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000277119 1001_ $$00000-0001-9050-7590$$aCastro-Espin, Carlota$$b0
000277119 245__ $$aAssociation of Mediterranean diet with survival after breast cancer diagnosis in women from nine European countries: results from the EPIC cohort study.
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000277119 520__ $$aThe Mediterranean diet has been associated with lower risk of breast cancer (BC) but evidence from prospective studies on the role of Mediterranean diet on BC survival remains sparse and conflicting. We aimed to investigate whether adherence to Mediterranean diet prior to diagnosis is associated with overall and BC-specific mortality.A total of 13,270 incident breast cancer cases were identified from an initial sample of 318,686 women in 9 countries from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Adherence to Mediterranean diet was estimated through the adapted relative Mediterranean diet (arMED), a 16-point score that includes 8 key components of the Mediterranean diet and excludes alcohol. The degree of adherence to arMED was classified as low (score 0-5), medium (score 6-8), and high (score 9-16). Multivariable Cox proportional hazards models were used to analyze the association between the arMED score and overall mortality, and Fine-Gray competing risks models were applied for BC-specific mortality.After a mean follow-up of 8.6 years from diagnosis, 2340 women died, including 1475 from breast cancer. Among all BC survivors, low compared to medium adherence to arMED score was associated with a 13% higher risk of all-cause mortality (HR 1.13, 95%CI 1.01-1.26). High compared to medium adherence to arMED showed a non-statistically significant association (HR 0.94; 95% CI 0.84-1.05). With no statistically significant departures from linearity, on a continuous scale, a 3-unit increase in the arMED score was associated with an 8% reduced risk of overall mortality (HR3-unit 0.92, 95% CI: 0.87-0.97). This result sustained when restricted to postmenopausal women and was stronger among metastatic BC cases (HR3-unit 0.81, 95% CI: 0.72-0.91).Consuming a Mediterranean diet before BC diagnosis may improve long-term prognosis, particularly after menopause and in cases of metastatic breast cancer. Well-designed dietary interventions are needed to confirm these findings and define specific dietary recommendations.
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000277119 650_7 $$2Other$$aBreast cancer
000277119 650_7 $$2Other$$aCancer survivors
000277119 650_7 $$2Other$$aDietary patterns
000277119 650_7 $$2Other$$aMediterranean diet
000277119 650_7 $$2Other$$aProspective studies
000277119 7001_ $$aBonet, Catalina$$b1
000277119 7001_ $$aCrous-Bou, Marta$$b2
000277119 7001_ $$aNadal-Zaragoza, Núria$$b3
000277119 7001_ $$aTjønneland, Anne$$b4
000277119 7001_ $$aMellemkjær, Lene$$b5
000277119 7001_ $$aHajji-Louati, Mariem$$b6
000277119 7001_ $$aTruong, Thérèse$$b7
000277119 7001_ $$0P:(DE-He78)fb68a9386399d72d84f7f34cfc6048b4$$aKatzke, Verena$$b8$$udkfz
000277119 7001_ $$0P:(DE-He78)2d4cac0f4bf270325b98fe07036dc6c6$$aLe Cornet, Charlotte$$b9$$udkfz
000277119 7001_ $$aSchulze, Matthias B$$b10
000277119 7001_ $$aJannasch, Franziska$$b11
000277119 7001_ $$aMasala, Giovanna$$b12
000277119 7001_ $$aSieri, Sabina$$b13
000277119 7001_ $$aPanico, Salvatore$$b14
000277119 7001_ $$aDi Girolamo, Chiara$$b15
000277119 7001_ $$aSkeie, Guri$$b16
000277119 7001_ $$aBorch, Kristin Benjaminsen$$b17
000277119 7001_ $$aOlsen, Karina Standahl$$b18
000277119 7001_ $$aSánchez, Maria-Jose$$b19
000277119 7001_ $$aAmiano, Pilar$$b20
000277119 7001_ $$aChirlaque, María-Dolores$$b21
000277119 7001_ $$aGuevara, Marcela$$b22
000277119 7001_ $$aSund, Malin$$b23
000277119 7001_ $$aBodén, Stina$$b24
000277119 7001_ $$aGunter, Marc J$$b25
000277119 7001_ $$aGonzalez-Gil, Esther M$$b26
000277119 7001_ $$aWeiderpass, Elisabete$$b27
000277119 7001_ $$aAguilera-Buenosvinos, Inmaculada$$b28
000277119 7001_ $$aTsilidis, Kostas K$$b29
000277119 7001_ $$aHeath, Alicia K$$b30
000277119 7001_ $$aAune, Dagfinn$$b31
000277119 7001_ $$aDossus, Laure$$b32
000277119 7001_ $$aAgudo, Antonio$$b33
000277119 773__ $$0PERI:(DE-600)2131669-7$$a10.1186/s12916-023-02934-3$$gVol. 21, no. 1, p. 225$$n1$$p225$$tBMC medicine$$v21$$x1741-7015$$y2023
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