Highlights
- •The association of three dietary patterns with breast cancer risk was evaluated in a case-control study. The dietary patterns were Western, Prudent and Mediterranean.
- •Greater adherence to the Western dietary pattern seems to increase breast cancer risk in both premenopausal and postmenopausal women.
- •While greater adherence to the Prudent pattern did not show any effect on breast cancer risk, the Mediterranean dietary pattern could be protective, but only in postmenopausal women.
- •Tumour subtype was unaffected by dietary pattern.
- •Dietary recommendations based on a departure from the Western dietary pattern in favour of the Mediterranean diet could reduce breast cancer risk in the general population.
Abstract
Objective
To externally validate the previously identified effect on breast cancer risk of the
Western, Prudent and Mediterranean dietary patterns.
Study design
MCC-Spain is a multicase-control study that collected epidemiological information
on 1181 incident cases of female breast cancer and 1682 healthy controls from 10 Spanish
provinces. Three dietary patterns derived in another Spanish case-control study were
analysed in the MCC-Spain study. These patterns were termed Western (high intakes
of fatty and sugary products and red and processed meat), Prudent (high intakes of
low-fat dairy products, vegetables, fruits, whole grains and juices) and Mediterranean
(high intake of fish, vegetables, legumes, boiled potatoes, fruits, olives, and vegetable
oil, and a low intake of juices). Their association with breast cancer was assessed
using logistic regression models with random province-specific intercepts considering
an interaction with menopausal status. Risk according to tumour subtypes – based on
oestrogen (ER), progesterone (PR) and human epidermal growth factor 2 (HER2) receptors
(ER+/PR+ & HER2−; HER2+; ER−/PR− & HER2−) – was evaluated with multinomial regression
models.
Main outcome measures
Breast cancer and histological subtype.
Results
Our results confirm most of the associations found in the previous case-control study.
A high adherence to the Western dietary pattern seems to increase breast cancer risk
in both premenopausal women (OR4thvs.1stquartile (95% CI):1.68 (1.02;2.79); OR1SD-increase (95% CI):1.19 (1.02;1.40)) and postmenopausal women (OR4thvs.1stquartile(95% CI):1.48(1.07;2.05); OR1SD-increase(95% CI): 1.14 (1.01;1.29)). While high adherence to the Prudent pattern did not show
any effect on breast cancer, the Mediterranean dietary pattern seemed to be protective,
but only among postmenopausal women (OR4thvs.1stquartile (95% CI): 0.72 (95% CI 0.53;0.98); p-int = 0.075). There were no significant differences by tumour subtype.
Conclusion
Dietary recommendations based on a departure from the Western dietary pattern in favour
of the Mediterranean diet could reduce breast cancer risk in the general population.
Abbreviations:
BC (breast cancer), EpiGEICAM (epidemiological study of the Spanish Group for Breast Cancer Research (Grupo Español de Investigación en Cáncer de Mama)), MCC-Spain (multicase-control study on common tumours in Spain), OR (odds ratio), 95%CI (95% Confidence Interval), FFQ (food frequency questionnaire), ER (oestrogen receptor), PR (progesterone receptor), HER2 (human epidermal growth factor receptor 2), TN (triple negative), SD (standard deviation), IQI (interquartile interval), BMI (body mass index), METs (metabolic equivalents), Kcal (kilocalories), PAF (population attributable fraction), n (number of individuals), p-int (p-value for the interaction), p-het (p-value for the heterogeneity), p-trend (p-value for trend)Keywords
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Article info
Publication history
Published online: June 14, 2017
Accepted:
June 9,
2017
Received in revised form:
June 1,
2017
Received:
April 3,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
