Breast Cancer In Iranian Women Research Articles

Exploring the Experts' Perspectives on the Most Important Risk Factors of Breast Cancer in Iranian Women: A Qualitative Delphi Consensus

Background: Several methods have been designed to assess the risk of breast cancer. But according to studies conducted in Iran, the risk of Iranian women could not be correctly calculated. Objective: This study aimed to explore the experts' perspectives on the most important risk factors of breast cancer in Iranian women. Method: In round one, the risk factors identified from an integrative review of literature and specialist interviews (Delphi round one) were used to design a questionnaire survey. In round two, specialists were asked to rate the importance of each risk factor. In round three, respondents were asked to reprioritize moderate important risk factors. The items considered very important in round three were included in the core risk factors set. Results: In the first round, a total of 119 items were obtained from the results of an integrative review of the literature and interview with experts. In round two, 30 specialists (response rate 50%) prioritized 119 risk factors of BC, and 43 low, 51 medium and 25 high-level risk factors were identified by the experts. From those, 43 low-level risk factors were removed, and 51 medium-level risk factors were carried forward to round three for consensus. No consensus was reached on any of the risk factors that went into round three (response rate 86.7%). Therefore, 25 high-level risk factors were recognized as the most important risk factors for BC in Iran. Conclusion: This study highlights the items that specialists feel would be most crucial to include in the clinical assessment of breast cancer risk. This study has the potential to provide an appropriate and usable tool for detecting high-risk women in primary health care in Iran.

Evaluation Factors Affecting on Recurrence, Metastasis, and Survival of Breast Cancer in Iranian Women by Multi-State Model Approach.

We used the multistate model to investigate how prognostic factors of breast cancer are seen to affect the disease process. This cohort study was conducted at Motamed Cancer Institute of Tehran, Iran on 2363 breast cancer patients admitted from 1978 to 2017, and they were followed up until 2018. We applied the multistate models, including four states: diagnosis, recurrence, metastasis, and final absorbing mortality state. Age over 50 years, positive lymph nodes and tumor size intensified the hazard of transition from diagnosis to metastasis (P=0.002, P<0.001 and P=0.001 respectively) and they also intensified the hazard of transition from diagnosis to mortality (P=0.010, P<0.001 and P<0.001 respectively). At the same time, the educational level decreased the hazard of mentioned transitions (P<0.001). Positive estrogen receptors reduced the hazard of transition from diagnosis to metastasis (P=0.007) and positive lymph nodes also intensified the hazard of transition from metastasis to mortality (P=0.040). Tumor size had an increasing role in the transitions from diagnosis to recurrence, recurrence to metastasis, and metastasis to mortality (P=0.014, P=0.018 and P=0.002 respectively). Multistate model presented the detailed effects of prognostic factors on progression of breast cancer. Implementing early diagnosis strategies and providing informational programs, especially in younger ages and lower educational level patients may be helpful in reducing the hazard of transition to higher states of breast cancer and increasing the survival of Iranian women with breast cancer by controlling tumor size growth, lymph nodes involvements and estrogen receptor status.

High Frequency of HPV Genotypes 16 and 18 Found in Breast Cancer Patients: Evidence for a More Comprehensive HPV Vaccination Program in Iran

Background &amp; Objectives: Papillomaviruses are found in many different types of infections and in a wide range of animals and humans. They can cause health problems, including benign and malignant tumors. In the present study, the association between human papillomavirus (HPV) infection and breast cancer (BC) in Iran was investigated.&#x0D; Materials &amp; Methods: In this cross-sectional study, the presence of the HPV genome was investigated in BC-suspected tissues for the first time in Qom Province, Iran. A total of 400 samples (including 200 BC-suspected tissue samples and 200 blood samples of women without BC) were collected from women referred to two cancer-specific general hospitals. To determine the presence of the L1 gene of HPV in the collected samples, nested polymerase chain reaction (PCR) was performed. Then, HPV-positive samples were tested by PCR using high-risk specific HPV-16 and 18 primers.&#x0D; Results: Out of 200 BC-suspected tissue samples, 172 were malignant (in terms of pathology). Based on the nested PCR method, the L1 gene of HPV was detected in 12% (24/200) of the BC-suspected tissue samples and in 1.5% (3/200) of the blood samples from women without BC. The high-risk HPV genotypes (which were the predominant types) were present in 75% of the samples.&#x0D; Conclusion: The results of the current study show a high frequency of HPV-16 and 18 genotypes in human BC in Iranian women. This is almost certainly due to poor rates of HPV vaccination, and it is strongly recommended that health organizations (such as the World Health Organization [WHO]) ensure adequate coverage of highly effective HPV vaccination in Iran.

