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Fruit and vegetable intake and risk of breast cancer by hormone receptor status.
J Natl Cancer Inst 2013; 105(3):219-36JNCI

Abstract

BACKGROUND

Estrogen receptor-negative (ER(-)) breast cancer has few known or modifiable risk factors. Because ER(-) tumors account for only 15% to 20% of breast cancers, large pooled analyses are necessary to evaluate precisely the suspected inverse association between fruit and vegetable intake and risk of ER(-) breast cancer.

METHODS

Among 993 466 women followed for 11 to 20 years in 20 cohort studies, we documented 19 869 estrogen receptor positive (ER(+)) and 4821 ER(-) breast cancers. We calculated study-specific multivariable relative risks (RRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression analyses and then combined them using a random-effects model. All statistical tests were two-sided.

RESULTS

Total fruit and vegetable intake was statistically significantly inversely associated with risk of ER(-) breast cancer but not with risk of breast cancer overall or of ER(+) tumors. The inverse association for ER(-) tumors was observed primarily for vegetable consumption. The pooled relative risks comparing the highest vs lowest quintile of total vegetable consumption were 0.82 (95% CI = 0.74 to 0.90) for ER(-) breast cancer and 1.04 (95% CI = 0.97 to 1.11) for ER(+) breast cancer (P (common-effects) by ER status < .001). Total fruit consumption was non-statistically significantly associated with risk of ER(-) breast cancer (pooled multivariable RR comparing the highest vs lowest quintile = 0.94, 95% CI = 0.85 to 1.04).

CONCLUSIONS

We observed no association between total fruit and vegetable intake and risk of overall breast cancer. However, vegetable consumption was inversely associated with risk of ER(-) breast cancer in our large pooled analyses.

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    Authors+Show Affiliations

    Jung S
    Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Longwood Avenue, Boston, MA 02115, USA. pojun@channing.harvard.edu
    Spiegelman D
    No affiliation info available
    Baglietto L
    No affiliation info available
    Bernstein L
    No affiliation info available
    Boggs DA
    No affiliation info available
    van den Brandt PA
    No affiliation info available
    Buring JE
    No affiliation info available
    Cerhan JR
    No affiliation info available
    Gaudet MM
    No affiliation info available
    Giles GG
    No affiliation info available
    Goodman G
    No affiliation info available
    Hakansson N
    No affiliation info available
    Hankinson SE
    No affiliation info available
    Helzlsouer K
    No affiliation info available
    Horn-Ross PL
    No affiliation info available
    Inoue M
    No affiliation info available
    Krogh V
    No affiliation info available
    Lof M
    No affiliation info available
    McCullough ML
    No affiliation info available
    Miller AB
    No affiliation info available
    Neuhouser ML
    No affiliation info available
    Palmer JR
    No affiliation info available
    Park Y
    No affiliation info available
    Robien K
    No affiliation info available
    Rohan TE
    No affiliation info available
    Scarmo S
    No affiliation info available
    Schairer C
    No affiliation info available
    Schouten LJ
    No affiliation info available
    Shikany JM
    No affiliation info available
    Sieri S
    No affiliation info available
    Tsugane S
    No affiliation info available
    Visvanathan K
    No affiliation info available
    Weiderpass E
    No affiliation info available
    Willett WC
    No affiliation info available
    Wolk A
    No affiliation info available
    Zeleniuch-Jacquotte A
    No affiliation info available
    Zhang SM
    No affiliation info available
    Zhang X
    No affiliation info available
    Ziegler RG
    No affiliation info available
    Smith-Warner SA
    No affiliation info available

    MeSH

    AdultAgedBiomarkers, TumorBreast NeoplasmsClinical Trials as TopicFeeding BehaviorFemaleFruitHumansMiddle AgedMultivariate AnalysisProspective StudiesReceptors, EstrogenReceptors, ProgesteroneRiskSurveys and QuestionnairesVegetables

