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Dietary isoflavone intake and breast cancer risk in case–control studies in Japanese, Japanese Brazilians, and non-Japanese Brazilians

  • Epidemiology
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Abstract

Although epidemiologic studies have shown an inverse association between isoflavones and breast cancer risk, little evidence for a dose–response relation is available. We conducted hospital-based case–control studies of patients aged 20–74 years with primary, incident, histologically confirmed invasive breast cancer, and matched controls from medical checkup examinees in Nagano, Japan and from cancer-free patients in São Paulo, Brazil. A total of 850 pairs (390 Japanese, 81 Japanese Brazilians and 379 non-Japanese Brazilians) completed validated food frequency questionnaires. The odds ratio of breast cancer according to isoflavone intake was estimated using a conditional logistic regression model. We found a statistically significant inverse association between isoflavone intake and the risk of breast cancer for Japanese Brazilians and non-Japanese Brazilians. For Japanese, a non-significant inverse association was limited to postmenopausal women. In the three populations combined, breast cancer risk linearly decreased from ‘no’ to ‘moderate’ isoflavone intake and thereafter leveled off. Compared to non-consumers, adjusted odds ratios (95% confidence interval) for consumers in increasing quintile intake categories (median intake in each category: 8.7, 23.1, 33.8, 45.7, and 71.3 mg/day) were 0.69 (0.44–1.09), 0.54 (0.31–0.94), 0.45 (0.26–0.77), 0.34 (0.19–0.62), and 0.43 (0.24–0.76), respectively. Overall, we found an inverse association between dietary isoflavone intake and risk of breast cancer. Our finding suggests a risk-reducing rather than risk-enhancing effect of isoflavones on breast cancer within the range achievable from dietary intake alone. In addition, women may benefit from risk reduction if they consume at least moderate amounts of isoflavones.

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Abbreviations

CI:

Confidence interval

ER:

Estrogen receptor

FFQ:

Food-frequency questionnaire

OR:

Odds ratio

PR:

Progesterone receptor

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Acknowledgments

This study was supported by a Grant-in-Aid for Research on Risk of Chemical Substances from the Ministry of Health, Labour and Welfare of Japan, and Grants-in-Aid for Scientific Research on Priority Areas (17015049) and for Young Scientists (B) (17790378 and 19790415) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan and the Japan Society for the Promotion of Science. We are grateful to the participants in the “São Paulo-Japan Breast Cancer Study Group”: C. I. Yamaguchi, C. M. Kunieda, and S. S. Sugama (Nikkei Disease Prevention Center, São Paulo); C. K. Taniguchi and J. A. Marques (Departamento de Ginecologia, Hospital Pérola Byington, São Paulo); M. R. Eichhorn (Departamento de Nutrição, Hospital Pérola Byington, São Paulo); H. Iyeyasu, M. S. Maciel, S. M. T. Carvalho, J. B. D. Collins, and C. E. M. Fontes (Departamento de Mastologia, Hospital A.C. Camargo, São Paulo); L. P. Kowalski and J. M. F. Toyota (Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia, A. C. Camargo Hospital, São Paulo); E. M. Barbosa (Departamento de Mastologia, Instituto Brasileiro de Controle ao Câncer, São Paulo); O. Ferraro (Departamento de Mastologia, Hospital do Servidor Público Estadual Francisco Morato de Oliveira, São Paulo); R. Anzai (Departamento de Mastologia, Hospital Santa Cruz); E. H. Hotta and D. A. Petti (Instituto de Ginecologia e Mastologia, Hospital Beneficencia Portuguesa); S. Mendes (Instituto Brasileiro de Mastologia e Ginecologia, Hospital Beneficencia Portuguesa).

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Authors and Affiliations

  1. Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Motoki Iwasaki, Minatsu Kobayashi, Junko Ishihara, Tomoyuki Hanaoka & Shoichiro Tsugane

  2. Nikkei Disease Prevention Center, São Paulo, Brazil

    Gerson Shigeaki Hamada

  3. Statistical Section/Head and Neck Surgery and Otorhinolaryngology Department, Hospital A.C. Camargo, São Paulo, Brazil

    Ines Nobuko Nishimoto

  4. Breast Surgery Department, Hospital A.C. Camargo, São Paulo, Brazil

    Mario Mourão Netto

  5. Department of Breast Surgery, Hospital Pérola Byington, São Paulo, Brazil

    Juvenal Motola Jr. & Fábio Martins Laginha

  6. Department of Surgery, Nagano Matsushiro General Hospital, Nagano, Japan

    Yoshio Kasuga

  7. Department of Breast and Thyroid Surgery, Nagano Red Cross Hospital, Nagano, Japan

    Shiro Yokoyama & Hiroshi Onuma

  8. Department of Surgery, Nagano Municipal Hospital, Nagano, Japan

    Hideki Nishimura

  9. Department of Surgery, Nagano Hokushin General Hospital, Nagano, Japan

    Ritsu Kusama

  10. Cancer Information Services and Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan

    Seiichiro Yamamoto

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  1. Motoki Iwasaki
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  2. Gerson Shigeaki Hamada
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  9. Hiroshi Onuma
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  13. Junko Ishihara
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  14. Seiichiro Yamamoto
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  15. Tomoyuki Hanaoka
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  16. Shoichiro Tsugane
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Correspondence to Motoki Iwasaki.

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Iwasaki, M., Hamada, G.S., Nishimoto, I.N. et al. Dietary isoflavone intake and breast cancer risk in case–control studies in Japanese, Japanese Brazilians, and non-Japanese Brazilians. Breast Cancer Res Treat 116, 401–411 (2009). https://doi.org/10.1007/s10549-008-0168-1

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  • DOI: https://doi.org/10.1007/s10549-008-0168-1

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