Abstract
Evidence from some previous studies suggests that lipophilic antioxidants, particularly carotenoids, may reduce the risk of breast cancer. We prospectively investigated the associations of plasma levels of tocopherols, retinol, carotenoids with the risk of developing breast cancer among Chinese women. We conducted a study of 365 incident breast cancer cases and 726 individually matched controls nested within a large cohort study of women aged 40–70 years at baseline. We observed no associations between breast cancer risk and any of the tocopherols, retinol, and most carotenoids. However, high levels of plasma lycopene other than trans, 5- and 7-cis or trans α-cryptoxanthin were inversely associated with the risk of developing breast cancer. Our results do not support an overall protective effect of lipophilic antioxidants on breast cancer risk. The few inverse associations observed for subtype of carotenoids may need to be confirmed in future studies.
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Gandini S et al (2000) Meta-analysis of studies on breast cancer risk and diet: the role of fruit and vegetable consumption and the intake of associated micronutrients. Eur J Cancer 36(5):636–646. doi:10.1016/S0959-8049(00)00022-8
Malin AS et al (2003) Intake of fruits, vegetables and selected micronutrients in relation to the risk of breast cancer. Int J Cancer 105(3):413–418. doi:10.1002/ijc.11088
Zhang S et al (1999) Dietary carotenoids and vitamins A, C, and E and risk of breast cancer. J Natl Cancer Inst 91(6):547–556. doi:10.1093/jnci/91.6.547
Dorgan JF et al (1998) Relationships of serum carotenoids, retinol, alpha-tocopherol, and selenium with breast cancer risk: results from a prospective study in Columbia, Missouri (United States). Cancer Causes Control 9(1):89–97. doi:10.1023/A:1008857521992
Machlin LJ, Bendich A (1987) Free radical tissue damage: protective role of antioxidant nutrients. FASEB J 1(6):441–445
Hunter DJ et al (1993) A prospective study of the intake of vitamins C, E, and A and the risk of breast cancer. N Engl J Med 329(4):234–240. doi:10.1056/NEJM199307223290403
Verhoeven DT et al (1997) Vitamins C and E, retinol, beta-carotene and dietary fibre in relation to breast cancer risk: a prospective cohort study. Br J Cancer 75(1):149–155
Michels KB et al (2001) Dietary antioxidant vitamins, retinol, and breast cancer incidence in a cohort of Swedish women. Int J Cancer 91(4):563–567. doi:10.1002/1097-0215(200002)9999:9999<∷AID-IJC1079>3.0.CO;2-9
Smith-Warner SA et al (2001) Intake of fruits and vegetables and risk of breast cancer: a pooled analysis of cohort studies. JAMA 285(6):769–776. doi:10.1001/jama.285.6.769
Moorman PG et al (2001) Vitamin supplement use and breast cancer in a North Carolina population. Public Health Nutr 4(3):821–827
Dorjgochoo T et al (2007) Vitamin supplement use and risk for breast cancer: the Shanghai Breast Cancer Study. Breast Cancer Res Treat 111(2):269–278
Sato R et al (2002) Prospective study of carotenoids, tocopherols, and retinoid concentrations and the risk of breast cancer. Cancer Epidemiol Biomarkers Prev 11(5):451–457
Tamimi RM et al (2005) Plasma carotenoids, retinol, and tocopherols and risk of breast cancer. Am J Epidemiol 161(2):153–160. doi:10.1093/aje/kwi030
Toniolo P et al (2001) Serum carotenoids and breast cancer. Am J Epidemiol 153(12):1142–1147. doi:10.1093/aje/153.12.1142
Wald NJ et al (1984) Plasma retinol, beta-carotene and vitamin E levels in relation to the future risk of breast cancer. Br J Cancer 49(3):321–324
Yu SM et al (2003) Vitamin–mineral supplement use among US women, 2000. J Am Med Womens Assoc 58(3):157–164
Satia JA et al (1999) Study of diet, biomarkers and cancer risk in the United States, China and Costa Rica. Int J Cancer 82(1):28–32
Yuan JM et al (2001) Prediagnostic levels of serum beta-cryptoxanthin and retinol predict smoking-related lung cancer risk in Shanghai, China. Cancer Epidemiol Biomarkers Prev 10(7):767–773
Jin F et al (1999) Cancer incidence trends in urban shanghai, 1972–1994: an update. Int J Cancer 83(4):435–440. doi:10.1002/(SICI)1097-0215(19991112)83:4<435∷AID-IJC1>3.0.CO;2-J