Diet-dependent acid load and the risk of breast cancer: A case–control study

Dietary acid load causes metabolic acidosis, which leads to inflammation and cell change, both of which are related to cancer development. Even though a high acid load has been associated with an increased risk of breast cancer (BC), epidemiologic evidence correlating diet-dependent acid load and cancer risk, particularly for BC, is still lacking. As a result, we intend to investigate its potential role. The potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores were calculated in this case-control study using the dietary intake of individuals as determined by a verified FFQ. Logistic regression was used to calculate odds ratios (ORs), which were adjusted for probable confounders. Using multivariate logistic regression models, the odds ratios (OR) of BC according to quartiles of PRAL and NEAP scores revealed that neither PRAL (P-trend=0.53) nor NEAP (P-trend=0.19) scores were significantly associated with BC risk. Multiple logistic regressions remained non-significant after controlling for covariates, indicating no significant relationships between PRAL (P-trend=0.96) and NEAP (trend=0.45) scores and the odds of BC. According to the findings of our study, there is no relation between DAL and the risk of BC in Iranian women.

The association between the inflammatory potential of diet and the risk of histopathological and molecular subtypes of breast cancer in northwestern Iran: Results from the Breast Cancer Risk and Lifestyle study.

This study explored the association between diet-associated inflammation and the risk of different molecular subtypes of breast cancer (BrCA) in a large, population-based case-control study conducted in northwestern Iran. The study consisted of 1007 women with histopathologically confirmed BrCA and 1004 controls admitted to hospitals in Tabriz, northwestern Iran, for nonneoplastic conditions. Dietary Inflammatory Index scores and energy-adjusted Dietary Inflammatory Index (E-DII) scores, with and without supplements, were computed on the basis of dietary intake collected using a validated 136-item food frequency questionnaire. Women with the highest E-DII scores (quartile 4) versus those with the lowest E-DII scores (quartile 1) showed a significantly increased BrCA risk (odds ratio for quartile 4 vs quartile 1 [ORQ4vsQ1 ], 1.87; 95% confidence interval [CI], 1.42-2.47), particularly for lobular carcinoma (ORQ4vsQ1 , 3.07; 95% CI, 1.34-7.02). Findings were similar for premenopausal women diagnosed with luminal A BrCA (ORQ4vsQ1 , 2.71; 95% CI, 1.74-4.22) or luminal B BrCA (ORQ4vsQ1 , 2.86; 95% CI, 1.39-5.89). Women consuming the most proinflammatory diets were 3 times more likely to have triple-negative BrCA (ORQ4vsQ1 , 3.00; 95% CI, 1.002-8.96) while compared to luminal A BrCA. The BrCA risk for women consuming diets in the highest half of E-DII scores (E-DII > 0) was 59% greater than the risk for those in the lowest half (95% CI, 1.29-1.97). Also, higher E-DII scores that took into account supplements were associated with larger tumor sizes (T3 > 5 cm; P < .05). A proinflammatory diet, as indicated by higher E-DII scores, appears to increase the risk of BrCA in Iranian women. Large increases in risk were seen in invasive molecular subtypes of BrCA. Anti-inflammatory diets are suggested to prevent the risk of overall BrCA and more aggressive forms of BrCA in particular.

Investigation of the association of three ATM polymorphisms with breast cancer in Iranian women

The ataxia-telangiectasia mutated (ATM) gene is responsible for DNA repair and involves tumor-suppressing, which its mutation increases the risk of women's breast cancer (BC). We investigated the association of three ATM polymorphisms (rs611646, rs609429 and, rs228593) with BC. Genotyping analyses were carried out using specific primers for the PCR-RFLP method. In this study, 236 patients and 223 healthy women were compared. The ancestral allele frequencies of rs611646, rs609429 and, rs228593 polymorphisms in control subjects were 42.2, 70.6, and 50.9%, and in BC cases were 38.3, 70.9, and 49.4%, respectively. The genotypic frequencies in the control group did not substantially differ from the Hardy-Weinberg equilibrium. There is a substantial linkage disequilibrium across three polymorphisms. Our results revealed that these three ATM polymorphisms did not associate with breast cancer susceptibility even after haplotype analysis.

