FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 329:234-240 July 22, 1993 Number 4 Next

	Full Text Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Although it has been hypothesized that large intakes of the antioxidant vitamins C, E, and A reduce the risk of breast cancer, few prospective data are available.

Methods We prospectively studied 89,494 women who were 34 to 59 years old in 1980 and who did not have diagnosed cancer. Their intakes of vitamins C, E, and A from foods and supplements were assessed at base line and in 1984 with the use of a validated semiquantitative food-frequency questionnaire.

Results Breast cancer was diagnosed in 1439 women during eight years of follow-up. After multivariate adjustment for known risk factors, the relative risk among women in the highest quintile group for intake of vitamin C as compared with the risk among those in the lowest quintile group was 1.03 (95 percent confidence interval, 0.87 to 1.21); for vitamin E, after vitamin A intake had been controlled for, the relative risk was 0.99 (95 percent confidence interval, 0.83 to 1.19). In contrast, among women in the highest quintile group for intake of total vitamin A the relative risk was 0.84 (95 percent confidence interval, 0.71 to 0.98; P for trend = 0.001). Among women in the lowest quintile group for intake of vitamin A from food, consumption of vitamin A from supplements was associated with a reduced risk (P = 0.03). The significant inverse association of vitamin A intake with the risk of breast cancer was also found on study of data based on the 1984 questionnaire and four years of follow-up.

Conclusions Large intakes of vitamin C or E did not protect women in our study from breast cancer. A low intake of vitamin A may increase the risk of this disease; any benefit of vitamin A supplements may be limited to women with diets low in vitamin A.

Source Information

From the Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital (D.J.H., J.E.M., G.A.C., M.J.S., C.H.H., F.E.S., W.C.W.), the Department of Preventive Medicine, Harvard Medical School (B.R., C.H.H.), and the Departments of Epidemiology (D.J.H., G.A.C., M.J.S., W.C.W.), Nutrition (W.C.W.), and Biostatistics (B.R.), Harvard School of Public Health -- all in Boston.

Address reprint requests to Dr. Hunter at Channing Laboratory, 180 Longwood Ave., Boston, MA 02115.

Full Text of this Article

Related Letters:

Vitamins and Breast Cancer
Ennever F. K., Paskett E. D., Hunter D. J., Stampfer M. J., Willett W. C.
Extract | Full Text  
N Engl J Med 1993; 329:1579, Nov 18, 1993. Correspondence

This article has been cited by other articles:

