| 32) Fink BN (2006) | The Long Island Breast Cancer Study Project (LIBCSP). | 1,235 invasive breast cancer cases (376 pre-menopausal, and 834 post-menopausal) age 25-98.
(USA) | 1996-97 to 2002-04 | 43 pre-menopausal, and 130 post-menopausal | All-cause mortality | Leafy vegetables (raw spinach; cooked spiinach; mustard greens, turnip greens, collards, kale; green salad) | At the 1996-97 case-control interview, respondents completed a FFQ.
Stratified by menopausal status:
| Pre-menopausal | Post-menopausal |
HR = 0.85 (0.39-1.85; P = 0.21) for the highest vs lowest quintile of consumption.
Amount specific data (in 0.5 cup servings per week):
0-2: HR = 1.
3: HR = 3.57 (1.39-9.13).
4-5: HR = 0.74 (0.31-1.76).
6-8: HR = 0.40 (0.16-1.02).
9+: HR = 0.85 (0.39-1.85).
|
HR = 0.72 (0.41-1.24; P = 0.31) for the highest vs lowest quintile of consumption.
Amount specific data (in 0.5 cup servings per week):
0-2: HR = 1.
3: HR = 0.80 (0.35-1.81).
4-5: HR = 0.86 (0.56-1.31).
6-8: HR = 0.87 (0.56-1.35).
9+: HR = 0.72 (0.41-1.24).
|
Postmenopausal women.
Stratified by ER/PR status:
| ER+ PR+ | ER+ PR-, ER- PR+, ER- PR- |
| HR = 0.66 (0.33-1.31; P = 0.33) for consumption ≥ 6 vs 0-5 0.5-cup servings per week.
|
HR = 0.90 (0.52-1.57; P = 0.85) for consumption ≥ 6 vs 0-5 0.5-cup servings per week.
|
Breast cancer mortality:
Results for breast cancer-specific mortality as the outcome were approximately equal to those for all-cause mortality (data not shown).Age and energy. |
| 28) Velie EM. (2005) | The Breast Cancer Detection Demonstration Project. | 23,183 women aged 40-91 with a BMI < 25. (USA) | 8 (1987-89 to 1997) | 1,024 | Breast cancer risk
(including in situ cases) | Cooked greens (collard, kale, and mustard) |
RH = 0.88 (0.71-1.10; P = 0.10) for the highest vs lowest quartile of consumption.
Amount specific data (Quartiles not defined):
Never eat: RH = 1.
Q2: RH = 1.11 (0.91-1.35).
Q3: RH = 0.73 (0.57-0.92).
Q4: RH = 0.88 (0.71-1.10).
Similar although less significant results were observed in the full sample of all study participants (40,599 women/ 1,868 cases) regardless of BMI (data not shown). | Age, total energy intake, education, family history of breast cancer, BMI, height, parity, age at first live birth, age at menarche, menopausal hormone use, average weekday vigorous physical activity, smoking status, and alcohol use. |
| 21) van Gils CH. (2005) | The EPIC Study. | 285 526 women between the ages of 25 and 70 years.
(8 European countries. Excluding Greece and Norway) | 5.4
(1992-98 to 2002) | 3,659 | invasive breast cancer risk | Leafy vegetables (excluding cabbages) |
RR = 1.16 (0.97-1.38; P = 0.23) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
≤ 6: RR = 1.
> 6-≤ 15: RR = 1.16 (1.00-1.35).
> 15-≤ 29: RR = 1.17 (1.00-1.36).
> 29-≤ 59: RR = 1.12 (0.95-1.32).
> 59: RR = 1.16 (0.97-1.38). | Stratified by center and age. Adjusted for energy intake divided into energy from fat and energy from nonfat sources, alcohol intake, saturated fat intake, height, weight, age at menarche, parity, current oral contraceptive use, current use of hormone therapy, menopausal status, smoking status, physical activity, and education. |
| 21 Olsen A (2003) | The Diet, Cancer and Health Cohort | 23,798 postmenopausal women age 50-64.
(Denmark) | 1993-97 to 2000 | 425? | Breast cancer risk | Leafy vegetables (not defined, but including salad) | No single subgroup of fruits and/or vegetables was strongly associated with the incidence rate of breast cancer in this study (no data shown). | Age, time under study, parity, previous benign breast tumor surgery, education, use of hormone replacement therapy, duration of HRT use, intake of alcohol and BMI. |
| 15) Smith-Warner SA. (2001) | Pooled Analysis of 8 Cohort Studies. | 351,825 | 5-16 | 7,377? | Invasive breast cancer risk | green leafy vegetables (i.e., spinach, lettuce, mustard/collard greens, kale) |
INCLUSION CRITERIA:
- 1) A published prospective study with at least 200 incident breast cancer cases.
- 2) Assessment of usual dietary intake.
