London S J, Sacks F M, Stampfer M J, Henderson I C, Maclure M, Tomita A, Wood W C, Remine S, Robert N J, Dmochowski J R
Department of Preventive Medicine, University of Southern California, Los Angeles.
J Natl Cancer Inst. 1993 May 19;85(10):785-93. doi: 10.1093/jnci/85.10.785.
Studies in animals and geographic correlations across populations suggest that fatty acid intake may have a positive relationship with breast cancer risk, but analytic epidemiologic studies of fat intake have been less supportive. Adipose tissue analysis provides a more objective assessment of intakes of fatty acids that are not endogenously synthesized than do the questionnaire survey methods used in many epidemiologic studies.
This case-control study of postmenopausal women was designed to examine the relationship between fatty acid composition of subcutaneous adipose tissue and risk of breast cancer and proliferative benign breast disease. In addition, we examined specific hypotheses that breast cancer risk is negatively associated with long-chain N-3 fatty acid intake, positively associated with trans fatty acid intake, and positively associated with increased intake of polyunsaturated fat together with low intake of antioxidants.
Aspirates of subcutaneous fat from the buttocks were obtained from 380 women with newly diagnosed stage I or II breast cancer and 176 with proliferative benign breast disease. A total of 397 women who were evaluated for breast abnormalities at the same institutions but did not require breast biopsy or whose biopsy revealed nonproliferative benign breast disease served as the control group. We examined associations between saturated, monounsaturated, polyunsaturated, trans, or long-chain N-3 fatty acids and breast cancer, atypical hyperplasia, or proliferative benign breast disease without atypia.
We observed no consistent patterns of association between breast cancer risk and any of the categories of fatty acids or the individual constituent fatty acids in the adipose tissue. Saturated fatty acids were inversely associated with risk of proliferative benign breast disease without atypia but not with atypical hyperplasia or breast cancer. This association was not observed, however, when total fat intake was taken into account. Women with high levels of polyunsaturated fatty acids in adipose tissue and low serum or dietary levels of antioxidants were not observed to be at higher risk of breast cancer.
Using an objective measure of intake, we observed no major associations between polyunsaturated fatty acids, including long-chain N-3 fatty acids and trans fatty acids, and risk of breast cancer or proliferative benign breast disease.
These data do not support the hypothesis that intake of specific fatty acids, particularly polyunsaturated and trans fatty acids, is an important risk factor for malignant or benign breast disease.
动物研究以及不同人群间的地理相关性研究表明，脂肪酸摄入量可能与乳腺癌风险呈正相关，但脂肪摄入的分析性流行病学研究对此支持较少。与许多流行病学研究中使用的问卷调查方法相比，脂肪组织分析能更客观地评估非内源性合成的脂肪酸摄入量。
本项针对绝经后女性的病例对照研究旨在探讨皮下脂肪组织的脂肪酸组成与乳腺癌及增殖性良性乳腺疾病风险之间的关系。此外，我们还检验了以下具体假设：乳腺癌风险与长链N-3脂肪酸摄入量呈负相关，与反式脂肪酸摄入量呈正相关，与多不饱和脂肪摄入量增加且抗氧化剂摄入量低呈正相关。
从380例新诊断为I期或II期乳腺癌的女性以及176例患有增殖性良性乳腺疾病的女性中获取臀部皮下脂肪抽吸物。共有397名在同一机构接受乳腺异常评估但无需进行乳腺活检或活检显示为非增殖性良性乳腺疾病的女性作为对照组。我们研究了饱和脂肪酸、单不饱和脂肪酸、多不饱和脂肪酸、反式脂肪酸或长链N-3脂肪酸与乳腺癌、非典型增生或无非典型性的增殖性良性乳腺疾病之间的关联。
我们未观察到乳腺癌风险与脂肪组织中任何一类脂肪酸或单个成分脂肪酸之间存在一致的关联模式。饱和脂肪酸与无非典型性的增殖性良性乳腺疾病风险呈负相关，但与非典型增生或乳腺癌无关。然而，当考虑总脂肪摄入量时，未观察到这种关联。脂肪组织中多不饱和脂肪酸水平高且血清或饮食中抗氧化剂水平低的女性，未观察到乳腺癌风险更高。
通过客观的摄入量测量方法，我们未观察到包括长链N-3脂肪酸和反式脂肪酸在内的多不饱和脂肪酸与乳腺癌或增殖性良性乳腺疾病风险之间存在主要关联。
这些数据不支持特定脂肪酸（尤其是多不饱和脂肪酸和反式脂肪酸）的摄入是恶性或良性乳腺疾病重要危险因素的假设。
