Dietary Patterns and Breast Cancer Risk: A KCPS-II Cohort Study

Abstract Background: There have been inconsistencies in the evidence for a role of dietary risk factors in the development of breast cancer. In this study, we used a large-scale cohort (Korean Cancer Prevention Study-II [KCPS-II]) to examine the association between dietary patterns and breast cancer risk in Korean women.Methods: The dietary patterns of 14,807 women from the KCPS-II were derived by factor analysis and 135 cases of breast cancer were diagnosed during the follow-up period. Cox proportional models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for the risk of breast cancer. Results: The following three major dietary factors were identified: “Korean dietary pattern” (high intake of Kimchi, vegetables, and rice); “Sweet dietary pattern” (high intake of soda and sugar); and “Western-like dietary pattern” (high intake of dairy products, eggs, oil, fruits, and bread). After adjusting for potential confounders, neither the Korean (HR for the highest compared with the lowest tertile, 1.04; 95% CI 0.53−2.06) nor the Sweet dietary patterns were associated with the risk of breast cancer. In contrast, the Western-like dietary pattern was found to be significantly associated with an increased risk of breast cancer with an HR (95% CI) of 1.01 (0.65−1.60) for the second tertile and 1.61 (1.04−2.50) for the third tertile as compared with the lowest tertile. After stratifying by menopausal status, these effects were only statistically significant among premenopausal women for the third tertile, compared with those in the bottom tertile (HR 1.69; 95% CI 1.06−2.68; p = 0.028). No significant association was observed between the Korean or Sweet dietary pattern and breast cancer among either pre- or postmenopausal women.Conclusions: Our findings revealed that a greater consumption of a Western-like diet was associated with an increased breast cancer risk and consequently offer a potential prevention strategy for Korean women.

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Multi-Grain Rice Diet Decreases Risk of Breast Cancer in Korean Women: Results from the Health Examinees Study

Nutrients ◽

10.3390/nu12082273 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2273

Author(s):

Woo-Kyoung Shin ◽

Hwi-Won Lee ◽

Aesun Shin ◽

Jong-koo Lee ◽

Sang-Ah Lee ◽

...

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Dietary Patterns ◽

Dietary Pattern ◽

Lower Risk ◽

Large Scale ◽

Korean Women ◽

White Rice ◽

Rice Diet

Although a number of studies explain the association between dietary patterns, which take into account that foods are eaten in combination, and breast cancer risk, the findings are inconsistent. We examined the association between dietary patterns and multi-grain rice intake, and the risk of breast cancer in a large-scale prospective cohort study in Korean women. A total of 93,306 women aged 40–69 years from the Health Examinees-Gem (HEXA-G) study (2004 and 2013) were included. We obtained Information on cancer diagnosis via linkage to the Korea Central Cancer Registry. Factor analysis was conducted to obtain dietary patterns, and Cox proportional models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CI) for breast cancer risk. For 494,490 person-years, 359 new cases of breast cancer occurred. We identified three major dietary patterns, that explained 23.9% of the total variance based on daily total food intake (g/day) from 37 food groups: the meat dietary pattern (higher intake of bread and red meat), the white rice dietary pattern (higher intake of white rice and lower intake of multi-grain rice), and the other pattern. Women who had higher white rice dietary pattern scores had a 35% higher risk of breast cancer, than did women with lower white rice dietary pattern scores (multivariable HR 1.35; 95% CI 1.00–1.84 for the highest vs. lowest quartile of the white rice dietary pattern scores, p for trend = 0.0384). We found that women who consumed three or more servings of multi-grain rice per day had 33% lower risk of breast cancer than did those who consumed one or less multi-grain rice serving per day among women under 50 years of age (multivariable HR 0.67; 95% CI 0.45–0.99, p for trend = 0.0204). Our study suggests that a multi-grain rice diet may be associated with lower risk of breast cancer in Korean women.

