Skip to main content

Advertisement

SpringerLink
Log in

Dietary fat intake in relation to lethal breast cancer in two large prospective cohort studies

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Whether fat intake influences risk of developing more aggressive, lethal breast tumors is unknown. We evaluated intakes of total fat, specific types of fat, and cholesterol prior to diagnosis in relation to lethal breast cancer risk in 88,759 women in the Nurses’ Health Study (NHS; 1980–2010) and 93,912 women in the Nurses’ Health Study II (NHSII; 1991–2010). Diet was assessed every 4 years using a semi-quantitative food frequency questionnaire. Breast cancers were confirmed with pathology reports; deaths were confirmed by next of kin or the National Death Index. We defined lethal cases as women with invasive breast cancer who died of breast cancer. We pooled the cohorts and used multivariable Cox proportional hazards models. We identified 1,529 lethal breast cancer cases (1,279 in NHS and 250 in NHSII). Higher total fat intake was associated with a slightly lower lethal breast cancer risk (top vs. bottom quintile hazard ratio [HR] 0.85; 95 % CI 0.72, 1.01; p trend = 0.05). Specific types of fat were generally not associated with lethal breast cancer risk. For example, compared with those in the lowest quintile of saturated fat intake, those in the highest quintile had a HR of 0.98 (95 % CI 0.75, 1.26; p trend = 0.96). Among women diagnosed with breast cancer, pre-diagnosis fat intake was not associated with survival. Higher pre-diagnosis fat intake was not associated with greater risk of lethal breast cancer in these large prospective cohort studies, consistent with the weight of the evidence against a causal role for fat intake and breast cancer incidence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Carroll KK, Khor HT (1971) Effects of level and type of dietary fat on incidence of mammary tumors induced in female Sprague–Dawley rats by 7,12-dimethylbenz()anthracene. Lipids 6(6):415–420

    Article  CAS  PubMed  Google Scholar 

  2. Tannenbaum A, Silverstone H (1953) Nutrition in relation to cancer. Adv Cancer Res 1:451–501

    Article  CAS  PubMed  Google Scholar 

  3. Willett WC (2013) Nutritional epidemiology. Oxford University Press, New York

    Google Scholar 

  4. Carroll KK (1975) Experimental evidence of dietary factors and hormone-dependent cancers. Cancer Res 35(11 Pt. 2):3374–3383

    CAS  PubMed  Google Scholar 

  5. Miller AB, Kelly A, Choi NW, Matthews V, Morgan RW, Munan L, Burch JD, Feather J, Howe GR, Jain M (1978) A study of diet and breast cancer. Am J Epidemiol 107(6):499–509

    CAS  PubMed  Google Scholar 

  6. Smith-Warner SA, Spiegelman D, Adami HO, Beeson WL, van den Brandt PA, Folsom AR, Fraser GE, Freudenheim JL, Goldbohm RA, Graham S, Kushi LH, Miller AB, Rohan TE, Speizer FE, Toniolo P, Willett WC, Wolk A, Zeleniuch-Jacquotte A, Hunter DJ (2001) Types of dietary fat and breast cancer: a pooled analysis of cohort studies. Int J Cancer 92(5):767–774

    Article  CAS  PubMed  Google Scholar 

  7. Prentice RL, Caan B, Chlebowski RT, Patterson R, Kuller LH, Ockene JK, Margolis KL, Limacher MC, Manson JE, Parker LM, Paskett E, Phillips L, Robbins J, Rossouw JE, Sarto GE, Shikany JM, Stefanick ML, Thomson CA, Van Horn L, Vitolins MZ, Wactawski-Wende J, Wallace RB, Wassertheil-Smoller S, Whitlock E, Yano K, Adams-Campbell L, Anderson GL, Assaf AR, Beresford SA, Black HR, Brunner RL, Brzyski RG, Ford L, Gass M, Hays J, Heber D, Heiss G, Hendrix SL, Hsia J, Hubbell FA, Jackson RD, Johnson KC, Kotchen JM, LaCroix AZ, Lane DS, Langer RD, Lasser NL, Henderson MM (2006) Low-fat dietary pattern and risk of invasive breast cancer: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA 295(6):629–642. doi:10.1001/jama.295.6.629

