Do both heterocyclic amines and omega-6 polyunsaturated fatty acids contribute to the incidence of breast cancer in postmenopausal women of the Malmö diet and cancer cohort?

Heterocyclic amines (HAs), formed when meat and fish are cooked at high temperatures, have been linked to mammary gland cancer in rats, and some epidemiological studies indicate increased breast cancer risk by consumption of well-done meat. The epidemiological evidence linking HAs per se to breast cancer is however sparse, especially from prospective studies. Moreover, high-fat diets rich in omega-6 polyunsaturated fatty acids (PUFAs) have produced higher frequencies of HA-induced mammary gland tumors in rats compared to those fed low-fat diets. The aim was to evaluate prospectively if intake of HAs is associated with breast cancer incidence, and if the association is independent of omega-6 PUFA intakes. Among women 50 years or older at baseline from the population-based prospective Malmö Diet and Cancer cohort (n = 11,699), 430 women were diagnosed with incident invasive breast cancer during a mean follow-up of 10.4 years. Information on dietary habits was collected by a modified diet history method. Cox proportional hazards regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer associated with energy-adjusted intakes of HAs and omega-6 PUFA. Intakes of HAs were not associated with breast cancer incidence (HR, 0.94; 95% CI, 0.69-1.28, for highest compared to lowest quintile). In individuals with low HA intakes, a significant increased risk was observed among those with high intakes of omega-6 PUFAs. In conclusion, intakes of HAs are not associated with breast cancer incidence in this Swedish cohort, but dietary patterns very high in omega-6 PUFA may promote breast cancer development.