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Dietary pattern and breast cancer risk in Japanese women: the Japan Public Health Center-based Prospective Study (JPHC Study)

British Journal Of Nutrition ◽

10.1017/s0007114516000684 ◽

2016 ◽

Vol 115 (10) ◽

pp. 1769-1779 ◽

Cited By ~ 13

Author(s):

Sangah Shin ◽

Eiko Saito ◽

Manami Inoue ◽

Norie Sawada ◽

Junko Ishihara ◽

...

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Dietary Patterns ◽

Dietary Pattern ◽

Menopausal Status ◽

Japanese Women ◽

Hazard Ratios ◽

Increased Risk

AbstractEvidence that diet is associated with breast cancer risk is inconsistent. Most of the studies have focused on risks associated with specific foods and nutrients, rather than overall diet. In this study, we aimed to evaluate the association between dietary patterns and breast cancer risk in Japanese women. A total of 49 552 Japanese women were followed-up from 1995 to 1998 (5-year follow-up survey) until the end of 2012 for an average of 14·6 years. During 725 534 person-years of follow-up, 718 cases of breast cancer were identified. We identified three dietary patterns (prudent, westernised and traditional Japanese). The westernised dietary pattern was associated with a 32 % increase in breast cancer risk (hazard ratios (HR) 1·32; 95 % CI 1·03, 1·70; Ptrend=0·04). In particular, subjects with extreme intake of the westernised diet (quintile (Q) Q5_5th) had an 83 % increase in risk of breast cancer in contrast to those in the lowest Q1 (HR 1·83; 95 % CI 1·25, 2·68; Ptrend=0·01). In analyses stratified by menopausal status, postmenopausal subjects in the highest quintile of the westernised dietary pattern had a 29 % increased risk of breast cancer (HR 1·29; 95 % CI 0·99, 1·76; Ptrend=0·04). With regard to hormone receptor status, the westernised dietary pattern was associated with an increased risk of oestrogen receptor-positive/progesterone receptor-positivetumours (HR 2·49; 95 % CI 1·40, 4·43; Ptrend<0·01). The other dietary patterns were not associated with the risk of breast cancer in Japanese women. A westernised dietary pattern is associated with an increased risk of breast cancer in Japanese women.

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Dietary Patterns and Breast Cancer Risk in Black Urban South African Women: The SABC Study

Nutrients ◽

10.3390/nu13114106 ◽

2021 ◽

Vol 13 (11) ◽

pp. 4106

Author(s):

Inarie Jacobs ◽

Christine Taljaard-Krugell ◽

Mariaan Wicks ◽

Herbert Cubasch ◽

Maureen Joffe ◽

...

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

South African ◽

Dietary Patterns ◽

Dietary Pattern ◽

Conditional Logistic Regression ◽

Principal Component ◽

Processed Food ◽

Food Groups

A total of 396 breast cancer cases and 396 population-based controls from the South African Breast Cancer study (SABC) matched on age and demographic settings was included. Validated questionnaires were used to collect dietary and epidemiological data. Dietary patterns were derived using principal component analysis with a covariance matrix from 33 food groups. Odds ratios and 95% confidence intervals were estimated using conditional logistic regression. A traditional, a cereal-dairy breakfast and a processed food dietary pattern were identified, which together explained 40.3% of the total variance in the diet. After adjusting for potential confounders, the traditional dietary pattern and cereal-dairy breakfast dietary pattern were inversely associated with breast cancer risk (highest tertile versus lowest tertile) (OR = 0.72, 95%CI: 0.57–0.89, p-trend = 0.004 and OR = 0.73, 95%CI: 0.59–0.90, p-trend = 0.004, respectively). The processed food dietary pattern was not significantly associated with breast cancer risk. The results of this study show that a traditional dietary pattern and a cereal-dairy breakfast dietary pattern may reduce the risk of developing breast cancer in this population.

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Higher volumetric breast density to predict risk for aggressive breast cancer subtype in postmenopausal Korean women.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e11584 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e11584-e11584

Author(s):

In Hae Park ◽

Kyungran Ko ◽

Ji Soo Choi ◽

So-youn Jung ◽

Seeyoun Lee ◽

...

