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A prospective evaluation of plasma phospholipid fatty acids and breast cancer risk in the EPIC study

Chajès V 1 , Assi N 2 , Biessy C 2 , Ferrari P 2 , Rinaldi S 2 , Slimani N 2 Show all authors , Lenoir GM 3 , Baglietto L 4 , His M 4 , Boutron-Ruault MC 4 , Trichopoulou A 5 , Lagiou P 6 , Katsoulis M 7 , Kaaks R 8 , Kühn T 8 , Panico S 9 , Pala V 10 , Masala G 11 , Bueno-de-Mesquita HB 12 , Peeters PH 13 , van Gils C 13 , Hjartåker A 14 , Standahl Olsen K 15 , Borgund Barnung R 15 , Barricarte A 16 , Redondo-Sanchez D 17 , Menéndez V 18 , Amiano P 19 , Wennberg M 20 , Key T 21 , Khaw KT 22 , Merritt MA 23 , Riboli E 23 , Gunter MJ 2 , Romieu I 2

Affiliations 

  • 1 Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon. Electronic address: chajesv@iarc.fr
  • 2 Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon
  • 3 Institut Gustave Roussy, Villejuif
  • 4 Institut Gustave Roussy, Villejuif; Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
  • 5 Hellenic Health Foundation, Athens; WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
  • 6 Hellenic Health Foundation, Athens; WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece; Department of Epidemiology, Harvard School of Public Health, Boston, USA
  • 7 Hellenic Health Foundation, Athens
  • 8 The German Cancer Research Center (DKFZ), Heidelberg, Germany
  • 9 Dipartimento Di Medicina Clinica E Chirurgia, Federico II University, Naples
  • 10 Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
  • 11 Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
  • 12 Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK; Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 13 Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
  • 14 Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo
  • 15 Department of Community Medicine, University of Tromsø-UiT-The Artic University of Norway, Tromsø, Norway
  • 16 Navarra Public Health Institute, Pamplona; Navarra Institute for Health Research (IdiSNA), Pamplona; CIBER Epidemiology and Public Health CIBERESP, Madrid
  • 17 CIBER Epidemiology and Public Health CIBERESP, Madrid; Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs.Granada, Hospitales Universitarios de Granada, Granada; Universidad de Granada, Granada
  • 18 Public Health Directorate, Asturias
  • 19 CIBER Epidemiology and Public Health CIBERESP, Madrid; Public Health Division of Gipuzkoa, Health Department, Basque Region, San Sebastian, Spain
  • 20 Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden
  • 21 The Cancer Epidemiology Unit, University of Oxford, Oxford
  • 22 University of Cambridge School of Clinical Medicine, Cambridge, UK
  • 23 Department of Epidemiology and Biostatistics, The School of Public Health, Imperial College London, London, UK
Ann Oncol, 2017 Nov 01;28(11):2836-2842.
PMID: 28950350 DOI: 10.1093/annonc/mdx482

Abstract

BACKGROUND: Intakes of specific fatty acids have been postulated to impact breast cancer risk but epidemiological data based on dietary questionnaires remain conflicting.

MATERIALS AND METHODS: We assessed the association between plasma phospholipid fatty acids and breast cancer risk in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition study. Sixty fatty acids were measured by gas chromatography in pre-diagnostic plasma phospholipids from 2982 incident breast cancer cases matched to 2982 controls. Conditional logistic regression models were used to estimate relative risk of breast cancer by fatty acid level. The false discovery rate (q values) was computed to control for multiple comparisons. Subgroup analyses were carried out by estrogen receptor (ER) and progesterone receptor expression in the tumours.

RESULTS: A high level of palmitoleic acid [odds ratio (OR) for the highest quartile compared with the lowest OR (Q4-Q1) 1.37; 95% confidence interval (CI), 1.14-1.64; P for trend = 0.0001, q value = 0.004] as well as a high desaturation index (DI16) (16:1n-7/16:0) [OR (Q4-Q1), 1.28; 95% C, 1.07-1.54; P for trend = 0.002, q value = 0.037], as biomarkers of de novo lipogenesis, were significantly associated with increased risk of breast cancer. Levels of industrial trans-fatty acids were positively associated with ER-negative tumours [OR for the highest tertile compared with the lowest (T3-T1)=2.01; 95% CI, 1.03-3.90; P for trend = 0.047], whereas no association was found for ER-positive tumours (P-heterogeneity =0.01). No significant association was found between n-3 polyunsaturated fatty acids and breast cancer risk, overall or by hormonal receptor.

CONCLUSION: These findings suggest that increased de novo lipogenesis, acting through increased synthesis of palmitoleic acid, could be a relevant metabolic pathway for breast tumourigenesis. Dietary trans-fatty acids derived from industrial processes may specifically increase ER-negative breast cancer risk.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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