title: Dietary patterns and breast cancer risk: a systematic review and meta-analysis.
abstract: BACKGROUND
  Dietary patterns, which represent whole-diet and possible food and nutrient interactions, have been linked to the risk of various cancers. However, the associations of these dietary patterns with breast cancer remain unclear.
  
  
  OBJECTIVE
  We critically appraised the literature and conducted meta-analyses to pool the results of studies to clarify the relation between dietary patterns and breast cancer risk.
  
  
  METHODS
  MEDLINE and EMBASE were searched for relevant articles that identified common dietary patterns published up to November 2009. Multivariable-adjusted odds ratios (ORs) comparing highest and lowest categories of dietary pattern scores and multivariable-adjusted ORs for a 20th-percentile increase in dietary pattern scores were combined by using random-effects meta-analyses.
  
  
  RESULTS
  Case-control and cohort studies were retrieved that identified prudent/healthy (n = 18), Western/unhealthy (n = 17), and drinker (n = 4) dietary patterns. There was evidence of a decrease in the risk of breast cancer in the highest compared with the lowest categories of prudent/healthy dietary patterns (OR = 0.89; 95% CI: 0.82, 0.99; P = 0.02) in all studies and in pooled cohort studies alone. An increase in the risk of breast cancer was shown for the highest compared with the lowest categories of a drinker dietary pattern (OR = 1.21; 95% CI: 1.04, 1.41; P = 0.01). There was no evidence of a difference in the risk of breast cancer between the highest and the lowest categories of Western/unhealthy dietary patterns (OR = 1.09; 95% CI: 0.98, 1.22; P = 0.12).
  
  
  CONCLUSIONS
  The results of this systematic review and meta-analysis indicate that some dietary patterns may be associated with breast cancer risk.
authors.affiliation: Nutrition and Metabolism Group, Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital, Belfast, United Kingdom. sbrennan19@qub.ac.uk
authors.forename: Sarah F
authors.initials: SF
authors.lastname: Brennan
authors.forename: Marie M
authors.initials: MM
authors.lastname: Cantwell
authors.forename: Chris R
authors.initials: CR
authors.lastname: Cardwell
authors.forename: Louiza S
authors.initials: LS
authors.lastname: Velentzis
authors.forename: Jayne V
authors.initials: JV
authors.lastname: Woodside
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology; D001943:Breast Neoplasms / Q000453:epidemiology*; D015331:Cohort Studies; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D015201:Meta-Analysis as Topic; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology