Nutritional Epidemiology of Postmenopausal Breast Cancer in Western New York

Graham, Saxon; Hellmann, Rosemary; Marshall, James R.; Freudenheim, Jo L.; Vena, John E.; Swanson, Mya; Zielezny, Maria; Nemoto, Takuma; Stubbe, Nancy; Raimondo, Teresa

doi:10.1093/oxfordjournals.aje.a116129

Cited by 211 publications

(70 citation statements)

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“…In our study, supplemental vitamin C intake was not associated with the risk of breast cancer, which is in agreement with results of other epidemiological studies (Graham et al, 1991;Shibata et al, 1992Hunter et al, 1993. Rohan et al (1993) reported a 40-50% increase in the risk of breast cancer in association with the intake of more than 250 mg day-' vitamin C supplements.…”

Section: Discussionsupporting

confidence: 93%

“…Some case-control studies showed a decrease in breast cancer risk with increased intake of the (pro)vitamins (Katsouyanni et al, 1988;Howe et al, 1990; Graham et al, 1991;Lee et al, 1991;Zaridze et al, 1991) and fibre (Iscovich et al, 1989;Howe et al, 1990;Van 't Veer et al, 1990; Graham et al, 1991;Baghurst and Rohan, 1994), whereas other case-control studies showed the opposite for (pro)vitamins (Toniolo et al, 1989;Ewertz and Gill, 1990;Richardson et al, 1991) and fibre (Katsouyanni et al, 1988;Ingram et al, 1991). Mostly negative non-significant associations between (pro)vitamin intake and the risk of breast cancer have been found in the few prospective cohort studies that have been conducted so far (Paganini-Hill et al, 1987;Graham et al, 1992;Hunter et al, 1993;Rohan et al, 1993).…”

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Vitamins C and E, retinol, beta-carotene and dietary fibre in relation to breast cancer risk: a prospective cohort study

Verhoeven

Assen²,

Goldbohm³

et al. 1997

Br J Cancer

161

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. A small reduction in risk was also observed with increasing intake of dietary vitamin C (RR highest/lowest quintile = 0.77, 95% Cl 0.55-1.08). For retinol, a weak positive association was observed (RR highest/lowest quintile = 1.24, 95% Cl 0.83-1.83). Among subjects with a high intake of polyunsaturated fatty acids (PUFAs), both 5-carotene and vitamin C intake showed a non-significant inverse association with breast cancer risk (P-trend = 0.15 and 0.16 respectively). Our findings do not suggest a strong role, if any, for intake of vitamins C and E, 13-carotene, retinol, dietary fibre, vegetables, fruit and potatoes in the aetiology of breast cancer.

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Section: Discussionsupporting

confidence: 93%

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confidence: 99%

Vitamins C and E, retinol, beta-carotene and dietary fibre in relation to breast cancer risk: a prospective cohort study

Verhoeven

Assen²,

Goldbohm³

et al. 1997

Br J Cancer

161

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“…The relative risk of breast cancer comparing the highest with the lowest category of intake was extracted from each study. Relative risks and CIs were calculated for three studies (Graham et al, 1982(Graham et al, , 1991Yuan et al, 1995) and confidence intervals were calculated for five studies (Hirayama, 1978;Kinlen, 1982;Levi et al, 1993;Landa et al, 1994;Toniolo et al, 1994) by cell frequencies shown in the data or standard error values (Fleiss, 1981), and are thus unadjusted for other variables. If the risk of breast cancer associated with the dietary variables was expressed in more than one way, the estimate extracted from the study was the one that reflected the greatest degree of controlling for confounders (i.e.…”

Section: Extraction and Classification Of Datamentioning

confidence: 99%

Dietary fat and breast cancer risk revisited: a meta-analysis of the published literature

et al. 2003

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Animal experiments and human ecological studies suggest that dietary fat intake is associated with a risk of breast cancer, but individual-based studies have given contradictory results. We have carried out a meta-analysis of this association to include all papers published up to July 2003. Case -control and cohort studies that examined the association of dietary fat, or fat-containing foods, with risk of breast cancer were identified. A total of 45 risk estimates for total fat intake were obtained. Descriptive data from each study were extracted with an estimate of relative risk and its associated 95% confidence interval (CI), and were analysed using the random effects model of DerSimonian and Laird. The summary relative risk, comparing the highest and lowest levels of intake of total fat, was 1.13 (95% CI: 1.03 -1.25). Cohort studies (N ¼ 14) had a summary relative risk of 1.11 (95% CI: 0.99 -1.25) and case -control studies (N ¼ 31) had a relative risk of 1.14 (95% CI 0.99 -1.32). Significant summary relative risks were also found for saturated fat (RR, 1.19; 95% CI: 1.06 -1.35) and meat intake (RR, 1.17; 95% CI 1.06 -1.29). Combined estimates of risk for total and saturated fat intake, and for meat intake, all indicate an association between higher intakes and an increased risk of breast cancer. Case -control and cohort studies gave similar results. British Journal of Cancer (2003) Breast cancer is the leading cause of cancer death, and the most frequently diagnosed cancer in women worldwide (Lacey et al, 2002). Large differences in rates of the disease exist between countries, with higher rates in North America and Western Europe, and lower rates in Asia and South America (Lacey et al, 2002). These differences are likely to be due to environmental rather than genetic factors. The rates of breast cancer change in migrants from low-to high-risk countries, who eventually acquire the rates of their adopted country (Ziegler et al, 1993;Pike et al, 2002). Menstrual and reproductive risk factors for breast cancer do not appear to account for these differences in rates (Wu et al, 1996).The differences in dietary practices between countries are well established, and could contribute to the differences in breast cancer risk. Support for an influence of dietary fat on breast cancer rates comes from its effect on mammary carcinogenesis in animals, and human ecological data.Two major meta-analyses, combining results from over 140 studies examining the relationship between dietary fat and breast cancer risk in rats and mice, show dietary fat to be a promoter of mammary carcinogenesis (Fay et al, 1997). This effect is independent of the effects of caloric intake (Freedman et al, 1990). Human ecological studies show a strong correlation (0.7 or more) between dietary fat intake, estimated from national food balance data, and incidence and mortality of breast cancer worldwide. (Prentice and Sheppard, 1990).However, case -control and cohort studies that have examined the relationship between dietary fat and breast cancer risk...

