Breast Cancer Research and Treatment

, Volume 162, Issue 3, pp 571–580 | Cite as

Plasma carotenoids and the risk of premalignant breast disease in women aged 50 and younger: a nested case–control study

  • Kevin Cohen
  • Ying Liu
  • Jingqin Luo
  • Catherine M. Appleton
  • Graham A. Colditz



To examine the association of plasma carotenoids, micronutrients in fruits, and vegetables, with risk of premalignant breast disease (PBD) in younger women.


Blood samples were collected at the Siteman Cancer Center between 2008 and 2012 from 3537 women aged 50 or younger with no history of cancer or PBD. The analysis included 147 participants diagnosed with benign breast disease or breast carcinoma in situ during a 27-month follow-up and 293 controls. Cases and controls were matched on age, race/ethnicity, and date of and fasting status at blood draw. Plasma carotenoids were quantified. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) and linear regression to assess racial differences in plasma carotenoids.


The risk reduction between the highest and lowest tertiles varied by carotenoid, with β-cryptoxanthin having the greatest reduction (OR 0.62; 95% CI, 0.62–1.09; P trend = 0.056) and total carotenoids the least (OR 0.83; 95% CI, 0.48–1.44; P trend = 0.12). We observed an inverse association between plasma carotenoids and risk of PBD in obese women (BMI ≥ 30 kg/m2; 61 cases and 115 controls) but not lean women (BMI < 25 kg/m2; 54 cases and 79 controls), although the interaction was not statistically significant. Compared to white women, black women had lower levels of α and β-carotene and higher levels of β-cryptoxanthin and lutein/zeaxanthin.


We observed suggestive inverse associations between plasma carotenoids and risk of PBD in younger women, consistent with inverse associations reported for invasive breast cancer. Carotenoids may play a role early in breast cancer development.


Carotenoids Benign breast disease Breast cancer African American Prevention 


Author’s contributions

LY and GAC secured funding, conceived, and designed the study. KC and LY conducted statistical analyses with input from JL. KC wrote the first draft of the manuscript, which was critically revised by LY and GAC. All authors read and approved the final manuscript.


The study was supported by the Breast Cancer Research Foundation and the Siteman Investment Program at the Alvin J. Siteman Cancer Center in Washington University School of Medicine, St. Louis, Missouri. We thank the Siteman Biostatistics Shared Resource, which is supported in part by NCI Cancer Center Support Grant P30CA091842, for assistance in data analysis. We also thank Jeremy Furtado and his team for the carotenoid assays at the Nutritional Biomarker Laboratory within the Harvard T.H. Chan School of Public Health.

Compliance with ethical standards

Conflict of interest

Kevin Conhen, Ying Liu, Jingqin Luo, and Graham A. Colditz have no conflict of interest. Catherine M. Appleton has a consultant/advisory role in Hologic and Siemens.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in this study based on the protocol approved by the Institutional Review Board at the Washington University in St. Louis.

Supplementary material

10549_2017_4152_MOESM1_ESM.docx (23 kb)
Supplementary material 1 (DOCX 22 kb)


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Kevin Cohen
    • 1
  • Ying Liu
    • 1
    • 2
  • Jingqin Luo
    • 1
    • 2
    • 3
  • Catherine M. Appleton
    • 4
  • Graham A. Colditz
    • 1
    • 2
  1. 1.Division of Public Health SciencesWashington University School of MedicineSt. LouisUSA
  2. 2.Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of MedicineSt. LouisUSA
  3. 3.Alvin J. Siteman Cancer Center Biostatistics Shared ResourceWashington University School of MedicineSt. LouisUSA
  4. 4.Division of Diagnostic Radiology, Department of RadiologyWashington University School of MedicineSt. LouisUSA

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