Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2013 Feb 6;105(3):219-36.
doi: 10.1093/jnci/djs635. Epub 2013 Jan 24.

Fruit and vegetable intake and risk of breast cancer by hormone receptor status

Seungyoun Jung  1 , 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
Affiliations
Meta-Analysis

Fruit and vegetable intake and risk of breast cancer by hormone receptor status

Seungyoun Jung et al. J Natl Cancer Inst. .

Abstract

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.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Study-specific and pooled multivariable-adjusted relative risks of estrogen receptor–negative (ER−) breast cancer and total vegetable consumption, quintile 5 vs quintile1. The squares and horizontal lines correspond to the study-specific relative risks and 95% confidence intervals, respectively, for the comparison of quintile 5 (Q5) to quintile 1 (Q1) of total vegetable consumption. The size of the squares reflects the study-specific weight (inverse of the variance). The diamond represents the pooled relative risk and 95% confidence interval. All statistical tests were two-sided. AARP = National Institutes of Health–AARP Diet and Health Study; CARET =Beta-Carotene and Retinol Efficacy Trial; BWHS = Black Women’s Health Study; BCDDP = Breast Cancer Detection Demonstration Project Follow-up Study; CTS = California Teachers Study, CLUE2 = Campaign Against Cancer and Heart Disease; CNBSS = Canadian National Breast Screening Study; CPS2 = Cancer Prevention Study II Nutrition Cohort; IWHS = Iowa Women’s Health Study; JPHCI = Japan Public Health Center-Based Prospective Study I; MCCS = Melbourne Collaborative Cohort Study; NHSa = Nurses’ Health Study(a); NHSb = Nurses’ Helath Study(b); NHS2 = Nurses’ Health Study II; NLCS = Netherlands Cohort Study; NYU = New York University Women’s Health Study; ORDET = Prospective Study on Hormones, Diet and Breast Cancer; PLCO = Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial; SMC = Swedish Mammography Cohort; WHS =Women’s Health Study; WLHS = Women’s Lifestyle and Health Study.
See this image and copyright information in PMC

Comment in

References

    1. Althuis MD, Fergenbaum JH, Garcia-Closas M, et al. Etiology of hormone receptor-defined breast cancer: a systematic review of the literature. Cancer Epidemiol Biomarkers Prev. 2004; 13(10):1558–1568 - PubMed
    1. Yasui Y, Potter JD. The shape of age-incidence curves of female breast cancer by hormone-receptor status. Cancer Causes Control. 1999; 10(5): 431–437 - PubMed
    1. Rosenberg LU, Einarsdottir K, Friman EI, et al. Risk factors for hormone receptor-defined breast cancer in postmenopausal women. Cancer Epidemiol Biomarkers Prev. 2006; 15(12): 2482–2488 - PubMed
    1. Aune D, Chan DS, Vieira AR, et al. Fruits, vegetables and breast cancer risk: a systematic review and meta-analysis of prospective studies. Breast Cancer Res Treat. 2012; 134(2): 479–493 - PubMed
    1. Boggs DA, Palmer JR, Wise LA, et al. Fruit and vegetable intake in relation to risk of breast cancer in the Black Women’s Health Study. Am J Epidemiol. 2010;172(11):1268–1279 - PMC - PubMed

Publication types