Table 4.
Studies evaluating postdiagnosis dietary fat subtypes in relation to breast cancer and all-cause mortalitya
| Reference | Location | Design | Sample (n) | Dietary assessment method |
Contrast | RR/HR (95% CI) for breast cancer mortality |
RR/HR for all-cause mortality |
Covariates |
|---|---|---|---|---|---|---|---|---|
| Saturated fat (SF)/animal fat | ||||||||
| Rohan et al. 1993 (50) | Australia | Prospective cohort study (follow-up of cases from a case-control study) |
412 cases Age: 20–74 years 112 breast cancer deaths |
FFQ | SF(g) Quintile 5 versus 1 |
1.65 (0.73–3.75) | Not available | Energy, age at menarche, BMI |
| Holmes et al. 1999 (25) | United States |
Prospective cohort study |
1,982 women with invasive breast cancer |
FFQ | Animal fat (g) Quintile 5versus 1 |
Not available | 1.01 (0.73–1.38) | Age, diet interval, calendar year of diagnosis, BMI, oral contraceptive use, menopausal status, HRT, smoking, age at first birth and parity, number of metastatic lymph nodes, tumor size, energy |
| SF(g) Quintile 5 versus 1 |
1.23 (0.89–1.69) | |||||||
| Goodwin et al. 2003 (22) | Canada | Prospective cohort study |
477 women with surgically resected breast cancer Age <75 years |
FFQ | Quadratic form: SF(g/d) Quintile 1 versus 5 |
Not available | 4.3 (p = 0.10) | Age, energy, BMI, tumor and nodule stage, adjuvant hormone therapy, adjuvant chemotherapy |
| Beasley et al. 2011 (9) | United States |
Prospective cohort study |
4,441 women with history of invasive breast cancer and no history of recurrence Age: 29–70 years 525 deaths; 26% due to breast cancer |
FFQ | SF (% energy) Quintile 5 versus 1 |
1.55 (0.88–2.75) | 1.41 (1.06–1.87) | Age, state of residence, menopausal status, smoking, disease stage, alcohol, history of HRT, energy, treatment, BMI, and physical activity |
| Trans fats | ||||||||
| Holmes et al. 1999 (25) | United States |
Prospective cohort study |
1,982 women with invasive breast cancer |
FFQ | 18:2 trans fat (g) Quintile 5 versus 1 |
Not available | 1.45 (1.06–1.99) | Age, diet interval, calendar year of diagnosis, BMI, oral contraceptive use, menopausal status, HRT, smoking, age at first birth and parity, number of metastatic lymph nodes, tumor size, energy |
| Beasley et al. 2011 (9) | United States |
Prospective cohort |
4,441 women with history of invasive breast cancer and no history of recurrence Age: 29–70 years 525 deaths; 26% due to breast cancer |
FFQ |
Trans fat(% energy) Quintile 5 versus 1 |
1.42 (0.80–2.52) | 1.78 (1.35–2.32) | Age, state of residence, menopausal status, smoking, disease stage, alcohol, history of HRT, energy, cancer treatment, BMI, physical activity |
| Monounsaturated fat (MUFA) | ||||||||
| Rohan et al. 1993 (50) | Australia | Prospective cohort study (follow-up of cases from a case-control study) |
412 cases Age: 20–74 years 112 breast cancer deaths |
FFQ | MUFA intake (g): Quintile 5 versus 1 |
1.33 (0.56–3.13) | Not available | Energy, age at menarche, BMI |
| Holmes et al. 1999 (25) | United States |
Prospective cohort study |
1,982 women with invasive breast cancer |
FFQ | Oleic acid (g) Quintile 5 versus 1 |
Not available | 1.23 (0.89, 1.70) | Age, diet interval, calendar year of diagnosis, BMI, oral contraceptive use, menopausal status, HRT, smoking, age at first birth and parity, number of metastatic lymph nodes, tumor size, energy |
| MUFA (g) Quintile 5 versus 1 |
1.34 (0.96–1.86) | |||||||