The Prevalence of Breast Cancer in Iranian Women: A Systematic Review and Meta-Analysis

Breast cancer is one of the main causes of women’s death. Breast cancer is the most common cancer in women over the world. Various studies have reported different incidence of breast cancer in women. However, we found no comprehensive study that showed the results of these studies in general, so the present study was conducted aimed to determine the prevalence of breast cancer in Iranian women in a systematic review and meta-analysis study. In this review study, with searching national and international databases of SID, MagIran, IranMedex, IranDoc, Google Scholar, Cochrane, Embase, ScienceDirect, Scopus, PubMed and Web of Science, the data were extracted between 1965 and September 2019. The random effects model was used for analysis, and heterogeneity of studies was investigated using I2 index. The data were analyzed using software Comprehensive Meta-Analysis (version 2). The prevalence of breast cancer in Iranian women in 24 papers with a sample size of 39,596 patients was 23.6% (95% CI: 15.3–34.7%). A significant difference was found in the prevalence of breast cancer in Iranian women regarding heterogeneity based on meta-regression, year of study and sample size (P < 0.005). The study results show that the prevalence of breast cancer in Iranian women is high. Hence, appropriate solutions should be applied to improve the aforementioned situation, find causes and monitor by providing feedback to hospitals at all levels.

Association of Empirically Derived Food-Based Inflammatory Potential of the Diet and Breast Cancer: A Hospital-Based Case-Control Study

BackgroundDiet may be a modifiable factor in the prevention of breast cancer (BC) by modulating inflammation. We used a food-based empirical dietary inflammatory index (FDII) to evaluate the association between FDII and odds of breast cancer in Iranian women. MethodsThe present case-control study carried out on 150 age-matched women with newly diagnosed breast cancer and controls. Data for dietary intake and anthropometric measures were collected. FDII score was developed according to participants dietary intakes of 27 pre-defined food groups. Multivariate odds ratios (OR) with 95% confidence intervals (CI) were used to investigate the association of empirically derived food-based inflammatory potential of the diet and breast cancer. ResultsThe odds ratios of BC according to quartiles of FDII score by multivariate logistic regression models indicated the FDII score was significantly associated with BC risk (OR: 2.38; 95% CI: 1.23-4.59, Ptrend = .04). After controlling confounders, multivariate logistic regressions remained significant which revealed in participants at the fourth quartile of FDII score chance of breast cancer was 2.8 times higher than participants in the first quartile. ConclusionsThe results of our study suggested that more pro-inflammatory diet (higher FDII scores) was associated with increased BC risk. These findings suggest that developing an effective dietary modification based on FDII may reduce risk of BC.

Vitamin D receptor gene polymorphisms and risk of breast cancer in Iranian women

ObjectivesVitamin D deficiency is a driving force of common cancers like breast cancer. Vitamin D receptor (VDR) can play a tumor suppressor role by helping the precise function of vitamin D in cells such as modulation TGF-β signaling pathway. This study aimed to investigate the association of VDR gene variants and susceptibility to breast cancer in Iranian women. MethodsGenomic DNAs were isolated from blood samples of 161 women with breast cancer and 150 healthy women. After amplification of five positions of VDR gene, the prepared amplicons were digested with TaqI, ApaI, BsmI, Cdx2, and FokI restriction enzymes. ResultsSubsequently, the digested products were electrophoresed on the 1.5% agarose gel. Odds ratios (ORs) for breast cancer were calculated for genotypes and estimated haplotypes. Binary logistic regression analysis showed FokI (rs2228570), BsmI (rs1544410), and ApaI (rs7975232) polymorphisms had the significant distribution in patients than to the normal group. Analysis of linkage disequilibrium for all pairs of SNPs showed that D′-value between SNP TaqI and SNP BsmI was significantly (p ≤ 0.05). We observed that four major haplotypes of ApaI, BsmI, FokI, Cdx2, and TaqI SNPs significantly were in high frequency than predicted frequency. Among these four haplotypes, CGTAT haplotype was in a higher significant association than others with breast cancer risk (p-value = 0.0001). ConclusionOur results showed that FokI, BsmI, and ApaI of VDR polymorphisms associated with the risk of breast cancer in Iranian population.