- 3) A validation study of the diet assessment method or a closely related instrument.
INCLUDED STUDIES (Follow-up years/No. of breast cancer cases):
- The Adventist Health Study (1976-1982/160).
Mills PK, Beeson WL, Phillips RL. Dietary habits and breast cancer incidence among Seventh-day Adventists. Cancer. 1989 Aug 1;64(3):582-90. Abstract
- The Canadian National Breast Screening Study (1982-1987/419).
Rohan TE, Howe GR, Friedenreich CM, Jain M, Miller AB. Dietary fiber, vitamins A, C, and E, and risk of breast cancer: a cohort study. Cancer Causes Control. 1993 Jan;4(1):29-37. Abstract
- The Iowa Women's Health Study (1986-1995/1130).
Kushi LH, Fee RM, Sellers TA, Zheng W, Folsom AR. Intake of vitamins A, C, and E and postmenopausal breast cancer. The Iowa Women's Health Study. Am J Epidemiol. 1996 Jul 15;144(2):165-74. Full text
- The Netherlands Cohort Study (1986-1992/937).
Verhoeven DT, Assen N, Goldbohm RA, Dorant E, van 't Veer P, Sturmans F. Vitamins C and E, retinol, beta-carotene and dietary fibre in relation to breast cancer risk: a prospective cohort study. Br J Cancer. 1997;75(1):149-55. Abstract
- The New York State Cohort (1980-1987/367).
Graham S, Zielezny M, Marshall J, Priore R, Freudenheim J, Brasure J. Diet in the epidemiology of postmenopausal breast cancer in the New York State Cohort. Am J Epidemiol. 1992 Dec 1;136(11):1327-37. Abstract
- The New York University Women's Health Study (1985-1994/386).
Toniolo P, Riboli E, Shore RE, Pasternacks BS. Consumption of meat, animal products, protein, and fat and risk of breast cancer: a prospective cohort study in New York. Epidemiology. 1994 Jul;5(4):391-7. Abstract
- The Nurses' Health Study A + B (A = 1980-1986/1023. B = 1986-1996/1638).
Zhang S, Hunter DJ, Forman MR, Rosner BA, Speizer FE, Colditz GA. Dietary carotenoids and vitamins A, C, and E and risk of breast cancer. J Natl Cancer Inst. 1999 Mar 17;91(6):547-56. Full text
- The Sweden Mammography Cohort (1987-1997/1318).
Wolk A, Bergstrom R, Hunter D, Willet W, Ljung H, Holmberg L. A prospective study of association of monounsaturated fat and other types of fat with risk of breast cancer. Arch Intern Med. 1998 Jan 12;158(1):41-5. Full text
RELATIVE RISK:
No association: RR = 0.99 (0.92-1.06) per 100 g/day increment.
Menopausal status at follow-up did not modify the associations (no data shown).
| Age at menarche, interaction between parity and age at birth of first child, oral contraceptive use (ever/never), history of benign breast disease, menopausal status at follow-up, postmenopausal hormone use, family history of breast cancer, smoking status (ever/never), education, BMI, BMI-menopausal status interaction, height, alcohol intake, and energy intake. |
| 4) Fung TT (2006) | The Nurses' Health Study. | 71,058 women. | 18
(1984-2002) | 575 | ER- Breast cancer incidence | Leafy vegetables (iceberg lettuce, other lettuce, spinach) |
RR = 0.71 (0.55-0.90; P = 0.13) for the highest vs lowest quartile of consumption.
Amount specific data:
< 2/wk: RR = 1.
2-4/wk: RR = 0.86 (0.69-1.07).
5-6/wk: RR = 0.72 (0.54-0.96).
1+/d: RR = 0.71 (0.55-0.90).
After additional adjustment for other vegetables, the RR became: 0.80 (0.58-1.07; P = 0.72). | Energy intake, smoking, BMI, alcohol, weight change since age 18 y, menopausal status and postmenopausal hormone use, BMI at age 18 y, family history of breast cancer, history of benign breast disease, physical activity, multivitamin supplement use. |
Prospective studies of green vegetables and breast cancer:
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments |
| 1) Shibata A. (1992) | The Leisure World Study. | 11,580 residents of a retirement community.
(USA) | 1981-1989 | 219 | Breast cancer risk | Dark green vegetables (spinach, chard, beet greens, turnip greens, mustard greens, collards, kale, dandelion greens, broccoli, Brussels sprouts.) |
RR = 0.91 (0.66-1.25; No P-value) for the highest vs lowest tertile of consumption.
Amount specific data (servings/day):
< 0.13: RR = 1.
0.13-< 0.53: RR = 0.91 (0.66-1.26).
≥ 0.53: RR = 0.91 (0.66-1.25).
| Age and smoking.
Adjustment for BMI or physical activity did not materially alter the results (data not shown). |
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