Copyright © 2004 by the Johns Hopkins Bloomberg School of Public Health
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A Case-Control Study of Risk Factors for Fibrocystic Breast Conditions
Shanghai Nutrition and Breast Disease Study, China, 1995–2000
1 Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
2 Department of Epidemiology, Zhong Shan Hospital Cancer Center, Shanghai, China.
3 Department of Epidemiology, University of Washington, Seattle, WA.
4 Shi Dong Hospital, Shanghai, China.
5 Veterans Administration Medical Center, Portland, OR.
6 Institute of Medical Biology, University of Tromsø, Tromsø, Norway.
7 Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
This study was conducted to identify reproductive and dietary factors associated with benign proliferative mammary epithelial cell changes. Subjects were women enrolled in a randomized trial of breast self-examination in Shanghai, China. Women who developed fibrocystic breast conditions classified as nonproliferative (175 women), proliferative (181 women), or proliferative with atypia (33 women) between 1995 and 2000 and 1,070 unaffected trial participants were administered general risk factor and food frequency questionnaires. Conditional logistic regression was used to estimate adjusted odds ratios and 95% confidence intervals. High parity and consumption of fresh fruits and vegetables were more strongly associated with a reduced risk of proliferative and atypical lesions than with nonproliferative conditions. For the fourth quartile of consumption versus the first, odds ratios for lesions diagnosed as nonproliferative, proliferative, and proliferative with atypia were 0.4 (95% confidence interval (CI): 0.2, 0.7), 0.2 (95% CI: 0.1, 0.4), and 0.1 (95% CI: 0.03, 0.5), respectively, for fruit intake and 0.6 (95% CI: 0.3, 1.1), 0.4 (95% CI: 0.2, 0.7), and 0.1 (95% CI: 0.1, 0.9), respectively, for vegetable intake. Reduced but nonsignificant risks in relation to soy products were observed for proliferative and atypical lesions. No single nutrient or botanical family was appreciably more strongly associated with proliferative conditions than with nonproliferative conditions, after results were controlled for total fruit and vegetable consumption. A diet rich in fruits and vegetables may reduce cellular proliferation in the mammary epithelium; this is one mechanism by which such a diet could reduce risk of breast cancer.
breast diseases; diet; estrogens; fibrocystic disease of breast; fruit; risk factors; soy foods; vegetables
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