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    23349252

    Citation

    Jung, Seungyoun, et al. "Fruit and Vegetable Intake and Risk of Breast Cancer By Hormone Receptor Status." Journal of the National Cancer Institute, vol. 105, no. 3, 2013, pp. 219-36.
    Jung S, Spiegelman D, Baglietto L, et al. Fruit and vegetable intake and risk of breast cancer by hormone receptor status. J Natl Cancer Inst. 2013;105(3):219-36.
    Jung, S., Spiegelman, D., Baglietto, L., Bernstein, L., Boggs, D. A., van den Brandt, P. A., ... Smith-Warner, S. A. (2013). Fruit and vegetable intake and risk of breast cancer by hormone receptor status. Journal of the National Cancer Institute, 105(3), pp. 219-36. doi:10.1093/jnci/djs635.
    Jung S, et al. Fruit and Vegetable Intake and Risk of Breast Cancer By Hormone Receptor Status. J Natl Cancer Inst. 2013 Feb 6;105(3):219-36. PubMed PMID: 23349252.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Fruit and vegetable intake and risk of breast cancer by hormone receptor status. AU - Jung,Seungyoun, AU - Spiegelman,Donna, AU - Baglietto,Laura, AU - Bernstein,Leslie, AU - Boggs,Deborah A, AU - van den Brandt,Piet A, AU - Buring,Julie E, AU - Cerhan,James R, AU - Gaudet,Mia M, AU - Giles,Graham G, AU - Goodman,Gary, AU - Hakansson,Niclas, AU - Hankinson,Susan E, AU - Helzlsouer,Kathy, AU - Horn-Ross,Pamela L, AU - Inoue,Manami, AU - Krogh,Vittorio, AU - Lof,Marie, AU - McCullough,Marjorie L, AU - Miller,Anthony B, AU - Neuhouser,Marian L, AU - Palmer,Julie R, AU - Park,Yikyung, AU - Robien,Kim, AU - Rohan,Thomas E, AU - Scarmo,Stephanie, AU - Schairer,Catherine, AU - Schouten,Leo J, AU - Shikany,James M, AU - Sieri,Sabina, AU - Tsugane,Schoichiro, AU - Visvanathan,Kala, AU - Weiderpass,Elisabete, AU - Willett,Walter C, AU - Wolk,Alicja, AU - Zeleniuch-Jacquotte,Anne, AU - Zhang,Shumin M, AU - Zhang,Xuehong, AU - Ziegler,Regina G, AU - Smith-Warner,Stephanie A, Y1 - 2013/01/24/ PY - 2013/1/26/entrez PY - 2013/1/26/pubmed PY - 2013/4/2/medline SP - 219 EP - 36 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 105 IS - 3 N2 - BACKGROUND: Estrogen receptor-negative (ER(-)) breast cancer has few known or modifiable risk factors. Because ER(-) tumors account for only 15% to 20% of breast cancers, large pooled analyses are necessary to evaluate precisely the suspected inverse association between fruit and vegetable intake and risk of ER(-) breast cancer. METHODS: Among 993 466 women followed for 11 to 20 years in 20 cohort studies, we documented 19 869 estrogen receptor positive (ER(+)) and 4821 ER(-) breast cancers. We calculated study-specific multivariable relative risks (RRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression analyses and then combined them using a random-effects model. All statistical tests were two-sided. RESULTS: Total fruit and vegetable intake was statistically significantly inversely associated with risk of ER(-) breast cancer but not with risk of breast cancer overall or of ER(+) tumors. The inverse association for ER(-) tumors was observed primarily for vegetable consumption. The pooled relative risks comparing the highest vs lowest quintile of total vegetable consumption were 0.82 (95% CI = 0.74 to 0.90) for ER(-) breast cancer and 1.04 (95% CI = 0.97 to 1.11) for ER(+) breast cancer (P (common-effects) by ER status < .001). Total fruit consumption was non-statistically significantly associated with risk of ER(-) breast cancer (pooled multivariable RR comparing the highest vs lowest quintile = 0.94, 95% CI = 0.85 to 1.04). CONCLUSIONS: We observed no association between total fruit and vegetable intake and risk of overall breast cancer. However, vegetable consumption was inversely associated with risk of ER(-) breast cancer in our large pooled analyses. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/23349252/Fruit_and_vegetable_intake_and_risk_of_breast_cancer_by_hormone_receptor_status_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djs635 DB - PRIME DP - Unbound Medicine ER -