    Article  CAS  PubMed  Google Scholar 

  8. Martin LJ, Li Q, Melnichouk O, Greenberg C, Minkin S, Hislop G, Boyd NF (2011) A randomized trial of dietary intervention for breast cancer prevention. Cancer Res 71(1):123–133. doi:10.1158/0008-5472.CAN-10-1436

    Article  CAS  PubMed  Google Scholar 

  9. Cho E, Spiegelman D, Hunter DJ, Chen WY, Stampfer MJ, Colditz GA, Willett WC (2003) Premenopausal fat intake and risk of breast cancer. J Natl Cancer Inst 95(14):1079–1085

    Article  PubMed  Google Scholar 

  10. Cho E, Chen WY, Hunter DJ, Stampfer MJ, Colditz GA, Hankinson SE, Willett WC (2006) Red meat intake and risk of breast cancer among premenopausal women. Arch Intern Med 166(20):2253–2259. doi:10.1001/archinte.166.20.2253

    Article  PubMed  Google Scholar 

  11. Bleyer A, Welch HG (2012) Effect of three decades of screening mammography on breast-cancer incidence. New Engl J Med 367(21):1998–2005. doi:10.1056/NEJMoa1206809

    Article  CAS  PubMed  Google Scholar 

  12. Welch HG, Albertsen PC (2009) Prostate cancer diagnosis and treatment after the introduction of prostate-specific antigen screening: 1986–2005. J Natl Cancer Inst 101(19):1325–1329. doi:10.1093/jnci/djp278

    Article  PubMed Central  PubMed  Google Scholar 

  13. Wilson KM, Giovannucci EL, Mucci LA (2012) Lifestyle and dietary factors in the prevention of lethal prostate cancer. Asian J Androl 14(3):365–374. doi:10.1038/aja.2011.142

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Strope SA, Andriole GL (2010) Prostate cancer screening: current status and future perspectives. Nat Rev Urol 7(9):487–493. doi:10.1038/nrurol.2010.120

    Article  PubMed  Google Scholar 

  15. Giovannucci E, Liu Y, Platz EA, Stampfer MJ, Willett WC (2007) Risk factors for prostate cancer incidence and progression in the health professionals follow-up study. Int J Cancer 121(7):1571–1578. doi:10.1002/ijc.22788

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Carey LA, Perou CM, Livasy CA, Dressler LG, Cowan D, Conway K, Karaca G, Troester MA, Tse CK, Edmiston S, Deming SL, Geradts J, Cheang MC, Nielsen TO, Moorman PG, Earp HS, Millikan RC (2006) Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA 295(21):2492–2502. doi:10.1001/jama.295.21.2492

    Article  CAS  PubMed  Google Scholar 

  17. Blows FM, Driver KE, Schmidt MK, Broeks A, van Leeuwen FE, Wesseling J, Cheang MC, Gelmon K, Nielsen TO, Blomqvist C, Heikkila P, Heikkinen T, Nevanlinna H, Akslen LA, Begin LR, Foulkes WD, Couch FJ, Wang X, Cafourek V, Olson JE, Baglietto L, Giles GG, Severi G, McLean CA, Southey MC, Rakha E, Green AR, Ellis IO, Sherman ME, Lissowska J, Anderson WF, Cox A, Cross SS, Reed MW, Provenzano E, Dawson SJ, Dunning AM, Humphreys M, Easton DF, Garcia-Closas M, Caldas C, Pharoah PD, Huntsman D (2010) Subtyping of breast cancer by immunohistochemistry to investigate a relationship between subtype and short and long term survival: a collaborative analysis of data for 10,159 cases from 12 studies. PLoS Med 7(5):e1000279. doi:10.1371/journal.pmed.1000279

