Breast Cancer Research and Treatment

, Volume 42, Issue 3, pp 243–251 | Cite as

Diet and premenopausal bilateral breast cancer: A case-control study

  • John S. Witte
  • Giske Ursin
  • Jack Siemiatycki
  • W. Douglas Thompson
  • Annali Paganini-Hill
  • Robert W. Haile


We investigated associations between diet and premenopausal bilateral breast cancer in a familial matched case-control study. We studied 140 cases from population-based registries in Los Angeles County (California) and Connecticut, and from the major hospitals in the southern parts of the Province of Quebec. Unaffected sisters of the cases served as matched controls (222 total). Dietary intake were assessed with a food frequency questionnaire. Total fat, monounsaturated fat, polyunsaturated fat, oleic acid, and linoleic acid intake was inversely associated with premenopausal bilateral breast cancer risk. Consumption of carbohydrates (and sweetened beverages) was associated with an increased risk. We observed no associations for dietary fiber, antioxidants, or major food groupings, but we did observe inverse associations for intake of low fat dairy products and tofu. These findings suggest that monounsaturated and polyunsaturated fats, as well as soy foods, might reduce the risk of premenopausal bilateral breast cancer.

case-control study diet fat premenopausal bilateral breast neoplasm 


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  1. 1.
    Hunter DJ, Willett WC: Diet, body size, and breast cancer. Epidemiol Rev 15: 110–132, 1993Google Scholar
  2. 2.
    Howe GR: Dietary fat and breast cancer risks: an epidemiologic perspective. Cancer 74: 1078–1084, 1994Google Scholar
  3. 3.
    Howe GR, Hirohata T, Hislop TG et al.: Dietary factors and risk of breast cancer: combined analysis of 12 case-control studies. J Natl Cancer Inst 82: 561–569, 1990Google Scholar
  4. 4.
    Vatten LJ, Solvoll K, Loken EB: Frequency of meat and fish intake and risk of breast cancer in a prospective study of 14,500 Norwegian women. Int J Cancer 46: 12–15, 1990Google Scholar
  5. 5.
    Martin-Moreno JM, Willett WC, Gorgojo L et al.: Dietary fat, olive oil intake and breast cancer risk. Int J Cancer 58: 774–780, 1994Google Scholar
  6. 6.
    Landa MC, Frago N, Tres A: Diet and the risk of breast cancer in Spain. European J Cancer Prev 3: 313–320, 1994Google Scholar
  7. 7.
    Willett WC, Hunter DJ, Stampfer MJ et al.: Dietary fat and fiber in relation to risk of breast cancer. J Am Med Assoc 268: 2037–2044, 1992Google Scholar
  8. 8.
    Rohan TE, Howe GR, Friedenreich GM, Jain M, Miller AB: Dietary fiber, vitamins A, C, and E, and risk of breast cancer: a cohort study. Cancer Causes Control 4: 29–37, 1993Google Scholar
  9. 9.
    Ottman R, Pike MC, King M-C, Casagrande JT, Henderson BE: Familial breast cancer in a population-based series. Am J Epidemiol 123: 15–21, 1986Google Scholar
  10. 10.
    Miki Y, Swensen J, Shattuck-Eidens D et al.: A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science 266: 66–71, 1994Google Scholar
  11. 11.
    Willett W: The search for the causes of breast and colon cancer. Nature 338: 389–394, 1989Google Scholar
  12. 12.
    Love RR: Prevention of breast cancer in premenopausal women. National Cancer Institute Monograph 16: 61–65, 1994Google Scholar
  13. 13.
    Zaridze D, Lifanova Y, Maximovitch D, Day NE, Duffy SW: Diet, alcohol consumption and reproductive factors in a case-control study of breast cancer in Moscow. Int J Cancer 48: 493–501, 1991Google Scholar