Zheng W et al (2005) The Shanghai Women’s Health Study: rationale, study design, and baseline characteristics. Am J Epidemiol 162(11):1123–1131. doi:10.1093/aje/kwi322
National Center for Health Statistics (2008) International Classification of Diseases, 9th revision (ICD-9). CDC
Franke AA et al (1993) Synthetic carotenoids as internal standards for plasma micronutrient analyses by high-performance liquid chromatography. J Chromatogr A 614(1):43–57
Goodman MT et al (2007) Hawaii cohort study of serum micronutrient concentrations and clearance of incident oncogenic human papillomavirus infection of the cervix. Cancer Res 67(12):5987–5996. doi:10.1158/0008-5472.CAN-07-0313
Hulten K et al (2001) Carotenoids, alpha-tocopherols, and retinol in plasma and breast cancer risk in northern Sweden. Cancer Causes Control 12(6):529–537. doi:10.1023/A:1011271222153
Muller H (1996) Daily intake of carotenoids (carotenes and xanthophylls) from total diet and the carotenoid content of selected vegetables and fruit. Z Ernahrungswiss 35(1):45–50. doi:10.1007/BF01612027
Schlatterer J et al (2006) Plasma responses in human subjects after ingestions of multiple doses of natural alpha-cryptoxanthin: a pilot study. Br J Nutr 92(2):371–376. doi:10.1079/BJN20061848
Lian F et al (2006) Beta-cryptoxanthin suppresses the growth of immortalized human bronchial epithelial cells and non-small-cell lung cancer cells and up-regulates retinoic acid receptor beta expression. Int J Cancer 119(9):2084–2089. doi:10.1002/ijc.22111
Arab L et al (2001) Participation of lycopene and beta-carotene in carcinogenesis: defenders, aggressors, or passive bystanders? Epidemiol Rev 23(2):211–230
Clinton SK et al (1996) Cis-trans lycopene isomers, carotenoids, and retinol in the human prostate. Cancer Epidemiol Biomarkers Prev 5(10):823–833
Stahl W et al (1992) Cis-trans isomers of lycopene and beta-carotene in human serum and tissues. Arch Biochem Biophys 294(1):173–177. doi:10.1016/0003-9861(92)90153-N
Sesso HD et al (2005) Dietary and plasma lycopene and the risk of breast cancer. Cancer Epidemiol Biomarkers Prev 14(5):1074–1081. doi:10.1158/1055-9965.EPI-04-0683
Comstock GW et al (2001) The repeatability of serum carotenoid, retinoid, and tocopherol concentrations in specimens of blood collected 15 years apart. Cancer Epidemiol Biomarkers Prev 10(1):65–68
Simon MS et al (2000) An evaluation of plasma antioxidant levels and the risk of breast cancer: a pilot case control study. Breast J 6(6):388–395. doi:10.1046/j.1524-4741.2000.20067.x
Willett WC et al (1984) Relation of serum vitamins A and E and carotenoids to the risk of cancer. N Engl J Med 310(7):430–434
Nomura AM et al (2003) Serum vitamins and the subsequent risk of bladder cancer. J Urol 170(4 Pt 1):1146–1150. doi:10.1097/01.ju.0000086040.24795.ad
Lee IM et al (2005) Vitamin E in the primary prevention of cardiovascular disease and cancer: the Women’s Health Study: a randomized controlled trial. JAMA 294(1):56–65. doi:10.1001/jama.294.1.56
Ambrosone CB et al (1999) Manganese superoxide dismutase (MnSOD) genetic polymorphisms, dietary antioxidants, and risk of breast cancer. Cancer Res 59(3):602–606
Van Kappel AL et al (2001) Serum carotenoids as biomarkers of fruit and vegetable consumption in the New York Women’s Health Study. Public Health Nutr 4(3):829–835
Acknowledgments
The authors would like to thank the study participants and Brandy Sue Venuti for technical assistance in the preparation of this manuscript. The authors also thank Cynthia Morrison for the skillful performance of HPLC assays and thank Dr. Bob Cooney for his helpful comments. This study was supported by USPHS grant R01CA106591 as well as USPHS grant R01CA70867 and NIH intramural program (N02 CP1101066) for the parent study.
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Dorjgochoo, T., Gao, YT., Chow, WH. et al. Plasma carotenoids, tocopherols, retinol and breast cancer risk: results from the Shanghai Women Health Study (SWHS). Breast Cancer Res Treat 117, 381–389 (2009). https://doi.org/10.1007/s10549-008-0270-4
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DOI: https://doi.org/10.1007/s10549-008-0270-4