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.
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.
Authors: Eugenia E Calle; Carmen Rodriguez; Eric J Jacobs; M Lyn Almon; Ann Chao; Marjorie L McCullough; Heather S Feigelson; Michael J Thun Journal: Cancer Date: 2002-01-15 Impact factor: 6.860
Authors: P C Prorok; G L Andriole; R S Bresalier; S S Buys; D Chia; E D Crawford; R Fogel; E P Gelmann; F Gilbert; M A Hasson; R B Hayes; C C Johnson; J S Mandel; A Oberman; B O'Brien; M M Oken; S Rafla; D Reding; W Rutt; J L Weissfeld; L Yokochi; J K Gohagan Journal: Control Clin Trials Date: 2000-12
Authors: S A Smith-Warner; D Spiegelman; S S Yaun; H O Adami; W L Beeson; P A van den Brandt; A R Folsom; G E Fraser; J L Freudenheim; R A Goldbohm; S Graham; A B Miller; J D Potter; T E Rohan; F E Speizer; P Toniolo; W C Willett; A Wolk; A Zeleniuch-Jacquotte; D J Hunter Journal: JAMA Date: 2001-02-14 Impact factor: 56.272
Authors: Pamela L Horn-Ross; K J Hoggatt; Dee W West; Melissa R Krone; Susan L Stewart; Hoda Anton; Culver Leslie Bernstei; Dennis Deapen; David Peel; Richard Pinder; Peggy Reynolds; Ronald K Ross; William Wright; Al Ziogas Journal: Cancer Causes Control Date: 2002-06 Impact factor: 2.506
Authors: Joshua Petimar; Yong-Moon Mark Park; Stephanie A Smith-Warner; Teresa T Fung; Dale P Sandler Journal: Am J Clin Nutr Date: 2019-05-01 Impact factor: 7.045
Authors: Megan S Rice; Shelley S Tworoger; Susan E Hankinson; Rulla M Tamimi; A Heather Eliassen; Walter C Willett; Graham Colditz; Bernard Rosner Journal: Breast Cancer Res Treat Date: 2017-07-12 Impact factor: 4.872
Authors: Julia S Sisti; Sara Lindström; Peter Kraft; Rulla M Tamimi; Bernard A Rosner; Tianying Wu; Walter C Willett; A Heather Eliassen Journal: Breast Cancer Res Treat Date: 2015-04-28 Impact factor: 4.872
Authors: Teresa T Fung; Stephanie E Chiuve; Walter C Willett; Susan E Hankinson; Frank B Hu; Michelle D Holmes Journal: Breast Cancer Res Treat Date: 2013-03-27 Impact factor: 4.872