Abstract
BackgroundAlthough benign breast changes are more common than breast cancer, little evidence regarding risk factors for benign breast conditions is available. Omega-3 (n–3) fatty acids have antiinflammatory and antiproliferative actions and may be important in reducing the risk of benign conditions. There is a lack of research on the association of n–3 fatty acids with risk of benign fibrocystic breast changes. ObjectivesThe objectives of the study were to evaluate the role of n–3 and other fatty acids in the development of benign proliferative fibrocystic conditions (PFCs) and nonproliferative fibrocystic conditions (NPFCs) in the breast and to evaluate the progression of fibrocystic changes in breast cancer. DesignWe conducted a case-control study to determine erythrocyte fatty acid concentrations in 155 women with NPFCs, 185 women with PFCs, 241 women with breast cancer (127 with nonproliferative and 114 with proliferative changes in the noncancerous extratumoral mammary epithelium), and 1030 control subjects. We estimated the relative risk of NPFCs, PFCs, and breast cancer with proliferative and nonproliferative changes in extratumoral tissue compared with the risk of these changes alone. ResultsWomen in the highest quartile of eicosapentaenoic acid concentrations were 67% less likely to have an NPFC alone or with breast cancer and 49% less likely to have breast cancer than were women with PFCs. γ-Linolenic acid (18:3n–6) was positively associated with all fibrocystic and cancerous conditions. Palmitic:palmitoleic acid (n–7 saturation index) was inversely associated with risk in all comparisons. ConclusionOur results support a protective effects of n–3 fatty acid intake and the n–7 saturation index against benign fibrocystic breast changes and the progression of proliferative changes to breast cancer.
Highlights
Fibrocystic breast conditions are relatively common among women, premenopausal women between the ages of 20 and 50 y
In comparison with control subjects, women with breast cancer with proliferative extratumoral tissue reported fewer live births; in addition, women with breast cancer with nonproliferative extratumoral changes were significantly younger at menarche than were control subjects and were more likely to be postmenopausal than were women with nonproliferative fibrocystic conditions (NPFCs) alone
A greater percentage of palmitic and palmitoleic acids was associated with a significant increase in risk of both NPFCs and breast cancer with nonproliferative changes as compared with control subjects
Summary
Fibrocystic breast conditions are relatively common among women, premenopausal women between the ages of 20 and 50 y. Chart review studies indicate that ’60% of women referred for evaluation of breast symptoms receive a diagnosis of a benign condition [1] Of these benign conditions, fibrocystic changes are the most common, and between 30% and 70% of these lesions show evidence of epithelial hyperplasia or proliferation [2, 3]. Objectives: The objectives of the study were to evaluate the role of n–3 and other fatty acids in the development of benign proliferative fibrocystic conditions (PFCs) and nonproliferative fibrocystic conditions (NPFCs) in the breast and to evaluate the progression of fibrocystic changes in breast cancer. Conclusion: Our results support a protective effects of n–3 fatty acid intake and the n–7 saturation index against benign fibrocystic breast changes and the progression of proliferative changes to breast cancer.
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