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Postmenopausal Women ◽

Cancer Patients ◽

Breast Density ◽

Korean Women ◽

Breast Cancer Patients ◽

Ki 67 ◽

Increased Risk

e11584 Background: In Asian population, the peak incidence of breast cancer is women in their late forties. We investigated the association between volumetric breast density and breast cancer risk according to menstruation status and breast cancer subtypes in Korean women. Methods: We prospectively enrolled 509 newly diagnosed breast cancer patients and 1336 healthy control subjects who performed mammography at the National Cancer Center in Korea between Sep 2011 and Nov 2012. Breast density was estimated using volumetric breast composition measurement (VolparaTM). We collected clinical data including menstruation status, parity, BMI and use of postmenopausal hormones. For cancer patient, we additionally acquired following pathologic data: histologic type, tumor size and grade, receptor status, Ki-67, and nodal status. Results: Of a total of subjects, 1064 (57.7%) women were postmenopausal status. The risk of breast cancer increased progressively with increase in volumetric breast density (Ptrend <0.001) in all subjects. In addition, breast cancer risk increased in women < 60 years old (odds radio (OR) = 1.81), higher body mass index (BMI) (< 25kg/m2 vs. ≥ 25kg/m2) (OR = 2.41), and fewer childbirth (0/1 vs. ≥ 2) (OR=2.38). In postmenopausal women, higher breast density (category 4) showed a 3.00-fold (OR = 3.00, 95% confidence interval (CI) = 1.75-5.16, P<0.001) increased risk of breast cancer compared with lower breast density (category 1-2). In contrast, there was no such association in premenopausal women. The associations of volumetric breast density were stronger for HER2 positivity (Ptrend <0.019), and high Ki-67 (Ptrend <0.006) in postmenopausal breast cancer patients. There was a statistically significant association between lower breast density and hormone receptor (HR) positive/HER2 negative breast cancer (Ptrend <0.019). Conclusions: High volumetric breast density is associated with the risk of breast cancer having more aggressive tumor characteristics in postmenopausal women.

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Nutrient-wide association study of 92 foods and nutrients and breast cancer risk

Proceedings of The Nutrition Society ◽

10.1017/s0029665120001275 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Alicia Heath ◽

David Muller ◽

Piet van den Brandt ◽

Nikos Papadimitriou ◽

Elena Critselis ◽

...

Keyword(s):

Breast Cancer ◽

Alcohol Consumption ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Association Study ◽

Cox Regression ◽

Dietary Factors ◽

Breast Cancers ◽

Study Approach ◽

Increased Risk

AbstractSeveral dietary factors have been extensively investigated for associations with risk of breast cancer, but to date unequivocal evidence only exists for alcohol consumption. We sought to systematically evaluate the association between 92 dietary factors and breast cancer risk using a nutrient-wide association study approach. Using data from 272,098 women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, we assessed dietary intake of 92 foods and nutrients estimated by dietary questionnaires. Cox regression with age as the time scale and adjustment for potential confounders, was used to quantify the association between each food or nutrient and risk of breast cancer. A false discovery rate (FDR) of 0.05 was used to select the set of foods and nutrients to evaluate in the independent replication cohort, the Netherlands Cohort Study (NLCS). During a median follow-up time of 15 years, 10,979 incident invasive breast cancers were identified in the women from the EPIC study. Six foods and nutrients were associated with risk of breast cancer when controlling the FDR at 0.05. Higher intake of alcohol overall was associated with a higher risk of breast cancer (hazard ratio (HR) for a 1 SD increment in intake = 1.05, 95% confidence interval (CI) 1.03–1.07), as was beer/cider intake and wine intake (HRs per 1 SD increment = 1.05, 95% CI 1.03–1.06 and 1.04, 95% CI 1.02–1.06, respectively), whereas higher intakes of fibre, apple/pear, and carbohydrates were associated with a lower risk of breast cancer (HRs per 1 SD increment = 0.96, 95% CI 0.94–0.98; 0.96, 95% CI 0.94–0.99; and 0.96, 95% CI 0.95–0.98, respectively). When evaluated in the NLCS (2368 invasive breast cancer cases), estimates for each of these foods and nutrients were similar in magnitude and direction, with the exception of beer/cider intake, which was not associated with risk of breast cancer in the NLCS. Our findings confirm the well-established increased risk of breast cancer associated with alcohol consumption, and suggest that higher intake of dietary fibre, and possibly fruit and carbohydrates, might be associated with reduced breast cancer risk.

