Breast Cancer Research and Treatment

, Volume 145, Issue 1, pp 255–265 | Cite as

Premenopausal dietary fat in relation to pre- and post-menopausal breast cancer

  • Maryam S. FarvidEmail author
  • Eunyoung Cho
  • Wendy Y. Chen
  • A. Heather Eliassen
  • Walter C. Willett


We examined the association between fat intake and breast cancer incidence in the Nurses’ Health Study II. We followed 88,804 women aged 26–45 years from 1991 to 2011 and documented incident breast cancers. Dietary fat, assessed by questionnaires in 1991, was examined in relation to total, premenopausal, and postmenopausal breast cancers. Multivariable-adjusted Cox proportional hazards models were used to estimate relative risk (RR) and 95 % confidence intervals (95 % CI). During 20 years of follow-up, 2,830 incident invasive breast cancer cases were diagnosed. Total fat intake was not associated with risk of breast cancer overall. After adjustment for demographic, anthropometric, lifestyle, and dietary factors, a positive association was observed between animal fat intake and breast cancer overall (RR for highest vs lowest quintile, 1.18; 95 % CI 1.04–1.33; P trend = 0.01). A positive association with animal fat intake was also seen among premenopausal women, but not among postmenopausal women. Higher intakes of saturated fat and monounsaturated fat were each associated with modestly higher breast cancer risk among all women, and higher cholesterol intake was associated with higher premenopausal breast cancer risk. However, the associations of saturated fat, monounsaturated fat and animal fat, were attenuated and non-significant after adjustment for red meat intake. Intakes of other types of fat including vegetable fat, dairy fat, polyunsaturated fat, and trans fat were not associated with breast cancer risk. Our finding suggests a positive association between early adult intake of animal fat and breast cancer risk.


Fat intake Animal fat Breast cancer 



The study was supported by the National Institutes of Health Grant (R01CA050385). The study sponsors were not involved in the study design and collection, analysis and interpretation of data, or the writing of the article or the decision to submit it for publication. The authors were independent from study sponsors. We would like to thank the participants and staff of the 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. Certain data used in this publication were obtained from the DPH. The authors’ responsibility were as follows: MSF, EC, WYC, AHE, and WCW: designed the research; MSF: analyzed and wrote the manuscript; and WCW: had primary responsibility for the final content of the manuscript; and all authors: provided critical input in the writing of the manuscript and read and approved the final manuscript. The authors assume full responsibility for analyses and interpretation of these data.

Conflict of interest

No potential conflicts of interest were disclosed.