    Article  PubMed Central  PubMed  Google Scholar 

  18. Yang XR, Sherman ME, Rimm DL, Lissowska J, Brinton LA, Peplonska B, Hewitt SM, Anderson WF, Szeszenia-Dabrowska N, Bardin-Mikolajczak A, Zatonski W, Cartun R, Mandich D, Rymkiewicz G, Ligaj M, Lukaszek S, Kordek R, Garcia-Closas M (2007) Differences in risk factors for breast cancer molecular subtypes in a population-based study. Cancer Epidemiol Biomark Prev 16(3):439–443. doi:10.1158/1055-9965.EPI-06-0806

    Article  CAS  Google Scholar 

  19. Millikan RC, Newman B, Tse CK, Moorman PG, Conway K, Dressler LG, Smith LV, Labbok MH, Geradts J, Bensen JT, Jackson S, Nyante S, Livasy C, Carey L, Earp HS, Perou CM (2008) Epidemiology of basal-like breast cancer. Breast Cancer Res Treat 109(1):123–139. doi:10.1007/s10549-007-9632-6

    Article  PubMed Central  PubMed  Google Scholar 

  20. Tamimi RM, Colditz GA, Hazra A, Baer HJ, Hankinson SE, Rosner B, Marotti J, Connolly JL, Schnitt SJ, Collins LC (2012) Traditional breast cancer risk factors in relation to molecular subtypes of breast cancer. Breast Cancer Res Treat 131(1):159–167. doi:10.1007/s10549-011-1702-0

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Razzaghi H, Troester MA, Gierach GL, Olshan AF, Yankaskas BC, Millikan RC (2013) Association between mammographic density and basal-like and luminal A breast cancer subtypes. Breast Cancer Res 15(5):R76. doi:10.1186/bcr3470

    Article  PubMed Central  PubMed  Google Scholar 

  22. Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, Hennekens CH, Speizer FE (1985) Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 122(1):51–65

    CAS  PubMed  Google Scholar 

  23. Salvini S, Hunter DJ, Sampson L, Stampfer MJ, Colditz GA, Rosner B, Willett WC (1989) Food-based validation of a dietary questionnaire: the effects of week-to-week variation in food consumption. Int J Epidemiol 18(4):858–867

    Article  CAS  PubMed  Google Scholar 

  24. Agriculture USDo (1993) Composition of foods-raw, processed, and prepared, 1963–1992. In: Agricultural Handbook No. 8 Series. Department of Agriculture, Government Printing Office, Washington, D.C

  25. Willett WL (2013) Reproducibility and validity of food frequency questionnaires. In: Willett W (ed) Nutritional epidemiology, 3rd edn. Oxford University Press, New York

    Google Scholar 

  26. London SJ, Sacks FM, Caesar J, Stampfer MJ, Siguel E, Willett WC (1991) Fatty acid composition of subcutaneous adipose tissue and diet in postmenopausal US women. Am J Clin Nutr 54(2):340–345

    CAS  PubMed  Google Scholar 

  27. Eliassen AH, Hankinson SE, Rosner B, Holmes MD, Willett WC (2010) Physical activity and risk of breast cancer among postmenopausal women. Arch Intern Med 170(19):1758–1764. doi:10.1001/archinternmed.2010.363

    Article  PubMed Central  PubMed  Google Scholar 

  28. Colditz GA, Rosner B (2000) Cumulative risk of breast cancer to age 70 years according to risk factor status: data from the Nurses’ Health Study. Am J Epidemiol 152(10):950–964

    Article  CAS  PubMed  Google Scholar 

  29. Rosner B, Colditz GA (1996) Nurses’ health study: log-incidence mathematical model of breast cancer incidence. J Natl Cancer Inst 88(6):359–364

    Article  CAS  PubMed  Google Scholar 

  30. Cook NR, Rosner BA, Hankinson SE, Colditz GA (2009) Mammographic screening and risk factors for breast cancer. Am J Epidemiol 170(11):1422–1432. doi:10.1093/aje/kwp304

