [Full Text of this Article]
John P. Pierce, PhD
jppierce@ucsd.edu
Moores UCSD Cancer Center
University of California, San Diego
La Jolla
Bette J. Caan, DrPH
Division of Research
Kaiser Permanente Northern California
Oakland
Cheryl Ritenbaugh, PhD, MPH
Department of Family and Community Medicine
University of Arizona
Tucson
Cheryl L. Rock, PhD, RD;
Loki Natarajan, PhD
Moores UCSD Cancer Center
University of California, San Diego
La Jolla
RELATED LETTER
Diet and Breast Cancer Recurrence
Rowan T. Chlebowski and George L. Blackburn
JAMA. 2007;298(18):2135.
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