Higher Fruits and Vegetables Consumption Is not Associated with Risk of Breast Cancer in Iranian Women

We aimed to investigate the association of fruits and vegetables (FVs) and their all subgroups intakes with breast cancer (BC) risk in Iranian women. The present case-control study conducted on 150 age-matched women with newly diagnosed BC and apparently healthy controls. Anthropometric measures were collected and eventually, the mean intakes of total FVs and each subgroup were obtained from a validated 147-item food frequency questionnaire. Multivariate regression analysis was used to estimate odds ratios (OR) with 95% confidence intervals (CI). Our findings revealed that the intake of only dark yellow vegetable was significantly higher in BC patients (P = 0.03) after controlling for covariates. OR of BC across tertiles of FVs intake, showed that there was not any statistical association of total FVs (OR: 1.83, CI: 0.54–6.24, P-trend = 0.3) and their subgroups intakes with BC risk. Except for berry fruits intake which was adversely associated with BC risk (OR: 0.36, CI: 0.09–1.37, P-trend = 0.02). Our findings did not support the hypothesis that higher total FVs and their subgroups intakes reduce BC risk and suggested that only higher berry fruits intake may have an association with lower BC risk.

Evaluation of association between the frequency of Epstein–Barr virus and cytomegalovirus infection in healthy and tumoral breast samples

IntroductionDespite advances in science and technology, breast cancer is the fifth most common cancer in Iran. Previous studies have reported that there is a concrete relationship between this type of cancer and different kinds of risk factors, especially infection diseases. Among various kinds of infectious risk factors, much attention has been given to Herpesviridae. As the prevalence of EBV and CMV in patients suffering from breast cancer is not clear, in this study we evaluated these two viruses using PCR. Material & methodsThe phenol-chloroform protocol was used to extract DNA. Then, to evaluate the EBV and CMV infections, PCR analysis was performed to assess the presence of EBNA-1 and Glycoprotein gB genes, respectively. ResultsPCR illustrated two EBV positive samples among cancerous tissues while all normal adjacent tissues were EBV negative. Moreover, we did not detect any CMV positive samples. ConclusionAccording to the present study, there is no association between EBV and CMV with breast cancer in Iranian women; however, further investigation was required.

Human papillomavirus infection and risk of breast cancer in Iran: a meta-analysis

Background: Breast cancer is the most common malignancy and a leading cause of death in women. Viruses are known to be the risk factors for breast cancer. This systematic review and meta-analysis aimed to evaluate the association between human papillomavirus (HPV) and the development of breast cancer in Iranian women. Methods: The international databases, including Web of Science, Embase, PubMed, Cochrane, and Scopus, were searched in this study. Furthermore, relevant studies published on the association between HPV and breast cancer were identified using the appropriate keywords. The data were analyzed in Stata software (version 14) using the random-effects model. Results: In total, 18 studies were found eligible to be included in this study. The total sample size was determined at 2466 cases with the mean ages of 47.25 and 39.9 years for experimental and control groups. The overall findings showed a significant relationship between developing breast cancer and HPV infection. The results also revealed that the HPV infection increased the risk of breast cancer in women 5.02 fold more than those without HPV infection (95% CI: 3.46-7.29, I2=65.2%, P=0.003). In addition, the prevalence of HPV infection among women with breast cancer was estimated at 25.66% (95% CI: 17.34-34.95, I2=86%, P=0.000). Conclusion: HPV infections, especially high-risk HPVs, are significantly frequent in breast cancer samples and should be considered an important risk factor for developing breast cancer.

