Folate intake and risk of breast cancer by estrogen and progesterone receptor status in a Swedish cohort.
BACKGROUND
Folate is a B vitamin involved in one-carbon metabolism and has been postulated to influence the risk of breast cancer. However, epidemiologic studies of folate intake in relation to breast cancer risk are inconclusive. We examined the association between dietary folate intake and the risk of breast cancer by estrogen receptor (ER) and progesterone receptor (PR) status of the breast tumor in the Swedish Mammography Cohort.


METHODS
Our study population consisted of 61,433 women who completed a food frequency questionnaire at baseline (1987-1990) and again in 1997. Cox proportional hazards models were used to estimate rate ratios (RR) with 95% confidence intervals (95% CI).


RESULTS
During an average of 17.4 years of follow-up, 2,952 incident cases of invasive breast cancer were ascertained. We observed no association between dietary folate intake and risk of total breast cancer or ER+/PR+ or ER-/PR- tumors. The multivariate RR of total breast cancer comparing extreme quintiles of folate intake was 1.01 (95% CI, 0.90-1.13; P(trend) = 0.84). However, folate intake was inversely associated with risk of ER+/PR- breast cancer (n = 417 cases; RR for highest versus lowest quintile, 0.79; 95% CI, 0.59-1.07; P(trend) = 0.01). Results did not vary by alcohol intake or menopausal status.


CONCLUSIONS
These findings do not support an overall association between folate intake and risk of breast cancer but suggest that folate intake may be inversely associated with ER+/PR- tumors.
Larsson
Susanna C
SC
Division of Nutritional Epidemiology, National Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-17177 Stockholm, Sweden. susanna.larsson@ki.se
Bergkvist
Leif
L
Wolk
Alicja
A
D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D008327:Mammography; D016016:Proportional Hazards Models; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D005492:Folic Acid