Association of Fruit, Vegetable, and Animal Food Intakes with Breast Cancer Risk Overall and by Molecular Subtype among Vietnamese Women

Abstract

Background: Evidence on associations between dietary intake and risk of breast cancer subtypes is limited and inconsistent. We evaluated associations of fruit, vegetable, meat, and fish consumption with risk of breast cancer overall and by molecular subtype in the Vietnamese Breast Cancer Study (VBCS). Method: VBCS includes 476 incident breast cancer cases and 454 age-matched controls. Dietary habits over the past 5 years were assessed by in-person interviews using a validated food frequency questionnaire. Associations of food groups with breast cancer were evaluated via logistic regression for overall and molecular subtype with adjustment for age, education, income, family history of cancer, menopausal status, body mass index, exercise, total energy intake, and other potential dietary confounders. Odds ratio (OR) was used to approximate relative risk. Results: High fruit intake was inversely associated with breast cancer risk, with adjusted ORs [95% confidence intervals (CI)] of 0.67 (95% CI, 0.47–0.95) and 0.41 (95% CI, 0.27–0.61) for second and third tertiles versus first tertile, respectively (Ptrend < 0.001). This association was stronger for triple-negative than other subtypes (Pheterogeneity < 0.001). High intake of freshwater fish was inversely associated with overall breast cancer (ORT3vsT1 = 0.63; 95% CI, 0.42–0.95; Ptrend = 0.03). An inverse association was observed between HER2-enriched subtype and red and organ meat intake (ORT3vsT1 = 0.40; 95% CI, 0.17–0.93; Ptrend = 0.04; Pheterogeneity = 0.50). Conclusions: High intakes of fruit and freshwater fish were associated with reduced breast cancer risk; association for the former was stronger for triple-negative subtype. Impact: Our findings suggest high intakes of fruit and freshwater fish may reduce breast cancer risk among Vietnamese women.

Chemotherapy-Induced Toxicities and Their Associations with Clinical and Non-Clinical Factors among Breast Cancer Patients in Vietnam

“…Our study was based on a prospective follow-up of 501 newly diagnosed Vietnamese breast cancer patients recruited into the VBCS, a case–control study of breast cancer. Details of designs and methods for the VBCS have been described [ 23 , 24 ]. Briefly, patients were recruited from July 2017 through June 2018 from inpatient surgical units and chemotherapy inpatient and outpatient units of two major cancer hospitals in North Vietnam: the Vietnam National Cancer Hospital and Hanoi Oncology Hospital (response rate of 93.1%).…”

“…Written consent was obtained from all VBCS participants. Approval for human subject research was obtained from the Vietnam National Cancer Institute and Vanderbilt University Medical Center [ 23 , 24 ].…”

Gut microbiome in association with chemotherapy‐induced toxicities among patients with breast cancer

“…The design and methods for the VBCS have been described in detail elsewhere. 10,11 Briefly, patients were recruited from July 2017 through June 2018 from inpatient surgical units and chemotherapy inpatient or outpatient units of two oncology hospitals in North Vietnam: the Vietnam National Cancer Hospital and Hanoi Oncology Hospital (response rate, 93.1%). Study eligibility criteria included patients who were newly diagnosed with primary breast cancer between the ages of 18 and 79 years, had not received prior chemotherapy, and were able to provide written informed consent.…”

“…Women with a history of other cancers or concurrent life-threatening illnesses (e.g., stroke, heart failure) were excluded from the study. Approval for human subject research was obtained from the Vietnam National Cancer Institute (VNCI) and Vanderbilt University Medical Center, 10,11 and written consent was obtained from all study participants.…”

Menstrual and Reproductive Factors in Association With Breast Cancer Risk in Vietnamese Women: A Case-Control Study

“…Details of design and methods for the VBCS have been described previously. 12 A total of 501 newly diagnosed breast cancer patients and 468 controls were included in this study from July 2017 to June 2018 in Hanoi, Vietnam (response rates of 93.1% and 97.7% for cases and controls, respectively).We excluded case participants who were subsequently confirmed to have a benign tumor based on a pathological review (n = 9) or who were diagnosed at stage 0 (n = 2). Finally, 490 cases and 468 controls remained in the current study.…”