Abstract
Animal experimental evidence and human ecological data suggest that dietary fat intake is related to breast cancer risk. Epidemiological studies within countries have given inconsistent results but are limited by the restricted range of dietary intake found in Western populations and by error in the measurement of fat consumption. Experimental evidence, derived from controlled clinical trials in which the range of fat intake is increased beyond that seen in most Western populations, is capable of overcoming this limitation of observational epidemiology, and would provide the strongest evidence available concerning the relationship of dietary fat intake to breast cancer risk. Further, such trials are the only means likely to answer the question of whether breast cancer risk in high-risk subjects can be modified by changing dietary fat intake. We describe here several aspects of the feasibility of an experimental approach to this problem, including the identification of subjects at increased risk for breast cancer, and the demonstration that such subjects will enter a clinical trial of dietary fat reduction and comply with a low-fat diet. It is shown that subjects can be recruited and retained in such trials, that satisfactory dietary compliance can be achieved over at least 24 mon and that the subjects selected are at demonstrably increased risk of breast cancer. This finding indicates that it is feasible to test the dietary fat-breast cancer hypothesis experimentally by means of a clinical trial.
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Abbreviations
- BCDDP:
-
Breast Cancer Detection and Demonstration Projects
- CI:
-
confidence interval
- HDL-C:
-
high-density lipoprotein cholesterol
- LDL:
-
low-density lipoprotein
References
Silverberg, E., and Lubra, J.A. (1988)Ca—A. Cancer J. for Clin. 38, 5–22.
Doll, R., and Peto, R. (1981)The Causes of Cancer: Quantitative Estimates of Avoidable Risks of Cancer in the United States, Oxford University Press, Oxford.
Welsch, C.W. (1986)Prog. Clin. Biol. Res. 222, 623–654.
Rogers, A.E., and Lee, S.Y. (1986)Prog. Clin. Biol. Res. 222, 255–282.
Welsch, C.W., DeHoog, J.V., O'Conner, D.H., and Sheffield, L.G. (1985)Cancer Res. 45, 6147–6154.
Prentice, R., Kakar, F., Hursting, S., Sheppard, L., Klein, R., and Kushi, L.H. (1988)J. Natl. Cancer Inst. 80, 802–814.
Willett, W.C., Stampfer, M.J., Colditz, G.A., Rosner, B.A., Hennekens, C.H., and Speizer, F.E. (1987)N. Engl. J. Med. 316, 22–28.
Goodwin, P., and Boyd, N.F. (1987)J. Natl. Cancer Inst. 79, 473–485.
Schatzkin, A., Greenwald, P., Byar, D.P., and Clifford, C. (1989)J. Am. Med. Assoc. 261, 3284–3287.
Cohen, L.A. (1987)Sci. Amer. 257, 42–48.
Rose, D.P. (1986)Cancer Surveys 3, 671–687.
Prentice, R.L., and Sheppard, L. (1990)Cancer Causes and Control 1, 81–97.
Willett, W.C. (1989)Nature 338, 389–394.
Howe, G.R., Hirohata, T., Hislop, T.G., Iscovich, J.M., Yuan, J.M. Katsouyanni, K., Lubin, F., Marubini, E., Modan, B., Rohan, T., Toniolo, P., and Shunzhang, Y. (1990)J. Natl. Cancer Inst. 82, 561–569.
Boyd, N.F., Cousins, M., Beaton, M., Fishell, E., Wright, B., Fish, E., Kriukov, V., Lockwood, G., Trichler, D., Hanna, W., and Page, D.L. (1988)J. Natl. Cancer Inst. 80, 1244–1248.
Lee-Han, H., Cousins, M., Beaton, M., McGuire, B., Kriukov, V., Chipman, M., and Boyd, N. (1988)Am. J. Clin. Nutr. 48, 575–586.
Boyd, N.F., Cousins, M., Beaton, M., Kuriov, V., Lockwood, G., and Trichler, D. (1990)Am. J. Clin. Nutr. 52, 470–476.
Brisson, J., Morrison, A.S., and Khalid H. (1988)J. Natl. Cancer Inst. 80, 1534–1539.
Self, S., Prentice, R., Iverson, D., Henderson, M., Thompson, D., Byar, D., Insull, W., Gorbach, S.L., Clifford, C., Goldman, S., Urban, N., Sheppard, L., and Greenwald, P. (1988)Controlled Clinical Trials 9, 119–136.
Boyd, N.F., O'Sullivan, B., Campbell, J.E., Fishell, E., Simor, I., Cooke, G., and Germanson, T. (1982)Br. J. Cancer 45, 185–193.
Brisson, J., Merletti, F., Sadowski, N.L., Twaddle, J.A., Morrison, A.S., and Cole, P. (1982)Am. J. Epidemiol. 115, 428–437.
Wolfe, J.N., Saftlas, A.F., and Salane, M. (1987)Am. J. Roentgenol. 148, 1087–1092.
Saftlas, A., Wolfe, J.N., Hoover, R.N., Brinton, L.A., Schairer, C., Salane, M., and Szklo, M. (1989)Am. J. Epidemiol. 129, 518–526.
Cowan, L.D., O'Connell, D.L., Criqui, M.H., Barrett-Connor, E., Bush, T.L., and Wallace, R.B. (1990)Am. J. Epidemiol., 131–468.
Boyd, N.F., McGuine, V., Fishell, E., Kriukov, V., Lockwood, G., and Trichler, D. (1989)Br. J. Cancer 59, 766–771.
Boyd, N.F., and McGuire, V. (1990)J. Natl. Cancer Inst. 82, 460–468.
Jones, D.Y., Judd, J.T., Taylor, P.R., Campbell, W.S., and Nair, P.P. (1987)Am. J. Clin. Nutr. 45, 1451–1456.
Kuusi, T., Ehnholm, C., Huttunen, J.K., Kostiainen, E., Pietinen, P., Leino, U., Uusitalo, U., Nikkari, T., Iacono, J.M., and Puska, P. (1985)J. Lipid Res. 26, 360–367.
Brussaard, J.H., Dallinga-Thie, G., Groot, P.H.E., and Katan, M.B. (1980)Atherosclerosis 36, 515.
Ehnholm, C., Huttenen, J.K., Pietinen, P., Leino, U., Mutanen, M., Kostianen, E., Pikkarainen, J., Dougherty, R., Iacono, J., and Puska, P. (1982)N. Engl. J. Med. 307, 850–855.
McCormick, J., and Skrababek, P. (1988)Lancet ii, 839–841.
Boyar, A.P., Rose, D.P., Loughridge, J.R., Engle, A., Palgi, A., Laakso, K., Kinne, D., and Wynder, E.L. (1988)Nutr. Cancer 11, 93–99.
Rose, D.P., Boyar, A.P., Cohen, C., and Strong, L.E. (1987)J. Natl. Cancer Inst. 78, 623–626.
Prentice, R., Thompson, D., Clifford, C., Gorbach, S., Goldin, B., and Byar, D. (1990)J. Natl. Cancer Inst. 82, 129–134.
Goldin, B.R., Aldercreutz, H., Gorbach, S.L., Warram, J.H., Dwyer, J.T., Swenson, L., and Woods, M.N. (1982)N. Engl. J. Med. 307, 1542–1547.
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Boyd, N.F., Cousins, M., Lockwood, G. et al. Dietary fat and breast cancer risk: The feasibility of a clinical trial of breast cancer prevention. Lipids 27, 821–826 (1992). https://doi.org/10.1007/BF02535857
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DOI: https://doi.org/10.1007/BF02535857