Cancer Causes & Control

, Volume 26, Issue 1, pp 79–90 | Cite as

Intakes of fat and micronutrients between ages 13 and 18 years and the incidence of proliferative benign breast disease

  • Xuefen Su
  • Caroline E. Boeke
  • Laura C. Collins
  • Heather J. Baer
  • Walter C. Willett
  • Stuart J. Schnitt
  • James L. Connolly
  • Bernard Rosner
  • Graham A. Colditz
  • Rulla M. Tamimi
Original paper



Dietary exposures during adolescence may exert important effects on breast development and future breast cancer risk. This study evaluated the associations between high school intakes of fat and micronutrients and the incidence of proliferative benign breast disease (BBD), a marker of increased breast cancer risk.


29,480 women (mean age 43.3 years, range 33.6–52.9) completed a high school food frequency questionnaire in 1998 in the Nurses’ Health Study II. Between 1991 and 2001, 682 women (follow-up time: 259,828 person-years) were diagnosed with proliferative BBD whose biopsy slides were reviewed and confirmed by the study pathologists.


In multivariate Cox proportional hazards models, high school intakes of total fat and types of fat were not associated with proliferative BBD. Women in the highest quintile of total retinol activity equivalents (RAEs), which incorporate retinol, α- and β-carotene, and β-cryptoxanthin intakes, had a 17 % lower risk of proliferative BBD than those in the lowest quintile [multivariate hazard ratio (HR) 95 % CI 0.83 (0.64, 1.07), p trend = 0.01]; however, additional adjustment for high school dietary factors (vitamin D, nuts, and fiber) rendered the association nonsignificant [0.99 (0.73, 1.34), p trend = 0.32]. Results were similar with additional adjustment for adult RAE intake. Intakes of vitamin E and individual carotenoids were not associated with proliferative BBD, although an inverse association cannot be ruled out.


In this study, adolescent fat and micronutrient intakes were not associated with risk of proliferative BBD.


Fat Micronutrients High school Dietary intake Proliferative benign breast disease 



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. This work was supported by the Breast Cancer Research Foundation and the National Institutes of Health (Grant Nos. UM1 CA176726, CA 050385, CA 046475). Caroline Boeke was funded by T32 CA 09001. Graham Colditz was supported by an American Cancer Society Clinical Research Professorship and by the Breast Cancer Research Foundation.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Xuefen Su
    • 1
    • 2
  • Caroline E. Boeke
    • 3
    • 4
  • Laura C. Collins
    • 5
  • Heather J. Baer
    • 4
    • 6
  • Walter C. Willett
    • 3
    • 4
    • 6
    • 7
  • Stuart J. Schnitt
    • 5
  • James L. Connolly
    • 5
  • Bernard Rosner
    • 3
    • 4
    • 6
    • 8
  • Graham A. Colditz
    • 9
  • Rulla M. Tamimi
    • 3
    • 4
    • 6
  1. 1.School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong KongPeople’s Republic of China
  2. 2.CUHK Shenzhen Research InstituteShenzhenPeople’s Republic of China
  3. 3.Channing Division of Network Medicine, Department of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  4. 4.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  5. 5.Department of PathologyHarvard Medical School and Beth Israel Deaconess Medical CenterBostonUSA
  6. 6.Department of MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  7. 7.Department of NutritionHarvard School of Public HealthBostonUSA
  8. 8.Department of BiostatisticsHarvard School of Public HealthBostonUSA
  9. 9.Alvin J. Siteman Cancer Center and Department of SurgeryWashington University School of MedicineSt LouisUSA

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