Breast Cancer: Diabetes Risk Reduction Diet Linked to Improved Survival Interview with:
Tengteng Wang, PhD, MSPH, MBBS
Postdoctoral Research Fellow
Department of Epidemiology
Harvard T.H. Chan School of Public Health
Channing Division of Network Medicine
Brigham and Women’s Hospital What is the background for this study? What are the main findings?

Response: Type 2 diabetes (T2D) has been associated with poor progression of breast cancer. Moreover, having a breast cancer diagnosis may also increase the risk of developing T2D. Therefore, identifying strategies for T2D prevention among breast cancer survivors may play a key role in improving their survival outcomes. One approach may be through a diabetes risk reduction diet (DRRD), a dietary pattern comprised of 9 components that has been associated with 40% lower T2D risk in a previous Nurses’ Health Study publication.1 However, no studies to date have evaluated the association between adherence to the DRRD (as measured by the DRRD score) and survival outcomes following breast cancer.

In this prospective cohort study among 8,320 breast cancer survivors, we found that greater adherence to the diabetes risk reduction diet after diagnosis was associated with a statistically significant 31% lower risk of overall mortality. Reduced breast cancer-specific mortality was also observed, which was more pronounced (20% lower risk) among those who improved adherence after diagnosis compared to women with consistently low DRRD adherence before and after diagnosis. What should readers take away from your report?

Response: The major take away is that greater adherence to a diabetes risk reduction diet (DRRD) is associated with improved survival outcomes after breast cancer diagnosis. Therefore, promoting dietary changes consistent with T2D prevention may be important for breast cancer survivors. What recommendations do you have for future research as a result of this study?

Response: Further investigation is needed to better understand the mechanism between the T2D prevention diet and breast cancer survival, especially by integrating circulating or tumor markers (i.e., C-peptide concentration, PIK3CA mutation) related to the insulin signaling pathway. We also need studies with larger sample size of breast cancer survivors to determine whether the diabetes risk reduction diet-mortality association differs by breast cancer intrinsic subtypes (i.e., luminal A, luminal B, HER2 over-expression, basal and normal-like tumors). Is there anything else you would like to add? Any disclosures?

Response: We would like to emphasize that we had repeated measures of diet after diagnosis, and used the cumulative average of repeated dietary measures after cancer diagnosis rather than a single dietary assessment. Not only does this better represent true long-term diet, but also reduces the chance of reverse causation.

We don’t have any disclosures to report

Citation: Rhee JJ, Mattei J, Hughes MD, Hu FB, Willett WC. Dietary diabetes risk reduction score, race and ethnicity, and risk of type 2 diabetes in women. Diabetes Care. 2015;38(4):596-603.

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Last Updated on December 10, 2020 by Marie Benz MD FAAD