  14. 14.
    de Waard F, Baanders-van Halewijn EA, Huizinga J: The bimodal age distribution of patients with mammary carcinoma: evidence for the existence of two types of human breast cancer. Cancer 17: 141–151, 1964Google Scholar
  15. 15.
    Willett WC: Implications of total energy for epidemiology studies of breast and large bowel cancer. Am J Clin Nutr 45: 354–360, 1987Google Scholar
  16. 16.
    Goldstein AM, Hodge SE, Haile RWC: Selection bias in case-control studies using relatives as the controls. Int J Epidemiol 18: 985–989, 1989Google Scholar
  17. 17.
    Willett WC, Sampson L, Stampfer MJ et al.: Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 122: 51–65, 1985Google Scholar
  18. 18.
    Berlin JA, Longnecker MP, Greenland S: Meta-analysis of epidemiologic dose-response data. Epidemiology 4: 218–228, 1993Google Scholar
  19. 19.
    Witte JS, Pike MP: Re: Can energy adjustment separate the effects of energy from those of specific macronutrients? (letter). Am J Epidemiol 142: 225–226, 1995Google Scholar
  20. 20.
    Willett WC, Stampfer MJ: Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 124: 17–27, 1986Google Scholar
  21. 21.
    Greenland S: Dose response and trend analysis in epidemiology: alternatives to categorical analysis. Epidemiology 6: 356–365, 1995Google Scholar
  22. 22.
    Witte JS, Greenland S: A nested approach to evaluating dose-response and trend (abstract). Am J Epidemiol 141: S48, 1995Google Scholar
  23. 23.
    Ursin G, Aragaki CC, Paganini-Hill A, Siemiatycki J, Thompson WD, Haile RW: Oral contraceptives and premenopausal bilateral breast cancer: a case-control study. Epidemiol 3: 414–419, 1992Google Scholar
  24. 24.
    Ursin G, Paganini-Hill A, Siemiatycki J, Thompson WD, Haile RW: Early adult body weight, body mass index and premenopausal bilateral breast cancer: data from a case-control study. Breast Cancer Res Treat 33: 75–82, 1994Google Scholar
  25. 25.
    Haile RW, Witte JS, Ursin G et al.: A case-control study of reproductive variables, alcohol, and smoking in premenopausal bilateral breast cancer. Breast Cancer Res Treat 37: 49–56, 1996Google Scholar
  26. 26.
    Willett WC, Hunter DJ: Prospective studies of diet and breast cancer. Cancer 74: 1085–1089, 1994Google Scholar
  27. 27.
    Hirayama T: Epidemiology of breast cancer with special reference to the role of diet. Prev Med 7: 173–195, 1978Google Scholar
  28. 28.
    Lubin JH, Burns PE, Blot WJ, Ziegler RG, Lees AW, Fraumeni JF: Dietary factors and breast cancer risk. Int J Cancer 28: 685–689, 1981Google Scholar
  29. 29.
    Hislop TG, Coldman AJ, Elwood JM, Brauer G, Kan L: Childhood and recent eating patterns and risk of breast cancer. Cancer Detection Prev 9: 47–58, 1986Google Scholar
  30. 30.
    La Vecchia C, Decarli A, Franceschi S, Gentile A, Negri E, Prazzini F: Dietary factors and the risk of breast cancer. Nutr Cancer 10: 205–214, 1987Google Scholar
  31. 31.
    Lee HP, Gourley L, Duffy SW, Esteve J, Lee J, Day NE: Risk factors for breast cancer by age and menopausal status: a case-control study in Singapore. Cancer Causes Cntrl 3: 313–322, 1992Google Scholar
  32. 32.
    Cohen LA, Wynder EI: Do dietary mono-unsaturated fatty acids play a protective role in carcinogenesis and cardiovascular disease? Med Hypotheses 31: 83–89, 1990Google Scholar
  33. 33.