• Cui, Y., Shikany, J. M, Liu, S., Shagufta, Y., Rohan, T. E (2008). Selected antioxidants and risk of hormone receptor-defined invasive breast cancers among postmenopausal women in the Women's Health Initiative Observational Study. Am. J. Clin. Nutr. 87: 1009-1018 [Abstract] [Full Text]  
• McDaniel, S. M., O'Neill, C., Metz, R. P., Tarbutton, E., Stacewicz-Sapuntzakis, M., Heimendinger, J., Wolfe, P., Thompson, H., Schedin, P. (2007). Whole-Food Sources of Vitamin A More Effectively Inhibit Female Rat Sexual Maturation, Mammary Gland Development, and Mammary Carcinogenesis than Retinyl Palmitate. J. Nutr. 137: 1415-1422 [Abstract] [Full Text]  
• Prentice, R. L (2007). Clinical trials and observational studies to assess the chronic disease benefits and risks of multivitamin-multimineral supplements. Am. J. Clin. Nutr. 85: 308S-313S [Abstract] [Full Text]  
• Ioannidis, J. P. A. (2005). Contradicted and Initially Stronger Effects in Highly Cited Clinical Research. JAMA 294: 218-228 [Abstract] [Full Text]  
• Tamimi, R. M., Hankinson, S. E., Campos, H., Spiegelman, D., Zhang, S., Colditz, G. A., Willett, W. C., Hunter, D. J. (2005). Plasma Carotenoids, Retinol, and Tocopherols and Risk of Breast Cancer. Am J Epidemiol 161: 153-160 [Abstract] [Full Text]  
• Shannon, J., Ray, R., Wu, C., Nelson, Z., Gao, D. L., Li, W., Hu, W., Lampe, J., Horner, N., Satia, J., Patterson, R., Fitzgibbons, D., Porter, P., Thomas, D. (2005). Food and Botanical Groupings and Risk of Breast Cancer: A Case-Control Study in Shanghai, China. Cancer Epidemiol. Biomarkers Prev. 14: 81-90 [Abstract] [Full Text]  
• Rousseau, C., Nichol, J. N., Pettersson, F., Couture, M.-C., Miller, W. H. Jr. (2004). ER{beta} Sensitizes Breast Cancer Cells to Retinoic Acid: Evidence of Transcriptional Crosstalk. Mol Cancer Res 2: 523-531 [Abstract] [Full Text]  
• Freudenheim, J. L., Bonner, M., Krishnan, S., Ambrosone, C. B., Graham, S., McCann, S. E., Moysich, K. B., Bowman, E., Nemoto, T., Shields, P. G. (2004). Diet and alcohol consumption in relation to p53 mutations in breast tumors. Carcinogenesis 25: 931-939 [Abstract] [Full Text]  
• Nkondjock, A., Ghadirian, P. (2004). Intake of specific carotenoids and essential fatty acids and breast cancer risk in Montreal, Canada. Am. J. Clin. Nutr. 79: 857-864 [Abstract] [Full Text]  
• Baer, H. J., Schnitt, S. J., Connolly, J. L., Byrne, C., Cho, E., Willett, W. C., Colditz, G. A. (2003). Adolescent Diet and Incidence of Proliferative Benign Breast Disease. Cancer Epidemiol. Biomarkers Prev. 12: 1159-1167 [Abstract] [Full Text]  
• U.S. Preventive Services Task Force*, (2003). Routine Vitamin Supplementation To Prevent Cancer and Cardiovascular Disease: Recommendations and Rationale. ANN INTERN MED 139: 51-55 [Abstract] [Full Text]  
• Olsen, A., Tjonneland, A., Thomsen, B. L., Loft, S., Stripp, C., Overvad, K., Moller, S., Olsen, J. H. (2003). Fruits and Vegetables Intake Differentially Affects Estrogen Receptor Negative and Positive Breast Cancer Incidence Rates. J. Nutr. 133: 2342-2347 [Abstract] [Full Text]  
• Neuhouser, M. L. (2003). Dietary Supplement Use by American Women: Challenges in Assessing Patterns of Use, Motives and Costs. J. Nutr. 133: 1992S-1996 [Abstract] [Full Text]  
• Padayatty, S. J., Katz, A., Wang, Y., Eck, P., Kwon, O., Lee, J.-H., Chen, S., Corpe, C., Dutta, A., Dutta, S. K, Levine, M. (2003). Vitamin C as an Antioxidant: Evaluation of Its Role in Disease Prevention. J. Am. Coll. Nutr. 22: 18-35 [Abstract] [Full Text]  
• Sato, R., Helzlsouer, K. J., Alberg, A. J., Hoffman, S. C., Norkus, E. P., Comstock, G. W. (2002). Prospective Study of Carotenoids, Tocopherols, and Retinoid Concentrations and the Risk of Breast Cancer. Cancer Epidemiol. Biomarkers Prev. 11: 451-457 [Abstract] [Full Text]  
• Mares-Perlman, J. A., Millen, A. E., Ficek, T. L., Hankinson, S. E. (2002). The Body of Evidence to Support a Protective Role for Lutein and Zeaxanthin in Delaying Chronic Disease. Overview. J. Nutr. 132: 518S-524 [Abstract] [Full Text]  
• Schlenker, E. D. (2001). The Evolution of Research in Family and Consumer Sciences: Food, Nutrition, and Health. Family and Consumer Sciences Research Journal 30: 140-196 [Abstract]  
• Antman, K., Benson, M. C., Chabot, J., Cobrinik, D., Grann, V. R., Jacobson, J. S., Joe, A. K., Katz, A. E., Kelly, K., Neugut, A. I., Russo, D., Tiersten, A., Weinstein, I. B. (2001). Complementary and Alternative Medicine: The Role of the Cancer Center. JCO 19: 55s-60 [Full Text]  
• Green, M. H., Snyder, R. W., Akohoue, S. A., Green, J. B. (2001). Increased Rat Mammary Tissue Vitamin A Associated with Increased Vitamin A Intake during Lactation Is Maintained after Lactation. J. Nutr. 131: 1544-1547 [Abstract] [Full Text]  
• Slattery, M. L. (2001). Does an Apple a Day Keep Breast Cancer Away?. JAMA 285: 799-801 [Full Text]  
• Bell, J., Robinson, D., Møller, H., Williams, R., Fielder, H., Oliver, R T D, Macleod, U. M, Ross, S., Watt, G. C M, Twelves, C., George, W D, Gillis, C. (2000). Management of women with early breast cancer. BMJ 321: 1408a-1408 [Full Text]  
• Segasothy, M., Phillips, P.A. (1999). Vegetarian diet: panacea for modern lifestyle diseases?. QJM 92: 531-544 [Abstract] [Full Text]  
• Carr, A. C, Frei, B. (1999). Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am. J. Clin. Nutr. 69: 1086-1107 [Abstract] [Full Text]  
• Zhang, S., Hunter, D. J., Forman, M. R., Rosner, B. A., Speizer, F. E., Colditz, G. A., Manson, J. E., Hankinson, S. E., Willett, W. C. (1999). Dietary Carotenoids and Vitamins A, C, and E and Risk of Breast Cancer. JNCI J Natl Cancer Inst 91: 547-556 [Abstract] [Full Text]  
• Seewaldt, V. L., Dietze, E. C., Johnson, B. S., Collins, S. J., Parker, M. B. (1999). Retinoic Acid-mediated G1-S-Phase Arrest of Normal Human Mammary Epithelial Cells Is Independent of the Level of p53 Protein Expression. Cell Growth Differ. 10: 49-59 [Abstract] [Full Text]  
• Yeum, K.-J., Ahn, S.-H., Rupp de Paiva, S. A., Lee-Kim, Y. C., Krinsky, N. I., Russell, R. M. (1998). Correlation between Carotenoid Concentrations in Serum and Normal Breast Adipose Tissue of Women with Benign Breast Tumor or Breast Cancer. J. Nutr. 128: 1920-1926 [Abstract] [Full Text]  
• Gardner, C., Winkleby, M. A., Viteri, F. E. (1995). Dietary Intake Patterns and Acculturation Levels of Hispanic Immigrant Men: A Pilot Study. Hispanic Journal of Behavioral Sciences 17: 347-361 [Abstract]  
• Willett, W. (1994). Diet and health: what should we eat?. Science 264: 532-537 [Abstract]  
• Kelsey, J. L., John, E. M. (1994). Lactation and the Risk of Breast Cancer. NEJM 330: 136-137 [Full Text]  
• Ennever, F. K., Paskett, E. D., Hunter, D. J., Stampfer, M. J., Willett, W. C. (1993). Vitamins and Breast Cancer. NEJM 329: 1579-1579 [Full Text]  
• (1993). VITAMIN A (BUT NOT C OR E) MAY PROTECT AGAINST BREAST CANCER. JWatch General 1993: 3-3 [Full Text]