Trinidad Dierssen-Sotos1,2, Inés Gómez-Acebo3,4, Camilo Palazuelos4, Esther Gracia-Lavedan3,5,6, Beatriz Pérez-Gómez3,7, Madalen Oribe8, Vicente Martín9, Marcela Guevara10, Paz Rodríguez-Cundín11, Guillermo Fernández-Tardón12, Rafael Marcos-Gragera13,14, Ana Molina-Barceló15, Marian Díaz-Santos16, Gemma Castaño-Vinyals3,5,6,17, Nuria Aragonés18, Ana López-Gonzalez19, Pilar Amiano3,8, Jesús Castilla3,10, Jessica Alonso-Molero4, Manolis Kogevinas3,5,6,17, Marina Pollán3,20, Javier Llorca3,4,5. 1. Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), Madrid, Spain. dierssent@unican.es. 2. Facultad de Medicina, Universidad de Cantabria-IDIVAL, Avda. Herrera Oria s/n, 39011, Santander, Spain. dierssent@unican.es. 3. Consortium for Biomedical Research in Epidemiology and Public Health (CIBER de Epidemiología Y Salud Pública-CIBERESP), Madrid, Spain. 4. Facultad de Medicina, Universidad de Cantabria-IDIVAL, Avda. Herrera Oria s/n, 39011, Santander, Spain. 5. ISGlobal, Barcelona, Spain. 6. Universitat Pompeu Fabra (UPF), Barcelona, Spain. 7. Cardiovascular and Metabolic Diseases Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain. 8. Public Health Division of Gipuzkoa, Health Department, BioDonostia Research Institute, San Sebastian, Basque Country, Spain. 9. Instituto de Biomedicina (IBIOMED), Universidad de León, León, Spain. 10. Instituto de Salud Pública de Navarra, IdiSNA, Pamplona, Spain. 11. Servicio de Medicina Preventiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 12. IUOPA, Universidad de Oviedo, Asturias, Spain. 13. Research Group on Statistics, Econometrics and Health (GRECS), Universitat de Girona, Girona, Spain. 14. Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona, Spain. 15. Cancer and Public Health Area, FISABIO-Public Health, Valencia, Spain. 16. Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain. 17. IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. 18. Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain. 19. Servicio de Oncología, Complejo Asistencial Universitario de León, León, Spain. 20. Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
Abstract
PURPOSE: To evaluate the association between dietary fat and fat subtype and breast cancer development. METHODS: We conducted a case-control study with 1181 cases of incident breast cancer, diagnosed between 2007 and 2012, and 1682 population controls frequency matched (by age, sex, and region) from the Spanish multicenter case-control study MCC-Spain. RESULTS: We found a significant protective effect in premenopausal women of total fat intake [OR 0.51 95% CI (0.31-0.86) highest versus lowest tertile], but no effect was observed in menopausal women [OR 1.15 95% CI (0.83-1.60)]. Analyzing by type of fat, this protective effect persisted only for the monounsaturated fatty acids [OR 0.51 95% CI (0.32-0.82)]. In contrast, other fatty acids did not have a significant effect. In addition, a protection against risk of breast cancer was found when polyunsaturated fats were "substituted" by monounsaturated, maintaining the same total fat intake [OR 0.68 95% CI (0.47-0.99)]. Finally, analyzing by breast cancer subtype, we found no effect, except in premenopausal women where intake of moderate [OR 0.52 95% CI (0.33-0.82)] and high monounsaturated fatty acids [OR 0.47 95% CI (0.27-0.82)] maintains a protective effect against ER/PR + tumors. In contrast, in menopausal women, a high intake of monounsaturated fatty acids was associated with higher risk of HER2 + tumors [OR 2.00 95% CI (0.97-4.13)]. CONCLUSION: Our study shows a differential effect of monounsaturated fatty acids according to menopausal status and breast cancer subtype.
PURPOSE: To evaluate the association between dietary fat and fat subtype and breast cancer development. METHODS: We conducted a case-control study with 1181 cases of incident breast cancer, diagnosed between 2007 and 2012, and 1682 population controls frequency matched (by age, sex, and region) from the Spanish multicenter case-control study MCC-Spain. RESULTS: We found a significant protective effect in premenopausal women of total fat intake [OR 0.51 95% CI (0.31-0.86) highest versus lowest tertile], but no effect was observed in menopausal women [OR 1.15 95% CI (0.83-1.60)]. Analyzing by type of fat, this protective effect persisted only for the monounsaturated fatty acids [OR 0.51 95% CI (0.32-0.82)]. In contrast, other fatty acids did not have a significant effect. In addition, a protection against risk of breast cancer was found when polyunsaturated fats were "substituted" by monounsaturated, maintaining the same total fat intake [OR 0.68 95% CI (0.47-0.99)]. Finally, analyzing by breast cancer subtype, we found no effect, except in premenopausal women where intake of moderate [OR 0.52 95% CI (0.33-0.82)] and high monounsaturated fatty acids [OR 0.47 95% CI (0.27-0.82)] maintains a protective effect against ER/PR + tumors. In contrast, in menopausal women, a high intake of monounsaturated fatty acids was associated with higher risk of HER2 + tumors [OR 2.00 95% CI (0.97-4.13)]. CONCLUSION: Our study shows a differential effect of monounsaturated fatty acids according to menopausal status and breast cancer subtype.
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