| Goodwin et al. 2003 (22) | Canada | Prospective cohort study |
477 women with surgically resected breast cancer Age <75 years |
FFQ | Quadratic form: Oleic acid (g/d) Quintile 1 versus 5 |
Not available | 3.1 (p = 0.03) | Age, energy, BMI, tumor and nodule stage, HRT, adjuvant chemotherapy |
| Beasley et al. 2011 (9) | United States |
Prospective cohort study |
4,441 women with history of invasive breast cancer and no history of recurrence Age: 29–70 years 525 deaths; 26% due to breast cancer |
FFQ | MUFA (% energy) Quintile 5 versus 1 |
0.89(0.49–1.60) | 1.14 (0.86–1.52) | Age, state of residence, menopausal status, smoking, disease stage, alcohol, history of HRT, energy, treatment, BMI, physical activity |
| Polyunsaturated fat (PUFA) | ||||||||
| Nomura et al. 1991 (43) | United States (Hawaii) |
Prospective cohort study (follow-up of cases from a case-control study) |
161 Caucasian Age: 45–74 years |
Diet history interview |
High versus low PUFA intake |
1.72 (0.74–4.00) | Not available | Disease stage, menopausal status, obesity index, estrogen use |
| Rohan et al. 1993 (50) | Australia | Prospective cohort study (follow-up of cases from a case-control study) |
412 cases Age: 20–74 years 112 breast cancer deaths |
FFQ | PUFA intake (g) Quintile 5 versus 1 |
1.57 (0.78–3.14) | Not available | Energy, age at menarche, BMI |
| Holmes et al. 1999 (25) | United States |
Prospective cohort study |
1,982 women with invasive breast cancer 686 premenopausal 1,267 postmenopausal |
FFQ | Omega-3 FA (g) Quintile 5 versus 1 |
Not available | 0.77 (0.56–1.07) | Age, diet interval, calendar year of diagnosis, BMI, oral contraceptive use, menopausal status, HRT, smoking, age at first birth and parity, number of metastatic lymph nodes, tumor size, energy |
| LA(g) Quintile 5 versus 1 |
1.05 (0.77–1.44) | |||||||
| EPA(g) Quintile 5 versus 1 |
0.78 (0.57–1.07) | |||||||
| PUFA (g) Quintile 5 versus 1 |
1.05 (0.77–1.43) | |||||||
| Goodwin et al. 2003 (22) | Canada | Prospective cohort study |
477 women with surgically resected Tl to T3, NO/1, MO breast cancer Age <75 years |
FFQ | Quadratic form: LA(g/d) Quintile 1 versus 5 |
Not available | 1.3 (p = 0.59) | Age, energy, BMI, tumor and nodule stage, HRT, adjuvant chemotherapy |
| Beasley et al. 2011 (9) | United States |
Prospective cohort study |
4,441 women with history of invasive breast cancer and no history of recurrence Age: 29–70 years 525 deaths; 26% due to breast cancer |
FFQ | PUFA (% energy) Quintile 5 versus 1 |
0.90 (0.52–1.55) | 0.91 (0.70–1.19) | Age, state of residence, menopausal status, smoking, disease stage, alcohol, history of HRT, energy, treatment, BMI, physical activity |
| Patterson et al. 2011 (45) |
United States |
Prospective cohort study (cohort analysis from RCT) |
3,081 women diagnosed and treated for early-stage breast cancer Age: 18–70 years |
24-hour recalls |
EPA and DHA (mg/day) |
Not available | Age, obesity, physical activity, intervention group, entry cohort |
|
| Food only: Tertile 3 versus 1 |
0.59 (0.43–0.82) | |||||||
| Food adjusted for supplements: Tertile 3 versus 1 |
0.60 (0.44–0.83) | |||||||
| Food plus supplements: Tertile 3 versus 1 |
0.68 (0.51–0.90) | |||||||
a
Abbreviations: BMI, body mass index; DHA, docosahexaenoic acid; EPA, eicosapentaenoic acid; FA, fatty acid; FFQ, food frequency questionnaire; HR, hazard ratio; HRT, hormone replacement therapy; LA, linoleic acid; RCT, randomized controlled trial; RR, rate ratio.