    Article  PubMed Central  PubMed  Google Scholar 

  31. Glynn RJ, Rosner B (2005) Comparison of risk factors for the competing risks of coronary heart disease, stroke, and venous thromboembolism. Am J Epidemiol 162(10):975–982. doi:10.1093/aje/kwi309

    Article  PubMed  Google Scholar 

  32. Rosner B, Glynn RJ, Tamimi RM, Chen WY, Colditz GA, Willett WC, Hankinson SE (2013) Breast cancer risk prediction with heterogeneous risk profiles according to breast cancer tumor markers. Am J Epidemiol. doi:10.1093/aje/kws457

    PubMed Central  Google Scholar 

  33. Lunn M, McNeil D (1995) Applying Cox regression to competing risks. Biometrics 51(2):524–532

    Article  CAS  PubMed  Google Scholar 

  34. Tamimi RM, Baer HJ, Marotti J, Galan M, Galaburda L, Fu Y, Deitz AC, Connolly JL, Schnitt SJ, Colditz GA, Collins LC (2008) Comparison of molecular phenotypes of ductal carcinoma in situ and invasive breast cancer. Breast Cancer Res 10(4):R67. doi:10.1186/bcr2128

    Article  PubMed Central  PubMed  Google Scholar 

  35. Collins LC, Marotti JD, Baer HJ, Tamimi RM (2008) Comparison of estrogen receptor results from pathology reports with results from central laboratory testing. J Natl Cancer Inst 100(3):218–221. doi:10.1093/jnci/djm270

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  36. Beasley JM, Newcomb PA, Trentham-Dietz A, Hampton JM, Bersch AJ, Passarelli MN, Holick CN, Titus-Ernstoff L, Egan KM, Holmes MD, Willett WC (2011) Post-diagnosis dietary factors and survival after invasive breast cancer. Breast Cancer Res Treat 128(1):229–236. doi:10.1007/s10549-010-1323-z

    Article  PubMed Central  PubMed  Google Scholar 

  37. Field AE, Willett WC, Lissner L, Colditz GA (2007) Dietary fat and weight gain among women in the Nurses’ Health Study. Obesity (Silver Spring) 15(4):967–976. doi:10.1038/oby.2007.616

    Article  Google Scholar 

  38. Willett WC (2012) Dietary fats and coronary heart disease. J Intern Med 272(1):13–24. doi:10.1111/j.1365-2796.2012.02553.x

    Article  CAS  PubMed  Google Scholar 

  39. Mozaffarian D, Aro A, Willett WC (2009) Health effects of trans-fatty acids: experimental and observational evidence. Eur J Clin Nutr 63(Suppl 2):S5–S21. doi:10.1038/sj.ejcn.1602973

    Article  CAS  PubMed  Google Scholar 

  40. Alexander DD, Morimoto LM, Mink PJ, Lowe KA (2010) Summary and meta-analysis of prospective studies of animal fat intake and breast cancer. Nutr Res Rev 23(1):169–179. doi:10.1017/S095442241000003X

    Article  CAS  PubMed  Google Scholar 

  41. Kroenke CH, Kwan ML, Sweeney C, Castillo A, Caan BJ (2013) High- and low-fat dairy intake, recurrence, and mortality after breast cancer diagnosis. J Natl Cancer Inst 105(9):616–623. doi:10.1093/jnci/djt027

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  42. Alexander DD, Morimoto LM, Mink PJ, Cushing CA (2010) A review and meta-analysis of red and processed meat consumption and breast cancer. Nutr Res Rev 23(2):349–365. doi:10.1017/S0954422410000235

    Article  CAS  PubMed  Google Scholar 

  43. Taylor VH, Misra M, Mukherjee SD (2009) Is red meat intake a risk factor for breast cancer among premenopausal women? Breast Cancer Res Treat 117(1):1–8. doi:10.1007/s10549-009-0441-y

