The Association between Dairy Intake and Breast Cancer in Western and Asian Populations: A Systematic Review and Meta-Analysis

Abstract

Purpose: To date, studies investigating the association between dairy consumption and breast cancer in women have produced conflicting results. As diet is an important, modifiable factor affecting cancer development, the aim of this study was to examine the association between dairy consumption and breast cancer risk.

Methods: PubMed, Embase, and Cochrane Library databases were searched with a priority for prospective cohort studies. Case-control studies were also considered in case of the absence of a cohort study.

Results: We analyzed 22 prospective cohort studies (1,566,940 participants) and five case-control studies (33,372 participants). High and modest dairy consumption (>600 and 400-600 g/day, respectively) significantly reduced the risk of breast cancer compared with low dairy consumption (<400 g/day; risk ratio [RR], 0.90, 95% confidence interval [CI], 0.83-0.98, and RR, 0.94, 95% CI, 0.91-0.98, respectively). A significant linear relationship between dairy consumption and breast cancer risk was found on dose-response analysis. Subgroup analysis found that yogurt (RR, 0.91; 95% CI, 0.83-0.99) and low-fat dairy (RR, 0.85; 95% CI, 0.75-0.96) reduced the risk of breast cancer, while other dairy product types did not. A reduced risk was observed for people in the United States (RR, 0.91; 95% CI, 0.83-0.99) and in those followed for ≥10 years (RR, 0.90; 95% CI, 0.81-0.99). Additionally, the highest level of dairy consumption among Asians was associated with a reduced risk of breast cancer (odds ratio, 0.74; 95% CI, 0.62-0.88).

Conclusion: Dairy consumption was inversely associated with the risk of developing breast cancer and this effect was dependent on the dose, dairy-type, and time.

Keywords: Breast neoplasms; Dairy products; Meta-analysis; Risk assessment.

Figure 1. Selection of studies for inclusion in the meta-analysis.

Figure 2. Combined relative risks (RRs) of the breast cancer for dairy, milk consumption and main subgroups (highest dairy consumption was deemed as >600 g/day; modest, 400-600 g/day).

CI=confidence interval.

Figure 3. Dose-response relationship between dairy consumption and the risk of breast cancer.

Figure 4. Dose-response relationship between milk consumption and the risk of breast cancer.

Figure 5. The summary odds ratio (OR) of breast cancer for high level of dairy or milk product compared with low level consumption (A) and doseresponse analysis for case-control studies from Asia (B).

CI=confidence interval; POM=postmenopausal; PRM=premenopausal; RR=relative risk.

Figure 6. Funnel plot of log relative risk (RR) versus standard error (s.e.) of log RRs for highest dairy versus lowest dairy consumption (A); for modest dairy versus lowest dairy consumption (B); for highest milk versus lowest dairy consumption (C); for case-control study (D).