Breast Cancer Research and Treatment

, Volume 132, Issue 1, pp 243–250 | Cite as

Folate intake and breast cancer mortality in a cohort of Swedish women

Epidemiology

Abstract

Folate may influence breast cancer development and progression through its role in one-carbon metabolism. However, epidemiologic data on the relation between folate and breast cancer survival are limited. We investigated whether dietary folate intake was associated with survival in 3,116 women diagnosed with breast cancer in the population-based Swedish Mammography Cohort. Participants completed a 67-item food frequency questionnaire in 1987. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for death from breast cancer and death from any cause. During 25,716 person-years of follow-up from 1987 to 2008, there were 852 deaths with 381 breast cancer deaths. Dietary folate intake was inversely associated with breast cancer and overall mortality. Women in the highest quartile of folate intake had a multivariable HR (95% CI) of death from breast cancer of 0.78 (0.58–1.03) compared to those in the lowest quartile (Ptrend = 0.03). The corresponding HR (95% CI) for death from any cause was 0.79 (0.66–0.96; Ptrend = 0.004). The protective association between dietary folate intake and breast cancer death was strongest among those with ER-negative tumors (HR = 0.42; 95% = CI 0.22–0.79; Ptrend = 0.01) comparing the highest to lowest quartile. Our findings suggest that folate intake before breast cancer diagnosis may improve breast cancer and overall survival. While these findings need to be confirmed in future studies, they do offer assurance that dietary folate intake at the levels observed in our population does not unfavorably affect survival after breast cancer.

Keywords

Breast cancer Survival Folate Diet 

Abbreviations

SMC

Swedish mammography cohort

BMI

Body mass index

SD

Standard deviation

ER

Estrogen receptor

PR

Progesterone receptor

FFQ

Food frequency questionnaire

ICD

International classification of diseases

HR

Hazard ratio

CI

Confidence interval

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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • Holly R. Harris
    • 1
    • 2
  • Leif Bergkvist
    • 3
  • Alicja Wolk
    • 1
  1. 1.Division of Nutritional EpidemiologyThe National Institute for Environmental Medicine, Karolinska InstitutetStockholmSweden
  2. 2.Obstetrics and Gynecology Epidemiology CenterBrigham and Women’s HospitalBostonUSA
  3. 3.Department of Surgery and Centre for Clinical ResearchCentral HospitalVästeråsSweden

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