  1. 1.
    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 92:767–774PubMedCrossRefGoogle Scholar
  2. 2.
    Thiébaut AC, Kipnis V, Chang SC, Subar AF, Thompson FE, Rosenberg PS, Hollenbeck AR, Leitzmann M, Schatzkin A (2007) Dietary fat and postmenopausal invasive breast cancer in the National Institutes of Health-AARP Diet and Health Study cohort. J Natl Cancer Inst 99:451–462PubMedCrossRefGoogle Scholar
  3. 3.
    Wirfält E, Mattisson I, Gullberg B, Johansson U, Olsson H, Berglund G (2002) Postmenopausal breast cancer is associated with high intakes of omega6 fatty acids (Sweden). Cancer Causes Control 13:883–893PubMedCrossRefGoogle Scholar
  4. 4.
    Kim EH, Willett WC, Colditz GA, Hankinson SE, Stampfer MJ, Hunter DJ, Rosner B, Holmes MD (2006) Dietary fat and risk of postmenopausal breast cancer in a 20-year follow-up. Am J Epidemiol 164:990–997PubMedCrossRefGoogle Scholar
  5. 5.
    Park SY, Kolonel LN, Henderson BE, Wilkens LR (2012) Dietary fat and breast cancer in postmenopausal women according to ethnicity and hormone receptor status: the Multiethnic Cohort Study. Cancer Prev Res (Phila) 5:216–228CrossRefGoogle Scholar
  6. 6.
    Sczaniecka AK, Brasky TM, Lampe JW, Patterson RE, White E (2012) Dietary intake of specific fatty acids and breast cancer risk among postmenopausal women in the VITAL cohort. Nutr Cancer 64:1131–1142PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Löf M, Sandin S, Lagiou P, Hilakivi-Clarke L, Trichopoulos D, Adami HO, Weiderpass E (2007) Dietary fat and breast cancer risk in the Swedish women’s lifestyle and health cohort. Br J Cancer 97:1570–1576PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Sieri S, Krogh V, Ferrari P, Berrino F, Pala V, Thiébaut AC et al (2008) Dietary fat and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition. Am J Clin Nutr 88:1304–1312Google Scholar
  9. 9.
    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 71:123–133PubMedCrossRefGoogle Scholar
  10. 10.
    Prentice RL, Caan B, Chlebowski RT, Patterson R, Kuller LH, Ockene JK et al (2006) Low-fat dietary pattern and risk of invasive breast cancer: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA 295:629–642PubMedCrossRefGoogle Scholar
  11. 11.
    Michels KB, Willett WC (2009) The women’s health initiative randomized controlled dietary modification trial: a post-mortem. Breast Cancer Res Treat 114:1–6PubMedCrossRefGoogle Scholar
  12. 12.
    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 95:1079–1085PubMedCrossRefGoogle Scholar
  13. 13.
    Land CE, Tokunaga M, Koyama K, Soda M, Preston DL, Nishimori I, Tokuoka S (2003) Incidence of female breast cancer among atomic bomb survivors, Hiroshima and Nagasaki, 1950–1990. Radiat Res 160:707–717PubMedCrossRefGoogle Scholar
  14. 14.
    Swerdlow AJ, Barber JA, Hudson GV, Cunningham D, Gupta RK, Hancock BW, Horwich A, Lister TA, Linch DC (2000) Risk of second malignancy after Hodgkin’s disease in a collaborative British cohort: the relation to age at treatment. J Clin Oncol 18:498–509PubMedGoogle Scholar
  15. 15.
    Wahner-Roedler DL, Nelson DF, Croghan IT, Achenbach SJ, Crowson CS, Hartmann LC, O’Fallon WM (2003) Risk of breast cancer and breast cancer characteristics in women treated with supradiaphragmatic radiation for Hodgkin lymphoma: Mayo Clinic experience. Mayo Clin Proc 78:708–715PubMedCrossRefGoogle Scholar
  16. 16.
    Nutrient Database for Standard Reference, Release 14: Department of Agriculture ARS (2001)Google Scholar
  17. 17.
    Holland GWA, Unwin ID, Buss DH, Paul AA, Dat S (1991) The composition of foods: Cambridge UK: The Royal Society of Chemistry and Ministry of Agriculture, Fisheries and FoodGoogle Scholar
  18. 18.
    Dial S (1995) Tocopherols and tocotrienols in key foods in the US diet. AOCS Press, Champaign, pp 327–342Google Scholar
  19. 19.
    Hu FB, Stampfer MJ, Rimm E, Ascherio A, Rosner BA, Spiegelman D, Willett WC (1999) Dietary fat and coronary heart disease: a comparison of approaches for adjusting for total energy intake and modeling repeated dietary measurements. Am J Epidemiol 149:531–540PubMedCrossRefGoogle Scholar
  20. 20.
    Willett W, Lenart E (2013) Reproducibility and validity of food-frequency questionnaires. Nutritional epidemiology. Oxford University Press, New York, pp 96–141Google Scholar
  21. 21.
    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 54:340–345PubMedGoogle Scholar
  22. 22.
    Willett W, Stampfer M, Chu NF, Spiegelman D, Holmes M, Rimm E (2001) Assessment of questionnaire validity for measuring total fat intake using plasma lipid levels as criteria. Am J Epidemiol 154:1107–1112PubMedCrossRefGoogle Scholar
  23. 23.
    Colditz GA, Stampfer MJ, Willett WC, Stason WB, Rosner B, Hennekens CH, Speizer FE (1987) Reproducibility and validity of self-reported menopausal status in a prospective cohort study. Am J Epidemiol 126:319–325PubMedCrossRefGoogle Scholar
  24. 24.
    Lunn M, McNeil D (1995) Applying Cox regression to competing risks. Biometrics 51:524–532Google Scholar
  25. 25.
    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 337:1491–1499 Google Scholar
  26. 26.
    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 23:169–179PubMedCrossRefGoogle Scholar
  27. 27.
    Egeberg R, Olsen A, Autrup H, Christensen J, Stripp C, Tetens I, Overvad K, Tjønneland A (2008) Meat consumption, N-acetyl transferase 1 and 2 polymorphism and risk of breast cancer in Danish postmenopausal women. Eur J Cancer Prev 17:39–47PubMedCrossRefGoogle Scholar
  28. 28.
    Taylor EF, Burley VJ, Greenwood DC, Cade JE (2007) Meat consumption and risk of breast cancer in the UK Women’s Cohort Study. Br J Cancer 96:1139–1146PubMedCentralPubMedCrossRefGoogle Scholar
  29. 29.
    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 166:2253–2259PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Maryam S. Farvid
    • 1
    • 2
    Email author
  • Eunyoung Cho
    • 3
    • 4
  • Wendy Y. Chen
    • 3
    • 5
  • A. Heather Eliassen
    • 3
    • 6
  • Walter C. Willett
    • 1
    • 3
    • 6
  1. 1.Department of NutritionHarvard School of Public HealthBostonUSA
  2. 2.Department of Community Nutrition, Faculty of Nutrition Sciences and Food TechnologyShahid Beheshti University of Medical SciencesTehranIran
  3. 3.Channing Division of Network Medicine, Department of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  4. 4.Department of DermatologyThe Warren Alpert Medical School of Brown UniversityProvidenceUSA
  5. 5.Department of Medical OncologyDana-Farber Cancer InstituteBostonUSA
  6. 6.Department of EpidemiologyHarvard School of Public HealthBostonUSA

Personalised recommendations