Health Behavior Constructs Scale (HBCS) for Breast Cancer Screening: Development, Validity and Reliability

Introduction: Given the importance of screening as one of the health behaviors in breast cancer, the aim of this research is to develop and evaluate the psychometric characteristics of Health Behavior Constructs Scale (HBCS) for breast cancer screening.Methods: In this cross sectional study, 376 women who referred to Javaheri Health Center during the study period due to health problems, were selected through convenience sampling method. Then, the instrument was developed and its content and face validities were examined. To ensure divergent and convergent validity, Depression Anxiety Stress Scale (DASS-21) was used. Internal consistency method (Cronbach's alpha) was used to determine the reliability of the questionnaire. Finally, confirmatory factor analysis was used to assess the construct validity of the Health Behavior Constructs Scale and SPSS and LISREL software were applied for analyzing data.Results: The findings of this study provided strong supports, which confirmed the content and face validities. Regarding the convergent and divergent validity, perceived vulnerability, perceived severity and deterioration, and perceived barriers have a direct and significant relationship with the three variables of depression, anxiety, and stress. On the other hand, perceived self-efficacy and perceived motivation had a significant inverse correlation with all three variables of depression, anxiety, and stress. The results of the Cronbach's alpha indicated the appropriate internal consistency of the whole questionnaire and its components. Cronbach's alpha for the whole questionnaire was 0.75. According to confirmatory factor analysis, the goodness of fit indicators of proposed model were confirmed and all paths were significant.Conclusion: HBCS is a reliable and valid tool for measuring the screening behavior of breast cancer in Iranian women and it appears to be a comprehensive and useful instrument for assessing women's beliefs related to breast cancer and breast cancer screening.

The association between plant-based dietary patterns and risk of breast cancer: a case\u2013control study

Limited data are available, linking the plant-based diets to breast cancer (BC). We examined the association of overall plant-based diet index (PDI), hypothesized healthful (hPDI) and unhealthful versions of a plant-based diet index (uPDI) with BC in Iranian women. This population-based case–control study included 350 cases with newly diagnosed BC and 700 age-matched apparently healthy controls. We collected dietary data using a validated, Willett-format semi-quantitative food frequency questionnaire. Using these data, we generated a PDI by dedicating positive scores to plant foods, and reverse scores to animal foods, hPDI by assigning positive scores to healthy plant foods and reverse scores to less healthy plant foods and animal foods, and finally uPDI in which positive scores were assigned to less healthy plant foods and reverse scores to healthy plant foods and animal foods. After controlling for potential confounders, individuals in the highest quartile of PDI had 67% lower odds of BC than those in the lowest quartile (OR 0.33; 95% CI 0.22–0.50). Individuals with the greatest adherence to hPDI were 36% less likely to have BC than those with the lowest adherence, in the fully adjusted model (OR 0.64; 95% CI 0.43–0.94). In terms of uPDI, women in the top quartile had a 2.23 times greater chance of BC than those in the bottom quartile (OR 2.23; 95% CI 1.48–3.36). Greater adherence to PDI and hPDI was inversely associated with the risk of BC, whereas uPDI was associated with an increased risk.

In Vitro Stem Cell Isolation from Human Breast Cancer

Background: Breast cancer (BC) is the most prevalent cancer among women worldwide with significant incidence and death rates. Nowadays, researchers hold that tumor formation, failure in therapy, and disease progression are all related to the presence of a small fraction of cancer cells with self-renewal capability known as “breast cancer stem cells” (BCSCs). Therefore, the study of this cancer cell population can be conducive to eradicating the tumor. The objective of the present study was to survey the existence and in vitro isolation of human BCSCs. Method: An in vitro research study was conducted under controlled laboratory settings to isolate, enrich, and identify breast cancer stem cells. Briefly, fresh breast tumors were carried to the lab immediately after surgery, followed by mechanical and enzymatic digestion (2 mg/ml collagenase I). Then, digested samples were passed through cell strainers (70 and 40 μm), and obtained cell suspension was cultured under the serum-free medium supplemented with growth factors for 21 days. The expression of cluster of differentiation 44 (CD44) and cluster of differentiation 24 (CD24) surface markers was assessed using immunocytochemistry, and stem cell gene expression was analyzed via RT-PCR. Results: BCSCs were able to survive in serum-free conditions and form floating spheres in vitro. Cells obtained from mammospheres expressed CD44 as the membranous and cytoplasmic pattern while CD24 expression was negative. Also, octameter-binding transcription factor 4 and SOX2 gene expression was observed in BCSCs. Conclusion: The presence of stem cells was confirmed in Iranian women BC, and an efficient in vitro mammosphere culture model was used to enrich and propagate BCSCs. In our opinion, this in vitro model could be a suitable method for isolating and enriching BCSCs.

