Nutrition and breast cancer among sporadic cases and gene mutation carriers: An overview

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Abstract

Background: Breast cancer is the second leading cause of cancer-related deaths among women in most industrialized countries. Most breast cancers are considered sporadic, with only 5–10% estimated to be due to inherited susceptibility. The objective of this paper is to provide an overview of the effect of nutrition on breast cancer risk among gene mutation carriers as well as those with sporadic breast cancer. Methods: The published literature from 1999 to 2007 was reviewed to examine the relationship between nutrition and breast cancer among sporadic cases and gene mutation carriers. Results: Evidence suggests that fruits and vegetables, low-fat dairy products, fish, monounsaturated and polyunsaturated fatty acids, vitamin D, calcium, and phytoestrogens may reduce the risk of breast cancer. However, high intake of meat, poultry, total energy, total fat and saturated fatty acids may play a causative role in this disease. Conclusions: Diet in breast cancer pathogenesis is a modifiable risk factor on which to focus prevention efforts. Identification of the relationship between nutrition and breast cancer among sporadic cases and gene mutation carriers provides necessary data for breast cancer prevention.

Introduction

Breast cancer is the most common invasive cancer, and the second leading cause of cancer-related deaths among women in North America [1]. The etiology of breast cancer is complex, but several risk factors have been identified. Numerous epidemiological and laboratory studies have revealed the effects of dietary patterns, food groups as well as single nutrients and other nutritional determinants on sporadic breast cancer risk [2]. Most breast cancers are considered sporadic, with only 5–10% estimated to be due to inherited susceptibility [3]. Individuals who have sporadic breast cancer may not inherit cancer-causing mutations from their parents [4]. Instead, certain cells undergo mutations that lead to cancer. These mutations can be caused by sun [5], exposure to radiation [6], certain chemicals [7], or other as yet unknown factors. In the case of hereditary cancer, tumor cells usually contain some mutations that are not found elsewhere in the body, but also harbor a critical mutation that every cell shares [8]. People born with a cancer-related mutation are more likely to develop cancer, especially at a young age, than those without an inherited mutation. Autosomal dominant alterations in two genes, BRCA1 on chromosome 17 and BRCA2 on chromosome 13, are likely to account for familial cases of early-onset breast cancer [4], [9]. Other suspected genetic factors are germ-line mutations in TP53 mutations in the cell cycle-checkpoint kinase gene (CHEK2) as well as PTEN [4].

In general, the role of nutritional factors in the etiology of breast cancer remains controversial. A number of dietary factors, including the consumption of fruits and vegetables [10], dairy products [11], meat, poultry and fish [12], dietary patterns featuring high intakes of fat [13], [14], or combination of essential fatty acids and antioxidant vitamins [15], have been intensively assessed in relation to breast cancer risk. The objective of this paper is to provide an overview on the effect of consumption of certain food groups on breast cancer risk among gene mutation carriers (women who inherited an altered form of a gene) as well as those with sporadic breast cancer. Table 1 provides and overview to some studies that are representative of the reviewed literature in this paper.

Section snippets

Methods

To identify studies on the relationship between nutrition and breast cancer among sporadic cases and gene mutation carriers, a literature search was conducted in the following electronic databases: Current Contents (Institute for Scientific Information, Philadelphia, PA), and Medline (National Library for Medicine, Bethesda, MD) for the years 1999–2007. The publications considered were those reporting on the consumption of fruits and vegetables, dairy products, meat, poultry, fish, total

Fruits and vegetables

Many fruits and vegetables contain protective substances, such as fiber, antioxidants, vitamins, minerals, and other potentially anticarcinogenic compounds, including dithiolthiones, isothiocyanates, indole-3-carbinol, flavonols, and ligans, among others [14] Associations between fruit and vegetable intake and breast cancer risk have been the subject of many case-control and a limited number of cohort studies. An extensive summary by the World Cancer Research Fund [2] concluded that vegetable

Discussion of methodological issues

Epidemiological studies may harbor biases that could influence their outcome. Bias could result from the dietary assessment methods employed [123]. While cohort and prospective studies have typically employed 24-h recall, diet records or FFQs, most case-control studies have administered FFQs to retrospectively assess dietary patterns or consumption frequency of foods, nutrients, or food groups believed to be related to the etiology of the disease under investigation.

When interpreting these

Conclusion

Since breast cancer may have latent initiation, genetics, environment, diet and lifestyle, therefore, should be considered as potential factors in its etiology. Numerous studies have tested theories of associations between dairy product consumption and breast cancer risk via the role played by fat from the dairy product in relation to IGF-1, GH and estrogens. Although estrogens and the GH/IGF-1 axis play a critical role in mammary gland development, the mechanisms are complex, and cancer is

Conflict of interest

None declared.

Acknowledgments

Funding for this study was received from the Montreal Cancer Institute. The authors acknowledge the editorial assistance of Ovid Da Silva, Research Support Office, Research Centre, CHUM, Montreal, Quebec, Canada.

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