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Meta-Analysis
. 2019 Jan 29;21(1):16.
doi: 10.1186/s13058-019-1096-1.

Associations between dietary patterns and the risk of breast cancer: a systematic review and meta-analysis of observational studies

Yunjun Xiao  1 , Junjie Xia  1 , Liping Li  2 , Yuebin Ke  1 , Jinquan Cheng  1 , Yaojie Xie  3 , Winnie Chu  4 , Polly Cheung  5 , Jean Hee Kim  6 , Graham A Colditz  7 , Rulla M Tamimi  8   9 , Xuefen Su  10
Affiliations
Meta-Analysis

Associations between dietary patterns and the risk of breast cancer: a systematic review and meta-analysis of observational studies

Yunjun Xiao et al. Breast Cancer Res. .

Abstract

Background: Epidemiologic evidence suggests that certain dietary patterns were associated with breast cancer risk, but the results have been inconclusive. We assessed the associations between different dietary patterns and the risk of breast cancer by conducting a meta-analysis of observational studies.

Methods: Relevant articles were searched in PubMed, Embase, and Cochrane library databases through September 2017. Multivariable-adjusted relative risks (RRs) and 95% confidence intervals (CIs) comparing the highest and lowest categories of Western and prudent dietary patterns were combined by using the random-effects meta-analyses.

Results: We identified 32 eligible articles including 14 cohort and 18 case-control studies (34 Western and 35 prudent studies). The pooled analyses found that a Western dietary pattern was associated with a 14% increased risk (RR 1.14, 95% CI 1.02, 1.28), whereas a prudent dietary pattern was associated with an 18% reduced risk of breast cancer (RR 0.82, 95% CI 0.75, 0.89). In addition, sub-group analyses showed that the positive association between a Western dietary pattern and breast cancer risk was significant among postmenopausal (RR 1.20, 95% CI 1.06, 1.35), but not premenopausal women (RR 1.18, 95% CI 0.99, 1.40), and significant for hormone receptor-positive tumors (RR 1.18, 95% CI 1.04, 1.33), but not receptor-negative tumors (RR 0.97, 95% CI 0.83, 1.12). In contrast, the inverse association between a prudent dietary pattern and breast cancer was significant in premenopausal (RR 0.77, 95% CI 0.61, 0.98), but not postmenopausal women (RR 0.88, 95% CI 0.74, 1.03), and significant for both hormone receptor-positive and receptor-negative tumors.

Conclusions: The results of the current meta-analysis suggest a possible increased risk of breast cancer associated with a Western dietary pattern and a reduced risk with a prudent dietary pattern. Large-scale cohort studies with a high quality need to be conducted to further confirm the findings of the current meta-analysis. As dietary patterns are modifiable, these findings may provide viable strategies for breast cancer prevention through changes in dietary intake.

Keywords: Breast cancer; Dietary patterns; Meta-analysis; Observational studies.

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The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Flow chart of literature search and selection of studies on dietary patterns and the risk of breast cancer
Fig. 2
Fig. 2
Forest plot shows the association between the highest category of a Western dietary pattern and the risk of breast cancer
Fig. 3
Fig. 3
Forest plot shows the association between the highest category of a prudent dietary pattern and the risk of breast cancer
Fig. 4
Fig. 4
Forest plot shows the association between dietary patterns and the risk of breast cancer by menopause status. a Western dietary pattern in premenopausal women. b Western dietary pattern in postmenopausal women. c Prudent dietary pattern in premenopausal women d Prudent dietary pattern in postmenopausal women
Fig. 5
Fig. 5
Forest plot shows the association between dietary patterns and the risk of breast cancer by hormone receptor status. a Western dietary pattern in breast cancer patients with estrogen and/or progesterone receptor positive. b Western dietary pattern in breast cancer patients with estrogen and/or progesterone receptor negative. c Prudent dietary pattern in breast cancer patients with estrogen and/or progesterone receptor positive. d Prudent dietary pattern in breast cancer patients with estrogen and/or progesterone receptor negative
See this image and copyright information in PMC

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