A comparative survival study between familial and sporadic breast cancer in iranian women

Background: Breast cancer (BC) is the most common cancer in Iranian women, with 13400 new cases annually. A few studies have reported that BC patients with a positive familial history had different prognoses and outcomes. The aim of the present study was to evaluate and compare survival between familial BC (FBC) patients and sporadic BC (SBC) patients in Iranian women. Materials and Metshods: In a longitudinal study, 1710 patients with complete medical records from the Cancer Research Center database were extracted and divided into two groups: The FBC group (n = 311) and the SBC group (n = 1399). Then, 5-year overall survival (OS) and 5-year disease-free survival (DFS) for these two groups were evaluated and compared. Results: The FBC group and SBC group represented 18.2% and 81.8% of all cases, with mean ages of 44.2 years and 47.7 years, respectively (P = 0.0024). There were more advanced stage and positive lymph nodes, higher grade of tumor, more positive lymphovascular invasion and P53 status and higher degrees of negative progesterone receptor status in the FBC group than in the SBC group (P = 0.0200, P = 0.0001, P = 0.0001, P = 0.0386, P = 0.0182 and P = 0.0003, respectively). In the FBC group and SBC group, the 5-year DFS was 81% and 86.5% (P = 0.0121), and the 5-year OS was 71.1% and 76.5%, respectively (P = 0.0401). Conclusions: The findings of this study showed better 5-year OS, 5-year DFS, and favorable prognostic factors in the SBT group than in the FBC group. The initial results might be helpful as better treatment modalities and careful follow-up in the FBC group.

Perceived Barriers to Early Detection of Breast Cancer in Iranian Women: A Qualitative Content Analysis

Background: Breast cancer is one of the most common cancers among Iranian women. The early diagnosis of this disease can decrease the mortality rate and promote patient survival. Objectives: This study aimed at identifying the barriers to early detection of breast cancer in Iranian women. Methods: In this qualitative study, which was extracted from a large research project, an exploratory sequential mixed-methods design was used, and conventional content analysis was carried out. Twenty-one participants were selected by purposeful sampling (ten health professionals and 11 female patients with breast cancer). Data were collected through in-depth, semi-structured interviews from July 2018 to June 2019. Results: The content analysis revealed three major themes related to delay in presentation: individual barriers (limited/lack of knowledge, other life preferences, negative reactions to the disease, and belief in fate), environmental barriers (insufficient social support, inaccurate information sources, and alternative therapy recommendations), and organizational barriers (poor quality of health services, inadequate access to health services, and role of media in informing people). Conclusions: Various perceived barriers, at different levels, play influential roles in the patients’ early detection. Therefore, collaboration between public health professionals, healthcare providers, and policymakers seems necessary for reducing delays in presentation among women.

Associations of Single Nucleotide Polymorphism in miR-146a Gene with Susceptibility to Breast Cancer in the Iranian Female.

Background:MicroRNAs (miRNAs), short regulatory RNAs, function as negative regulators able to modulate gene expression. Just as other genetic variant, single nucleotide polymorphisms (SNPs) in miRNA genes, may have an impact on their expression and/or maturation and hence leading to different consequences in carcinogenesis. Accordingly, this study aimed to assess the frequency of miR-146a G/C (rs2910164) polymorphism and its association with susceptibility to breast cancer in Iranian women. Methods:We conducted a case-control study using Tetra ARMS polymerase chain reaction (Tetra ARMS PCR) method in 100 Iranian female participants (50 breast cancer patients and 50 controls). Besides, a number of sequenced samples were chosen to confirm the accuracy of genotyping by Tetra ARMA PCR. SPSS software was utilized for all statistical analyses. The odds ratios (ORs) and 95% confidence intervals (95% CIs) were applied to analyze the association between the SNP frequency and breast cancer. Results:The frequency of genotypes for G/G, G/C, and C/C were 23 (46%), 26 (52%), and 1 (2%) among cases and 15 (30%), 33 (66%), and 2(4%) among controls, respectively. The results generated by the groups did not show any significant correlation between miR-146a G/C (rs2910164) polymorphism and breast cancer, either at genotype or allele levels (P>0.05). F-SNP-based in silico analysis indicated possible modifications in transcriptional regulations induced by miR-146a G/C (rs2910164) variations. Conclusion:Overall, our results indicated no correlation between miR-146a G/C (rs2910164) polymorphism and genetic susceptibility to breast cancer in Iranian female populations. However, these findings need to be further confirmed by analyses of a larger number of cases.

