title: Diet and body constitution in relation to subgroups of breast cancer defined by tumour grade, proliferation and key cell cycle regulators.
abstract: BACKGROUND
  The general lack of clear associations between diet and breast cancer in epidemiological studies may partly be explained by the fact that breast cancer is a heterogeneous disease that may have disparate genetic associations and different aetiological bases.
  
  
  METHODS
  A total of 346 incident breast cancers in a prospective cohort of 17,035 women enrolled in the Malmö Diet and Cancer study (Sweden) were subcategorized according to conventional pathology parameters, proliferation and expression of key cell cycle regulators. Subcategories were compared with prediagnostic diet and body measurements using analysis of variance.
  
  
  RESULTS
  A large hip circumference and high body mass index were associated with high grade tumours (P = 0.03 and 0.009, respectively), whereas low energy and unadjusted fat intakes were associated with high proliferation (P = 0.03 and 0.004, respectively). Low intakes of saturated, monounsaturated and polyunsaturated fatty acids were also associated with high proliferation (P = 0.02, 0.004 and 0.003, respectively). Low energy and unadjusted fat intakes were associated with cyclin D1 overexpression (P = 0.02 and 0.007, respectively), whereas cyclin E overexpression was positively correlated with fat intake. Oestrogen receptor status and expression of the tumour suppressor gene p27 were not associated with either diet or body constitution.
  
  
  CONCLUSIONS
  Low energy and low total fat (polyunsaturated fatty acids in particular) intakes, and high body mass index were associated with relatively more malignant breast tumours. Dietary behaviours and body constitution may be associated with specific types of breast cancer defined by conventional pathology parameters and cyclin D1 and cyclin E expression. Further studies including healthy control individuals are needed to confirm our results.
authors.affiliation: Division of Pathology, Department of Laboratory Medicine, Malmö University Hospital, S-205 02 Malmö, Sweden.
authors.forename: Signe
authors.initials: S
authors.lastname: Borgquist
authors.forename: Elisabet
authors.initials: E
authors.lastname: Wirfält
authors.forename: Karin
authors.initials: K
authors.lastname: Jirström
authors.forename: Lola
authors.initials: L
authors.lastname: Anagnostaki
authors.forename: Bo
authors.initials: B
authors.lastname: Gullberg
authors.forename: Göran
authors.initials: G
authors.lastname: Berglund
authors.forename: Jonas
authors.initials: J
authors.lastname: Manjer
authors.forename: Göran
authors.initials: G
authors.lastname: Landberg
mesh_terms: D015992:Body Mass Index; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology*; D049109:Cell Proliferation; D015331:Cohort Studies; D056741:Cyclin D; D019927:Cyclin E / Q000378:metabolism; D016213:Cyclins / Q000378:metabolism; D004032:Diet; D004041:Dietary Fats; D002149:Energy Intake; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D013548:Sweden / Q000453:epidemiology
chemical_list: D056741:Cyclin D; D019927:Cyclin E; D016213:Cyclins; D004041:Dietary Fats