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Dietary patterns and knowledge perception of breast cancer risk patients

Nutrition & Food Science ◽

10.1108/nfs-05-2016-0060 ◽

2017 ◽

Vol 47 (2) ◽

pp. 270-287 ◽

Cited By ~ 3

Author(s):

Suvasish Das Shuvo ◽

Tanvir Ahmad ◽

Dipak Kumar Paul ◽

Md. Ashrafuzzaman Zahid

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Dietary Patterns ◽

Principal Component ◽

Marginal Effect ◽

Poor Knowledge ◽

Content Type ◽

Increased Risk ◽

Risk Patients

Purpose Breast cancer is the most increasing female cancer worldwide, including Bangladesh. The purpose of this study was to investigate the association between dietary patterns and knowledge perception of breast cancer risk patients in Bangladesh. Design/methodology/approach A questionnaire survey about 27 frequently consumed food items was conducted among 140 patients in Amader Gram Cancer Care & Research Center. A logistic regression was applied to estimate breast cancer risk. Dietary patterns were analyzed by the principal component analysis: the fat-rich foods (meat, oil, etc.), fruits, vegetables, sugar, tea, coffee, eggs and fish patterns. Findings The marginal effect of the logit model estimated an increased risk of breast cancer for a“Fatty Diet”, characterized by a higher consumption of milk (1.2 per cent, p < 0.01), vegetable oils and fats, butter (3.7 per cent, p < 0.05) and red meat (4.9 per cent, p < 0.05), but a decreased risk of breast cancer for a “Fruity and Vegetable Diet”, characterized by a higher consumption of fish (1.3 per cent, p < 0.01), chicken and eggs (5.1 per cent, p < 0.05), fruits (0.05 per cent, p < 0.01) and vegetables (2.9 per cent, p < 0.05). The findings of this study also suggested that weight (0.07 per cent, p < 0.01) and age (19 per cent, p < 0.05) were associated with an increased risk of breast cancer, but exercise (13 per cent, p < 0.05) reduced breast cancer risk. The findings also showed that maximum patients had inadequate knowledge on dietary and clinical factors of breast cancer risk, in addition to poor cancer screening practice. Poor knowledge and practice of breast screening were likely to lead to late stage presentation of breast cancer. Originality/value The authors found an association between the prudent dietary patterns and breast cancer risk and poor knowledge on nutrition and breast cancer.

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Dietary Patterns and Breast Cancer Risk in Korean Women

Nutrition and Cancer ◽

10.1080/01635581.2010.514660 ◽

2010 ◽

Vol 62 (8) ◽

pp. 1161-1169 ◽

Cited By ~ 18

Author(s):

Young Ae Cho ◽

Jeongseon Kim ◽

Aesun Shin ◽

Ki-Soon Park ◽

Jungsil Ro

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Dietary Patterns ◽

Korean Women

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Adolescent and early adulthood inflammation-associated dietary patterns in relation to premenopausal mammographic density

Breast Cancer Research ◽

10.1186/s13058-021-01449-0 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Nichole A. Garzia ◽