Legume and Nuts Consumption in Relation to Odds of Breast Cancer: A Case-Control Study

Previous studies on the association between legume and nuts intake and risk of breast cancer have mainly been focused on individual components of legume or nuts, rather than consumption of the whole food group. This study aimed to investigate the relation between legume and nuts intake in relation to breast cancer in Iranian women. In this population-based case-control study, we enrolled 350 pathologically confirmed new cases of breast cancer and 700 controls which were matched with cases in terms of age and socioeconomic status. Dietary intakes were assessed using a validated block-format 168-item semi-quantitative food frequency questionnaire. Legume intake was computed by summing up the consumption of lentils, peas, chickpeas, and different kinds of beans, including red beans and pinto beans. To calculate nuts consumption, we summed up intake of mixed nuts, almond, peanut, walnut and hazelnut. Data on potential confounding variables were also collected using pre-tested questionnaires. Mean consumption of legume and nuts among cases and controls were 14.7 ± 15.0 and 2.3 ± 5.6, respectively. A significant inverse association was found between legume intake and breast cancer (OR: 0.41, 95% CI: 0.30–0.57); such that after adjusting for confounders, participants in the top tertile of legume intake had 46% lower odds of breast cancer compared with those in the bottom tertile (OR: 0.54, 95% CI: 0.36–0.88). Such inverse association was seen among postmenopausal women (OR: 0.51, 95% CI: 0.31–0.85) and also among normal-weight participants (OR: 0.49, 95% CI: 0.29–0.82). In terms of nuts intake, it was inversely associated with odds of breast cancer (OR: 0.16, 95% CI: 0.11–0.23). This association remained significant even after taking potential confounders into account (OR: 0.15, 95% CI: 0.09–0.26). The same association was also seen in premenopausal women (OR: 0.21, 95% CI: 0.14–0.31), postmenopausal women (OR: 0.23, 95% CI: 0.13–0.42), normal-weight (OR: 0.15, 95% CI: 0.08–0.28), and overweight or obese people (OR: 0.27, 95% CI: 0.10–0.71). Our findings on the inverse association of legume and nuts intake with odds of breast cancer support the current recommendations on these foods. Prospective studies are needed to further examine this link.

Association between Adherence to “Dietary Approaches to Stop Hypertension” Eating Plan and Breast Cancer

Despite the favorable association of components of “dietary approaches to stop hypertension (DASH)” diet and breast cancer (BC), limited data are available linking the whole DASH diet to BC. The aim of the present study was to examine the association between adherence to DASH eating plan and odds of BC in Iranian women. This population-based case-control study was conducted among women aged ≥30 years, who were residing in Isfahan, Iran. Cases were 350 patients with newly diagnosed stage I-IV breast cancer, for whom in-situ or invasive status of BC was confirmed by physical examination and mammography. Controls were 700 age-matched apparently healthy individuals who were randomly selected from general population. Dietary data were collected using a validated 106-item Willett-format semi-quantitative dish-based food frequency questionnaire. To investigate participants’ adherence to DASH diet, we created DASH scores based on foods and nutrients emphasized or minimized in the DASH diet. After controlling for potential confounders, individuals in the highest quartile of the DASH diet score had 85% lower odds of breast cancer than women in the bottom quartile (OR: 0.15; 95% CIs: 0.09–0.24). Stratified analysis by menopausal status revealed such association in postmenopausal women (OR: 0.11; 95% CI: 0.06–0.19), but not in premenopausal women (OR: 0.60; 95% CI: 0.14–2.59). In addition, when stratified by BMI status, we found statistically significant inverse association between adherence to the DASH eating pattern and odds of breast cancer among normal-weight (OR for comparing extreme quartiles: 0.13; 95% CI: 0.07–0.24; P-trend < 0.001) and obese women (0.13; 0.05–0.34; P-trend < 0.001). In conclusion, our findings indicated an inverse association between adherence to the DASH eating plan and odds of breast cancer among Iranian women. Further, prospective studies are required to confirm our findings.