    Vatten LJ, Bjerve KS, Andersen A, Jellum E: Polyunsaturated fatty acids in serum phospholipids and risk of breast cancer: a case-control study from the Janus serum bank in Norway. Eur J Cancer 29A: 532–538, 1993Google Scholar
  34. 34.
    Reaven P, Parthasarathy S, Grasse BJ, Miller E, Steinberg D, Witztum JL: Effects of oleate-rich and linoleate-rich diets on the susceptibility of low density lipoprotein to oxidative modification in mildly hypercholesterolemic subjects. J Clin Invest 91: 668–676, 1993Google Scholar
  35. 35.
    Lee HP, Gourley L, Duffy SW, Esteve J, Lee J, Day NE: Dietary effects on breast cancer risk for Singapore. Lancet 337: 1197–1200, 1991Google Scholar
  36. 36.
    Zaridze DG, Chevchenko VE, Levtshuk AA, Lifanova YE, Maximovitch D: Fatty acid composition of phospholipids in erythrocyte membranes and risk of breast cancer. Int J Cancer 45: 807–810, 1990Google Scholar
  37. 37.
    Katsouyanni K, Trichopoulos D, Boyle P et al.: Diet and breast cancer: a case-control study in Greece. Int J Cancer 38: 815–820, 1986Google Scholar
  38. 38.
    Lubin F, Wax Y, Modan B: Role of fat, animal protein, and dietary fiber in breast cancer etiology: case-control study. J Natl Cancer Inst 3: 605–611, 1986Google Scholar
  39. 39.
    Katsouyanni K, Willett W, Trichopoulos D et al.: Risk of breast cancer among Greek women in relation to nutrient intake. Cancer 61: 181–185, 1988Google Scholar
  40. 40.
    Freudenheim JL, Graham S, Marshall JR et al.: Intake of vegetable/fruits and associated nutrients in the epidemiology of premenopausal breast cancer. Am J Epidemiol (abstract) 8: 1001, 1992Google Scholar
  41. 41.
    Block G, Patterson B, Subar A: Fruit, vegetables, and cancer prevention: a review of the epidemiological evidence. Nutr Cancer 18: 1–29, 1992Google Scholar
  42. 42.
    Graham S, Marshall J, Mettlin C, Rzepka T, Nemoto T, Byers T: Diet in the epidemiology of breast cancer. Am J Epidemiol 116: 68–75, 1982Google Scholar
  43. 43.
    Kennedy AR: The evidence for soybean products as cancer preventive agents. J Nutr 125: 733s–743s, 1995Google Scholar
  44. 44.
    Cassidy A, Gingham S, Setchell KD: Biological effects of a diet of soy protein rich in isoflavones on the menstrual cycle of premenopausal women. Am J Clin Nutr 60: 333–340, 1994Google Scholar
  45. 45.
    Persky V, Van Horn L: Epidemiology of soy and cancer: perspectives and directions. J Nutr 125: 790s–712s, 1995Google Scholar
  46. 46.
    Giovanucci E, Stampfer MJ, Colditz GA et al.: A comparison of prospective and retrospective assessments of diet in the study of breast cancer. Am J Epidemiol 137: 502–511, 1993Google Scholar
  47. 47.
    Friedenreich CM, Howe GR, Miller AB: Recall bias in the association of micronutrient intake and breast cancer. J Clin Epidemiol 46: 1009–1017, 1993Google Scholar

Copyright information

© Kluwer Academic Publishers 1997

Authors and Affiliations

  • John S. Witte
    • 1
  • Giske Ursin
    • 2
  • Jack Siemiatycki
    • 3
  • W. Douglas Thompson
    • 4
  • Annali Paganini-Hill
    • 2
  • Robert W. Haile
    • 2
  1. 1.Department of Epidemiology and BiostaticsCase Western Reserve UniversityClevelandUSA
  2. 2.Department of Preventive MedicineUniversity of Southern CaliforniaLos AngelesUSA
  3. 3.Department of EpidemiologyInstitut Armand FrappierCanada
  4. 4.Applied Medical SciencesUniversity of Southern MainePortlandUSA

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