Fruit and Vegetable Intake and Risk of Breast Cancer by Hormone Receptor Status

Seungyoun Jung; Donna Spiegelman; Laura Baglietto; Leslie Bernstein; Deborah A. Boggs; Piet A. van den Brandt; Julie E. Buring; James R. Cerhan; Mia M. Gaudet; Graham G. Giles; Gary Goodman; Niclas Hakansson; Susan E. Hankinson; Kathy Helzlsouer; Pamela L. Horn-Ross; Manami Inoue; Vittorio Krogh; Marie Lof; Marjorie L. McCullough; Anthony B. Miller; Marian L. Neuhouser; Julie R. Palmer; Yikyung Park; Kim Robien; Thomas E. Rohan; Stephanie Scarmo; Catherine Schairer; Leo J. Schouten; James M. Shikany; Sabina Sieri; Schoichiro Tsugane; Kala Visvanathan; Elisabete Weiderpass; Walter C. Willett; Alicja Wolk; Anne Zeleniuch-Jacquotte; Shumin M. Zhang; Xuehong Zhang; Regina G. Ziegler; Stephanie A. Smith-Warner

doi:10.1093/jnci/djs635

Fruit and Vegetable Intake and Risk of Breast Cancer by Hormone Receptor Status

Seungyoun Jung^*, Donna Spiegelman, Laura Baglietto, Leslie Bernstein, Deborah A. Boggs, Piet A. van den Brandt, Julie E. Buring, James R. Cerhan, Mia M. Gaudet, Graham G. Giles, Gary Goodman, Niclas Hakansson, Susan E. Hankinson, Kathy Helzlsouer, Pamela L. Horn-Ross, Manami Inoue, Vittorio Krogh, Marie Lof, Marjorie L. McCullough, Anthony B. MillerMarian L. Neuhouser, Julie R. Palmer, Yikyung Park, Kim Robien, Thomas E. Rohan, Stephanie Scarmo, Catherine Schairer, Leo J. Schouten, James M. Shikany, Sabina Sieri, Schoichiro Tsugane, Kala Visvanathan, Elisabete Weiderpass, Walter C. Willett, Alicja Wolk, Anne Zeleniuch-Jacquotte, Shumin M. Zhang, Xuehong Zhang, Regina G. Ziegler, Stephanie A. Smith-Warner

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Estrogen receptornegative (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. 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. 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 (Pcommon-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). 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.

Original language	English
Pages (from-to)	219-236
Journal	Journal of the National Cancer Institute
Volume	105
Issue number	3
DOIs	https://doi.org/10.1093/jnci/djs635
Publication status	Published - Feb 2013

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10.1093/jnci/djs635

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Jung, S., Spiegelman, D., Baglietto, L., Bernstein, L., Boggs, D. A., van den Brandt, P. A., Buring, J. E., Cerhan, J. R., Gaudet, M. M., Giles, G. G., Goodman, G., Hakansson, N., Hankinson, S. E., Helzlsouer, K., Horn-Ross, P. L., Inoue, M., Krogh, V., Lof, M., McCullough, M. L., ... 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), 219-236. https://doi.org/10.1093/jnci/djs635

@article{493f64daf8b34626823eabbc52b2251d,

title = "Fruit and Vegetable Intake and Risk of Breast Cancer by Hormone Receptor Status",

abstract = "Estrogen receptornegative (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. 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. 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 (Pcommon-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). 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.",

author = "Seungyoun Jung and Donna Spiegelman and Laura Baglietto and Leslie Bernstein and Boggs, {Deborah A.} and {van den Brandt}, {Piet A.} and Buring, {Julie E.} and Cerhan, {James R.} and Gaudet, {Mia M.} and Giles, {Graham G.} and Gary Goodman and Niclas Hakansson and Hankinson, {Susan E.} and Kathy Helzlsouer and Horn-Ross, {Pamela L.} and Manami Inoue and Vittorio Krogh and Marie Lof and McCullough, {Marjorie L.} and Miller, {Anthony B.} and Neuhouser, {Marian L.} and Palmer, {Julie R.} and Yikyung Park and Kim Robien and Rohan, {Thomas E.} and Stephanie Scarmo and Catherine Schairer and Schouten, {Leo J.} and Shikany, {James M.} and Sabina Sieri and Schoichiro Tsugane and Kala Visvanathan and Elisabete Weiderpass and Willett, {Walter C.} and Alicja Wolk and Anne Zeleniuch-Jacquotte and Zhang, {Shumin M.} and Xuehong Zhang and Ziegler, {Regina G.} and Smith-Warner, {Stephanie A.}",

year = "2013",

month = feb,

doi = "10.1093/jnci/djs635",

language = "English",

volume = "105",

pages = "219--236",

journal = "Journal of the National Cancer Institute",

issn = "0027-8874",

publisher = "Oxford University Press",

number = "3",

}

Jung, S, Spiegelman, D, Baglietto, L, Bernstein, L, Boggs, DA, van den Brandt, PA, Buring, JE, Cerhan, JR, Gaudet, MM, Giles, GG, Goodman, G, Hakansson, N, Hankinson, SE, Helzlsouer, K, Horn-Ross, PL, Inoue, M, Krogh, V, Lof, M, McCullough, ML, Miller, AB, Neuhouser, ML, Palmer, JR, Park, Y, Robien, K, Rohan, TE, Scarmo, S, Schairer, C, Schouten, LJ, Shikany, JM, Sieri, S, Tsugane, S, Visvanathan, K, Weiderpass, E, Willett, WC, Wolk, A, Zeleniuch-Jacquotte, A, Zhang, SM, Zhang, X, Ziegler, RG & Smith-Warner, SA 2013, 'Fruit and Vegetable Intake and Risk of Breast Cancer by Hormone Receptor Status', Journal of the National Cancer Institute, vol. 105, no. 3, pp. 219-236. https://doi.org/10.1093/jnci/djs635

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.

PY - 2013/2

Y1 - 2013/2

N2 - Estrogen receptornegative (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. 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. 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 (Pcommon-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). 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.

AB - Estrogen receptornegative (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. 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. 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 (Pcommon-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). 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.

U2 - 10.1093/jnci/djs635

DO - 10.1093/jnci/djs635

M3 - Article

C2 - 23349252

SN - 0027-8874

VL - 105

SP - 219

EP - 236

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

IS - 3

ER -