    Article  PubMed  Google Scholar 

  44. Missmer SA, Smith-Warner SA, Spiegelman D, Yaun SS, Adami HO, Beeson WL, van den Brandt PA, Fraser GE, Freudenheim JL, Goldbohm RA, Graham S, Kushi LH, Miller AB, Potter JD, Rohan TE, Speizer FE, Toniolo P, Willett WC, Wolk A, Zeleniuch-Jacquotte A, Hunter DJ (2002) Meat and dairy food consumption and breast cancer: a pooled analysis of cohort studies. Int J Epidemiol 31(1):78–85

    Article  PubMed  Google Scholar 

  45. Nechuta S, Caan BJ, Chen WY, Kwan ML, Lu W, Cai H, Poole EM, Flatt SW, Zheng W, Pierce JP, Shu XO (2013) Postdiagnosis cruciferous vegetable consumption and breast cancer outcomes: a report from the After Breast Cancer Pooling Project. Cancer Epidemiol Biomark Prev 22(8):1451–1456. doi:10.1158/1055-9965.EPI-13-0446

    Article  CAS  Google Scholar 

  46. Hu FB, Stampfer MJ, Manson JE, Rimm E, Colditz GA, Rosner BA, Hennekens CH, Willett WC (1997) Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 337(21):1491–1499. doi:10.1056/NEJM199711203372102

    Article  CAS  PubMed  Google Scholar 

  47. Astrup A, Dyerberg J, Elwood P, Hermansen K, Hu FB, Jakobsen MU, Kok FJ, Krauss RM, Lecerf JM, LeGrand P, Nestel P, Riserus U, Sanders T, Sinclair A, Stender S, Tholstrup T, Willett WC (2011) The role of reducing intakes of saturated fat in the prevention of cardiovascular disease: where does the evidence stand in 2010? Am J Clin Nutr 93(4):684–688. doi:10.3945/ajcn.110.004622

    Article  CAS  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to thank the participants and staff of the Nurses’ Health Study and Nurses’ Health Study II for their valuable contributions as well as the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, WY. In addition, this study was approved by the Connecticut Department of Public Health (DPH) Human Investigations Committee. We acknowledge Elizabeth M. Poole and Erica T. Warner for their assistance with this analysis. Certain data used in this publication were obtained from the DPH. This work was supported by the Breast Cancer Research Foundation and the National Institutes of Health (P01 CA87969, UM1 CA176726, R01 CA 050385). Caroline Boeke was funded by the National Institutes of Health Cancer Epidemiology Training Grant T32 CA 09001.

Disclosures

None.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA

    Caroline E. Boeke, A. Heather Eliassen, Michelle D. Holmes, Bernard Rosner, Walter C. Willett & Rulla M. Tamimi

  2. Channing Division of Network Medicine, Brigham and Women’s Hospital, 181 Longwood Avenue, Boston, MA, 02115, USA

    Caroline E. Boeke, A. Heather Eliassen, Wendy Y. Chen, Eunyoung Cho, Michelle D. Holmes, Bernard Rosner, Walter C. Willett & Rulla M. Tamimi

  3. Department of Medicine, Harvard Medical School, Boston, MA, USA

    A. Heather Eliassen, Michelle D. Holmes, Bernard Rosner, Walter C. Willett & Rulla M. Tamimi

  4. Department of Medical Oncology, Dana-Farber Cancer Institute Boston, 450 Brookline Ave, Boston, MA, 02215, USA

    Wendy Y. Chen

  5. Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA

    Bernard Rosner

  6. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA

    Walter C. Willett

  7. Department of Dermatology, The Warren Alpert Medical School of Brown University, 339 Eddy Street, Providence, RI, 02903, USA

    Eunyoung Cho

Authors
  1. Caroline E. Boeke
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Heather Eliassen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wendy Y. Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eunyoung Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michelle D. Holmes
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bernard Rosner
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Walter C. Willett
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Rulla M. Tamimi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Caroline E. Boeke.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Boeke, C.E., Eliassen, A.H., Chen, W.Y. et al. Dietary fat intake in relation to lethal breast cancer in two large prospective cohort studies. Breast Cancer Res Treat 146, 383–392 (2014). https://doi.org/10.1007/s10549-014-3005-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-014-3005-8

Keywords

Search

Navigation