The potential contribution of dietary factors to breast cancer prevention

Abstract

Breast cancer (BC), the leading cancer in women, is increasing in prevalence worldwide, concurrent with western metabolic epidemics, that is, obesity, metabolic syndrome, and diabetes, and shares major risk factors with these diseases. The corresponding potential for nutritional contributions toward BC prevention is reviewed and related to critical stages in the life cycle and their implications for carcinogenic and pathometabolic trajectories. BC initiation potentially involves diet-related pro-oxidative, inflammatory, and procarcinogenic processes, that interact through combined lipid/fatty acid peroxidation, estrogen metabolism, and related DNA-adduct/depurination/mutation formation. The pathometabolic trajectory is affected by high estrogen, insulin, and growth factor cascades and resultant accelerated proliferation/progression. Anthropometric risk factors – high birth weight, adult tallness, adiposity/BMI, and weight gain – are often reflective of these trends. A sex-based nutritional approach targets women’s specific risk in western obesogenic environments, associated with increasing fatness, estrogen metabolism, n-6 : n-3 polyunsaturated fatty acid ratio, and n-6 polyunsaturated fatty acid conversion to proinflammatory/carcinogenic eicosanoids, and effects of timing of life events, for example, ages at menarche, full-term pregnancy, and menopause. Recent large-scale studies have confirmed the effectiveness of the evidence-based recommendations against BC risk, emphasizing low-energy density diets, highly nutritious plant-based regimes, physical activity, and body/abdominal adiposity management. Better understanding of dietary inter-relationships with BC, as applied to food intake, selection, combination, and processing/preparation, and recommended patterns, for example, Mediterranean, DASH, plant-based, low energy density, and low glycemic load, with high nutrient/phytonutrient density, would increase public motivation and authoritative support for early/timely prevention, optimally merging with other dietary/health goals, for lifelong BC prevention.

Breast cancer in adolescents and young adults

“…Breast cancer is the most common cancer among women worldwide . It is the most common cancer among AYAs in the United States (US), accounting for 15% of all invasive cancer and 30% of cancer in females (SEER).…”

“…Most AYAs who survive breast cancer will live for decades following treatment and are at significant risk for second breast cancers and other malignancies . Providers should proactively encourage AYA breast cancer survivors to adopt risk‐reduction strategies, including regular vigorous exercise, limitation of alcohol, and a diet low in energy density and rich in plants …”

“…Breast cancer is the most common cancer among women worldwide. 4 It is the most common cancer among AYAs in the United States (US), Abbreviations: AJCC, American Joint Committee on Cancer; AYAs, Adolescent and young adults; DHEAS, Dehydroepiandrosterone Sulfate; EGFR, Epithelial growth factor receptor; ER, Estrogen receptor; HR, Hazard ratio; PR, Progesterone receptor; RR, Relative risk; SEER, United States Surveillance, Epidemiology and End Results database; US, United States accounting for 15% of all invasive cancer and 30% of cancer in females (SEER). In 2013, approximately 11,000 AYA women in the US were diagnosed with invasive breast cancer and approximately 1,000 died of the disease.…”

“…30,31 A diet high in energy-rich foods, such as red meat or fast food, increases premenopausal breast cancer risk. 4,10,32,33 In contrast, a whole food, plant-based, low-energy density diet reduces the risk for AYA breast cancer. 4,32,33 Substituting legumes for one serving of meat per day lowers breast cancer risk by 19% among premenopausal women.…”

Obesity, Dietary Factors, Nutrition, and Breast Cancer Risk

“…Diet may modify biomarkers of cancer progression in patients who have been treated for cancer [151]. In observational studies, a prudent dietary pattern, rich in plant foods has been associated with reduced mortality after diagnosis of breast cancer [152, 153].…”