Biomarkers of dietary fatty acid intake and the risk of breast cancer: a meta-analysis.

The use of the fatty acid composition of adipose tissue, erythrocyte membranes, serum and plasma as biological markers of fatty acid intake was recently introduced in epidemiological studies. The biomarkers of fatty acid intake have the advantage of providing quantitative measurement independent of energy intake and of the subject's memory. We performed a meta-analysis of published results of epidemiological studies of the composition of fatty acids in biological samples and breast cancer risk. The analysis was based on 3 cohort and 7 case-control studies including 2,031 cases and 2,334 controls. The summary statistic used was the average of the relative risk estimated for each level of the fatty acid on study, weighted by the inverse of its variance. Random effect models were assumed when the test for heterogeneity was significant. Overall relative risks were estimated for studies including pre- and post-menopausal breast cancer and separately for post-menopausal women. In cohort studies, a significant protective effect was found for total n-3 polyunsaturated fatty acids, while total monounsaturated fatty acids, oleic acid (C18:1 n-9c) and palmitic acid (C16:0) were significantly associated with an increase of breast cancer risk. Total saturated fatty acids were significantly associated with breast cancer risk in cohort studies only in postmenopausal women. For case-control studies, the only finding was for alpha linolenic acid (C18:3, n-3), which showed an inverse association bordering on statistical significance. The findings of cohort studies fit well with hypotheses derived from experimental animal studies. More epidemiological cohort studies that integrate biological markers of dietary fatty acid intake are needed in order to determine the contribution of different types of fatty acids in the etiology of breast cancer.