Breast Cancer Diet "BCD": A Review of Healthy Dietary Patterns to Prevent Breast Cancer Recurrence and Reduce Mortality

Abstract

Breast cancer (BC) represents the most common cancer in women, while overweight and obesity are the second preventable cause of cancer. Weight gain and fat accumulation are common after BC diagnosis; moreover, weight gain during the treatment decreases the survival rate and increases the risk of recurrence in breast cancer survivors (BCS). To reduce the risk of second primary cancer or BC recurrence, and all-cause mortality in BCS, multiple interventions have been investigated to obtain reduction in weight, BMI and/or waist circumference. The aim of this narrative review is to analyze evidence on BCS for their risk of recurrence or mortality related to increased weight or fat deposition, and the effects of interventions with healthy dietary patterns to achieve a proper weight and to reduce fat-related risk. The primary focus was on dietary patterns instead of single nutrients and supplements, as the purpose was to investigate on secondary prevention in women free from disease at the end of their cancer treatment. In addition, BC relation with insulin resistance, dietary carbohydrate, and glycemic index/glycemic load is discussed. In conclusion, obesity and overweight, low rates of physical activity, and hormone receptor-status are associated with poorer BC-treatment outcomes. To date, there is a lack of evidence to suggest which dietary pattern is the best approach for weight management in BCS. In the future, multimodal lifestyle interventions with dietary, physical activity and psychological support after BC diagnosis should be studied with the aim of reducing the risk of BC recurrence or mortality.

Keywords: breast cancer (BC); breast cancer survival; healthy dietary patterns; secondary prevention.

Figure 1

Visual Abstract, the complex interplay between lifestyle modification and healthy weight maintenance/achievement for primary and secondary cancer prevention; healthy dietary patterns together with physical activity and psychological support can affect multiple, and not yet fully known, physiological and pathological pathways related to the excess of adipose tissue (immune system, inflammation, adipokines and inflammatory cytokines, insulin resistance and metabolic homeostasis, cell cycle signaling). Legend: BC breast cancer, DASH dietary approach to stop hypertension, DII dietary inflammatory index, CHFP Chinese food pagoda, MiRNA micro-RNA, IGFs insulin-like growth factors, * further research needed.

Figure 2

Flow diagram to describe paper identification and selection; Legend: BCS breast cancer survivors.