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“…[20][21][22] Furthermore, a series of animal studies reported that the inhibitory effect of dietary fiber on the promotion of mammary carcinogenesis was not only through modulating the level of circulating 17b-estradiol, 8,23,24 but a potential effect of bioactive compounds with anticancer properties such as antioxidants, phytoestrogens, phytic acid and protease inhibitors in dietary fiber was also discussed. [25][26][27][28] Epidemiological studies have evaluated intake of total fiber in relation to overall breast cancer risk in 10 cohorts, [29][30][31][32][33][34][35][36][37][38] in a metaanalysis of 12 older case-control studies, 39 and 8 more recent case-control studies, [40][41][42][43][44][45][46][47] but results are not consistent. To date, only 2 prospective studies with a limited number of cases have reported the association between intake of fiber and the risk of postmenopausal breast cancer defined by ER/PR status.…”

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confidence: 99%

Dietary fiber intake and risk of postmenopausal breast cancer defined by estrogen and progesterone receptor status—A prospective cohort study among Swedish women

Suzuki

Rylander-Rudqvist

et al. 2007

Intl Journal of Cancer

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There is few data on the association between dietary fiber intake and estrogen receptor (ER)/progesterone receptor (PR)-defined breast cancer risk. We evaluated the association between dietary fiber and ER/PR-defined breast cancer risk stratified by postmenopausal hormone use, alcohol intake, and family history of breast cancer in the population-based Swedish Mammography Screening Cohort comprising 51,823 postmenopausal women. Fiber intake was measured by food-frequency questionnaire collected in 1987 and 1997. Relative risks (RRs) were estimated by hazard ratio derived from Cox proportional hazard regression models. During an average of 8.3-year follow-up, 1,188 breast cancer cases with known ER/PR status were diagnosed. When comparing the highest to the lowest quintile, we observed non-significant inverse associations between total fiber intake and the risk of all tumor subtypes; the multivariate-adjusted RRs were 0.85 (95% CI: 0.69-1.05) for overall, 0.85 (0.64-1.13) for ER1PR1, 0.83 (0.52-1.31) for ER1PR2 and 0.94 (0.49-1.80) for ER2PR2. For specific fiber, we observed statistically significant risk reductions for overall (34%) and for ER1PR1 (38%) for the highest versus lowest quintile of fruit fiber, and non-significant inverse associations for other subtypes of cancer and types of fiber. Among ever-users of postmenopausal hormone (PMH), total fiber intake and especially cereal fiber were statistically significantly associated with 50% reduced risk for overall and ER1PR1 tumors when comparing the highest to the lowest quartile, but no association was observed among PMH never users. Our results suggest that dietary fiber intake from fruit and cereal may play a role in reducing breast cancer risk. ' 2007 Wiley-Liss, Inc.Key words: breast cancer; estrogen receptor; progesterone receptor; dietary fiber; risk Breast cancer is the most prevalent malignancy among women in Western countries. A number of studies indicate that a high level of endogenous/exogenous steroid hormones may play a critical role in the development of postmenopausal breast cancer. 1-4 It has been postulated that dietary fiber intake may reduce estrogen levels through interference of fiber with their enterohepatic metabolism. 5 Proposed mechanisms include increasing fecal excretion of estrogens, inhibition of intestinal reabsorption of estrogens by suppressing bacterial b-glucuronidase activity or binding unconjugated estrogens to fiber in the colon. 6-10 It has been also reported an association of increased dietary fiber intake and fiber-related phytochemicals with a reduction of estrogen levels in blood 6,[11][12][13] and with increased level of sex hormone-binding globulin (SHBG), which binds estradiol affecting its bioavailability. [14][15][16] Thus, it has been hypothesized that fiber intake may be associated with a decreased risk of breast cancer through the reduction of circulating estrogen levels. 17 Moreover, fiber might also indirectly reduce the risk of postmenopausal breast cancer by preventing obesity and type 2 diabetes-both bei...

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Nutritional Epidemiology of Postmenopausal Breast Cancer in Western New York

Cited by 211 publications

References 0 publications

Vitamins C and E, retinol, beta-carotene and dietary fibre in relation to breast cancer risk: a prospective cohort study

Vitamins C and E, retinol, beta-carotene and dietary fibre in relation to breast cancer risk: a prospective cohort study

Dietary fat and breast cancer risk revisited: a meta-analysis of the published literature

Dietary fiber intake and risk of postmenopausal breast cancer defined by estrogen and progesterone receptor status—A prospective cohort study among Swedish women

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