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Risk of Breast Cancer Recurrence Associated with Carbohydrate Intake and Tissue Expression of IGF-1 Receptor

Emond, Jennifer A.; Pierce, John P.; Natarajan, Loki; Gapuz, Laarni R.; Nguyen, John; Parker, Barbara A.; Varki, Nissi M.; Patterson, Ruth E.

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April 22, 2014

10.1158/1055-9965.EPI-13-1218

Publisher: American Association for Cancer Research Section: Research Article PMID: 24755714

Abstract:

Background: The insulin-like growth factor-1 (IGF-1) receptor is a potential target for breast cancer treatment and may be influenced by dietary intake. Methods: Nested, case-control study of 265 postmenopausal breast cancer survivors; primary breast cancer tissue was stained to determine IGF-1 receptor status. Change in carbohydrate intake from baseline to Year 1 of study was estimated from 24-hour dietary recalls. Breast cancer recurrence cases (91) were matched to 2 controls (n=174) on disease and study characteristics and counter-matched on change in carbohydrate intake. Weighted conditional logistic regression models fit the risk of recurrence on IGF-1 receptor status and dietary change. Results: Half of tumors were IGF-1 receptor positive. Increased risk of recurrence was associated with IGF-1 receptor positive status (HR 1.7; 95% CI: 1.2-2.5) and, separately, with a stable/increased intake of carbohydrates (HR 2.0; 95% CI: 1.3 5.0). There was a borderline significant interaction between those two variables (p=0.11). Specifically, carbohydrate intake had no significant impact on risk of recurrence among women who were receptor negative, yet increased the risk of recurrence by over 5-fold among women who were receptor positive (HR 5.5; 95% CI 1.8-16.3). Conclusions: Among women whose tumor tissue is positive for the IGF 1 receptor, reducing carbohydrate intake after diagnosis could reduce the risk of breast cancer recurrence. These findings need replication in a larger sample. Impact: This is the first study to suggest that it may be possible to personalize dietary recommendations for breast cancer survivors based on molecular characteristics of their primary tumor tissue.

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