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Previous Volume 334:356-361 February 8, 1996 Number 6 Next

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ABSTRACT

Background Experiments in animals, international correlation comparisons, and case–control studies support an association between dietary fat intake and the incidence of breast cancer. Most cohort studies do not corroborate the association, but they have been criticized for involving small numbers of cases, homogeneous fat intake, and measurement errors in estimates of fat intake.

Methods We identified seven prospective studies in four countries that met specific criteria and analyzed the primary data in a standardized manner. Pooled estimates of the relation of fat intake to the risk of breast cancer were calculated, and data from study-specific validation studies were used to adjust the results for measurement error.

Results Information about 4980 cases from studies including 337,819 women was available. When women in the highest quintile of energy-adjusted total fat intake were compared with women in the lowest quintile, the multivariate pooled relative risk of breast cancer was 1.05 (95 percent confidence interval, 0.94 to 1.16). Relative risks for saturated, monounsaturated, and polyunsaturated fat and for cholesterol, considered individually, were also close to unity. there was little overall association between the percentage of energy intake from fat and the risk of breast cancer, even among women whose energy intake from fat was less than 20 percent. correcting for error in the measurement of nutrient intake did not materially alter these findings.

Conclusions We found no evidence of a positive association between total dietary fat intake and the risk of breast cancer. There was no reduction in risk even among women whose energy intake from fat was less than 20 percent of total energy intake. In the context of the Western lifestyle, lowering the total intake of fat in midlife is unlikely to reduce the risk of breast cancer substantially.

Source Information

From the Departments of Epidemiology (D.J.H., D.S., W.W.), Nutrition (W.W.), and Biostatistics (D.S.), and the Center for Cancer Prevention (D.J.H.), Harvard School of Public Health, Boston; the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston (D.J.H., A.M., F.E.S., S.-S.Y., W.W.); the Center for Health Research, Loma Linda University School of Medicine, Loma Linda, Calif. (L.B., G.E.F.); the National Cancer Institute of Canada Epidemiology Unit, Department of Preventive Medicine and Biostatistics, Faculty of Medicine, University of Toronto, Toronto (G.R.H., A.B.M.); the Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis (A.R.F., L.H.K.); the Department of Epidemiology, University of Limburg, Maastricht, the Netherlands (P.A.B.); the Department of Nutrition, TNO Nutrition and Food Research Institute, Zeist, the Netherlands (R.A.G.); the Department of Social and Preventive Medicine, State University of New York, Buffalo (S.G., J.R.M.); and the Department of Cancer Epidemiology, University Hospital, Uppsala, Sweden (H.-O.A., A.W.).

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

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Dietary Fat and the Risk of Breast Cancer
Blackburn G. L., Ishikawa M., Smith J. A., Flynn M., Walker A. R.P., Walker B. F., Hunter D. J., Spiegelman D., Willett W.
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N Engl J Med 1996; 334:1606-1607, Jun 13, 1996. Correspondence

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