Breast Cancer Research and Treatment

, Volume 146, Issue 2, pp 383–392

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

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


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.


Fat Breast cancer Mortality Survival Cholesterol Lethal 


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Caroline E. Boeke
    • 1
    • 2
  • A. Heather Eliassen
    • 1
    • 2
    • 3
  • Wendy Y. Chen
    • 2
    • 4
  • Eunyoung Cho
    • 2
    • 7
  • Michelle D. Holmes
    • 1
    • 2
    • 3
  • Bernard Rosner
    • 1
    • 2
    • 3
    • 5
  • Walter C. Willett
    • 1
    • 2
    • 3
    • 6
  • Rulla M. Tamimi
    • 1
    • 2
    • 3
  1. 1.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  2. 2.Channing Division of Network MedicineBrigham and Women’s HospitalBostonUSA
  3. 3.Department of MedicineHarvard Medical SchoolBostonUSA
  4. 4.Department of Medical OncologyDana-Farber Cancer Institute BostonBostonUSA
  5. 5.Department of BiostatisticsHarvard School of Public HealthBostonUSA
  6. 6.Department of NutritionHarvard School of Public HealthBostonUSA
  7. 7.Department of DermatologyThe Warren Alpert Medical School of Brown UniversityProvidenceUSA

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