Dietary fat and breast cancer.

High-fat diets are thought to increase the risk of breast cancer because animals develop mammary cancer more readily when they are fed high-fat compared to low-fat diets, and breast cancer incidence and mortality are higher in countries with high-fat as compared to those with low-fat diets. Prospective cohort studies and case-control studies have failed to provide much support for this theory, but such studies are less capable of showing the relationship because of smaller differences in dietary fat intakes of the study populations; difficulties in assessing the diets of individuals over a period of time; and possible differences in genetic susceptibility of cases and controls to breast cancer. Studies on migrants have shown that breast cancer incidence and mortality increase in populations who move from countries with low-fat to those with high-fat diets, indicating that observed geographical differences in breast cancer are due to environmental rather than genetic factors. This is supported by time-trend studies showing that breast cancer increases in countries as the level of fat in the diet rises. Controlled, long-term dietary trials are needed to determine whether the converse is true: namely, that reduction of dietary fat can reduce the risk of breast cancer. Large groups are required to achieve statistical significance, but smaller numbers may be adequate for studies on high-risk individuals. Preliminary experiments already have demonstrated the feasibility of carrying out such dietary trials.