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© 2003 The American Society for Nutritional Sciences J. Nutr. 133:2342-2347, July 2003

Nutritional Epidemiology

Fruits and Vegetables Intake Differentially Affects Estrogen Receptor Negative and Positive Breast Cancer Incidence Rates

Anja Olsen2, Anne Tjønneland, Birthe L. Thomsen, Steffen Loft*, Connie Stripp, Kim Overvad{dagger}, Susanne Møller** and Jørgen H. Olsen

Institute of Cancer Epidemiology, The Danish Cancer Society, Denmark; * Institute of Public Health, University of Copenhagen, Denmark; {dagger} Department of Clinical Epidemiology, Aalborg Hospital and Aarhus University Hospital, and Department of Epidemiology and Social Medicine, University of Aarhus, Denmark; and ** Danish Breast Cancer Co-operative Group, Rigshospitalet, Denmark

2To whom correspondence should be addressed. E-mail: email: anja{at}cancer.dk.

Despite intensive research, the evidence for a protective effect of fruits and vegetables on breast cancer risk remains inconclusive. Other risk factors for breast cancer seem to vary with the estrogen receptor status of the breast tumor, and it is thus possible that the inconsistent results regarding a preventive effect of fruits and vegetables are due to lack of controlling for estrogen receptor status. The objective of this study was to investigate the effect of fruit and vegetable intake on postmenopausal breast cancer and explore whether the estrogen receptor status of the tumor modifies this relation. Postmenopausal women (n = 23,798; aged 50–64 y) provided information about diet and established risk factors for breast cancer in the cohort "Diet, Cancer and Health." During follow-up, 425 cases were diagnosed with breast cancer. Associations between intake of fruits and vegetables and the breast cancer rate were analyzed using Cox’s regression model. The association for all breast cancers was an incidence rate ratio (IRR) of 1.02 (95% CI, 0.98–1.06) per 100 g/d increment of total intake of fruits, vegetables and juice. For estrogen receptor–positive (ER+) breast cancer, a borderline significant increase in the rate was seen, IRR: 1.05 (95% CI, 1.00–1.10), whereas a preventive effect was seen for estrogen receptor–negative (ER-) breast cancers, IRR: 0.90 (95% CI, 0.81–0.99). In conclusion, we did not find the overall breast cancer rate to be associated with the intake of fruits and vegetables, but there seemed to be different effects for ER+ and ER- breast cancer.

KEY WORDS: • breast neoplasms • fruits • vegetables • estrogen receptors • cohort study




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