Kara Cushing-Haugen ◽

Thomas W. Kensler ◽

Rulla M. Tamimi ◽

Holly R. Harris

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Mammographic Density ◽

Dietary Patterns ◽

Dietary Pattern ◽

Early Adulthood ◽

Food Frequency ◽

Cancer Risk Factors ◽

Breast Cancer Risk Factors

Abstract Background Adolescence and early adulthood has been identified as a critical time window for establishing breast cancer risk. Mammographic density is an independent risk factor for breast cancer that may be influenced by diet, but there has been limited research conducted on the impact of diet on mammographic density. Thus, we sought to examine the association between adolescent and early adulthood inflammatory dietary patterns, which have previously been associated with breast cancer risk, and premenopausal mammographic density among women in the Nurses’ Health Study II (NHSII). Methods This study included control participants with premenopausal mammograms from an existing breast cancer case-control study nested within the NHSII who completed a Food Frequency Questionnaire in 1998 about their diet during high school (HS-FFQ) (n = 685) and/or a Food Frequency Questionnaire in 1991 (Adult-FFQ) when they were 27–44 years old (n = 1068). Digitized analog film mammograms were used to calculate the percent density, absolute dense, and non-dense areas. Generalized linear models were fit to evaluate the associations of a pro-inflammatory dietary pattern and the Alternative Healthy Eating Index (AHEI, an anti-inflammatory dietary pattern) with each breast density measure. Results Significant associations were observed between an adolescent pro-inflammatory dietary pattern and mammographic density in some age-adjusted models; however, these associations did not remain after adjustment for BMI and other breast cancer risk factors. No associations were observed with the pro-inflammatory pattern or with the AHEI pattern in adolescence or early adulthood in fully adjusted models. Conclusions To our knowledge, this is the first study to evaluate the dietary patterns during adolescence and early adulthood in relation to mammographic density phenotypes. Our findings do not support an association between adolescent and early adulthood diet and breast density in mid-adulthood that is independent of BMI or other breast cancer risk factors.

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Dietary patterns and breast cancer risk among women

Public Health Nutrition ◽

10.1017/s1368980013001018 ◽

2013 ◽

Vol 17 (5) ◽

pp. 1098-1106 ◽

Cited By ~ 28

Author(s):

Zeinab Karimi ◽

Mahsa Jessri ◽

Anahita Houshiar-Rad ◽

Hamid-Reza Mirzaei ◽

Bahram Rashidkhani

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Dietary Patterns ◽

Dietary Pattern ◽

Processed Meat ◽

Iranian Women ◽

Food Pattern ◽

Healthy Dietary Pattern

AbstractObjectiveBreast cancer is the most common type of cancer in women worldwide. Several studies have examined the role of single nutrients and food groups in breast cancer pathogenesis but fewer investigations have addressed the role of dietary patterns. Our main objective was to identify the relationship between major dietary patterns and breast cancer risk among Iranian women.DesignHospital-based case–control study.SettingShohada Teaching Hospital, Tehran, Iran.SubjectsOverall, 100 female patients aged 30–65 years with breast cancer and 174 female hospital controls were included in the present study. Dietary intake was assessed using a valid and reliable semi-quantitative FFQ consisting of 168 food items.ResultsTwo dietary patterns were identified explaining 24·31 % of dietary variation in the study population. The ‘healthy’ food pattern was characterized by the consumption of vegetables, fruits, low-fat dairy products, legumes, olive and vegetable oils, fish, condiments, organ meat, poultry, pickles, soya and whole grains; while the ‘unhealthy’ food pattern was characterized by the consumption of soft drinks, sugars, tea and coffee, French fries and potato chips, salt, sweets and desserts, hydrogenated fats, nuts, industrial juice, refined grains, and red and processed meat. Compared with the lowest tertile, women in the highest tertile of the ‘healthy’ dietary pattern score had 75 % decreased risk of breast cancer (OR = 0·25, 95 % CI 0·08, 0·78), whereas women in the highest tertile of the ‘unhealthy’ dietary pattern had a significantly increased breast cancer risk (OR = 7·78, 95 % CI 2·31, 26·22).ConclusionsA healthy dietary pattern may be negatively associated with breast cancer risk, while an unhealthy dietary pattern is likely to increase the risk among Iranian women.

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