Cited by 183Nutritional Studies and DietCancer Risks and FactorsGlobal Cancer Incidence and Screening

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

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Jung, Seungyoun, Spiegelman, Donna, Baglietto, Laura, Bernstein, Leslie, Boggs, Deborah A., van den Brandt, Piet A., Buring, Julie E., Cerhan, James R. +32 more·2013·JNCI Journal of the National Cancer Institute

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.

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  1. Michels KB, Holmberg L, Bergkvist L, et al. Dietary antioxidant vitamins, retinol, and breast cancer incidence in a cohort of Swedish women. Int J Cancer. 2001;91(4):563-567.
  2. Rothman KJ, Greenland S. Modern Epidemiology. 2nd ed. Philadelphia: Lippincott -Raven Publishers; 1998.

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Authors
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., Miller, A. B., Neuhouser, M. L., Palmer, J. R., Park, Y., Robien, K., Rohan, T. E., Scarmo, S., Schairer, C., Schouten, L. J., Shikany, J. M., Sieri, S., Tsugane, S., Visvanathan, K., Weiderpass, E., Willett, W. C., Wolk, A., Zeleniuch-Jacquotte, A., Zhang, S. M., Zhang, X., Ziegler, R. G., & Smith-Warner, S. A.
Affiliations
  • Brigham and Women's Hospital (US)
  • Boston University (US)
Venue
JNCI Journal of the National Cancer Institute
Published
2013-02-05
Volume
105
Issue
3
Pages
219-236
ISSN
  • 0027-8874 (ISSN-L)
  • 1460-2105
OpenAlex
W2108138991
Cited by
183
References
89
Citations by year
2026: 6 · 2025: 2 · 2024: 3 · 2023: 9 · 2022: 7 · 2021: 13 · 2020: 14 · 2019: 12 · 2018: 19 · 2017: 20 · 2016: 24 · 2015: 21 · 2014: 15 · 2013: 17
FWCI
3.67
Type
journal article
Language
en
Open access
Locations
  • JNCI Journal of the National Cancer Institute (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, other-oa)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Funders
National Cancer Institute (R01CA077398, CA-55075, R01CA039742, P01CA055075, R01CA047988)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Oncology › Cancer Risks and Factors
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
Keywords
fruit and vegetable intake, breast cancer, estrogen receptor-negative breast cancer, estrogen receptor-positive breast cancer, vegetable consumption, fruit consumption, dietary risk factors, pooled analysis of cohort studies
MeSH terms
Adult, Aged, Breast Neoplasms, Clinical Trials as Topic, Feeding Behavior, Female, Fruit, Humans, Middle Aged, Prospective Studies, Surveys and Questionnaires, Receptors, Estrogen, Receptors, Progesterone, Risk, Biomarkers, Tumor, Vegetables, Multivariate Analysis

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