Castelló Adela, Boldo Elena, Pérez-Gómez Beatriz, Lope Virginia, Altzibar Jone M, Martín Vicente, Castaño-Vinyals Gemma, Guevara Marcela, Dierssen-Sotos Trinidad, Tardón Adonina, Moreno Víctor, Puig-Vives Montserrat, Llorens-Ivorra Cristóbal, Alguacil Juan, Gómez-Acebo Inés, Castilla Jesús, Gràcia-Lavedán Esther, Dávila-Batista Verónica, Kogevinas Manolis, Aragonés Nuria, Amiano Pilar, Pollán Marina
Cancer Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Manuel de Falla 1, 28222, Madrid, Spain.
Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Carlos III Institute of Health, Avenida Monforte de Lemos 5, 28029, Madrid, Spain; Breast Cancer Screening Program, Osakidetza-Health Basque Region Service, Avenida Navarra, 4, 20013, San Sebastián, Spain.
Maturitas. 2017 Sep;103:8-15. doi: 10.1016/j.maturitas.2017.06.020. Epub 2017 Jun 12.
To externally validate the previously identified effect on breast cancer risk of the Western, Prudent and Mediterranean dietary patterns.
MCC-Spain is a multicase-control study that collected epidemiological information on 1181 incident cases of female breast cancer and 1682 healthy controls from 10 Spanish provinces. Three dietary patterns derived in another Spanish case-control study were analysed in the MCC-Spain study. These patterns were termed Western (high intakes of fatty and sugary products and red and processed meat), Prudent (high intakes of low-fat dairy products, vegetables, fruits, whole grains and juices) and Mediterranean (high intake of fish, vegetables, legumes, boiled potatoes, fruits, olives, and vegetable oil, and a low intake of juices). Their association with breast cancer was assessed using logistic regression models with random province-specific intercepts considering an interaction with menopausal status. Risk according to tumour subtypes - based on oestrogen (ER), progesterone (PR) and human epidermal growth factor 2 (HER2) receptors (ER+/PR+ & HER2-; HER2+; ER-/PR- & HER2-) - was evaluated with multinomial regression models.
Breast cancer and histological subtype.
Our results confirm most of the associations found in the previous case-control study. A high adherence to the Western dietary pattern seems to increase breast cancer risk in both premenopausal women (OR (95% CI):1.68 (1.02;2.79); OR (95% CI):1.19 (1.02;1.40)) and postmenopausal women (OR(95% CI):1.48(1.07;2.05); OR(95% CI): 1.14 (1.01;1.29)). While high adherence to the Prudent pattern did not show any effect on breast cancer, the Mediterranean dietary pattern seemed to be protective, but only among postmenopausal women (OR (95% CI): 0.72 (95% CI 0.53;0.98); p-int=0.075). There were no significant differences by tumour subtype.
Dietary recommendations based on a departure from the Western dietary pattern in favour of the Mediterranean diet could reduce breast cancer risk in the general population.
对外验证先前确定的西方饮食模式、谨慎饮食模式和地中海饮食模式对乳腺癌风险的影响。
MCC - 西班牙研究是一项多病例对照研究，收集了来自西班牙10个省份的1181例女性乳腺癌新发病例和1682名健康对照的流行病学信息。在MCC - 西班牙研究中分析了另一项西班牙病例对照研究中得出的三种饮食模式。这些模式分别称为西方饮食模式（高脂肪、高糖产品以及红肉和加工肉类摄入量高）、谨慎饮食模式（低脂乳制品、蔬菜、水果、全谷物和果汁摄入量高）和地中海饮食模式（鱼类、蔬菜、豆类、煮土豆、水果、橄榄和植物油摄入量高，果汁摄入量低）。使用具有随机省份特定截距的逻辑回归模型评估它们与乳腺癌的关联，并考虑与绝经状态的相互作用。根据肿瘤亚型 - 基于雌激素（ER）、孕激素（PR）和人表皮生长因子2（HER2）受体（ER + /PR + & HER2 -；HER2 +；ER - /PR - & HER2 -） - 用多项回归模型评估风险。
乳腺癌及组织学亚型。
我们的结果证实了先前病例对照研究中发现的大多数关联。高度遵循西方饮食模式似乎会增加绝经前女性（比值比（95%置信区间）：1.68（1.02；2.79）；比值比（95%置信区间）：1.19（1.02；1.40））和绝经后女性（比值比（95%置信区间）：1.48（1.07；2.05）；比值比（95%置信区间）：1.14（1.01；1.29））患乳腺癌的风险。虽然高度遵循谨慎饮食模式对乳腺癌没有显示出任何影响，但地中海饮食模式似乎具有保护作用，但仅在绝经后女性中（比值比（95%置信区间）：0.72（95%置信区间0.53；0.98）；p值交互作用 = 0.075）。肿瘤亚型之间没有显著差异。
基于摒弃西方饮食模式而倾向于地中海饮食的饮食建议可能会降低普通人群患乳腺癌的风险。
