Inflammatory potential of the diet and risk of breast cancer in the European Investigation into Cancer and Nutrition (EPIC) study

Abstract

The role of chronic infammation on breast cancer (BC) risk remains unclear beyond as an underlying mechanism of obesity and physical activity. We aimed to evaluate the association between the infammatory potential of the diet and risk of BC overall, according to menopausal status and tumour subtypes. Within the European Prospective Investigation into Cancer and Nutrition cohort, 318,686 women were followed for 14 years, among whom 13,246 incident BC cases were identifed. The infammatory potential of the diet was characterized by an infammatory score of the diet (ISD). Multivariable Cox regression models were used to assess the potential efect of the ISD on BC risk by means of hazard ratios (HR) and 95% confdence intervals (CI). ISD was positively associated with BC risk. Each increase of one standard deviation (1-Sd) of the score increased by 4% the risk of BC (HR=1.04; 95% CI 1.01–1.07). Women in the highest quintile of the ISD (indicating a most pro-infammatory diet) had a 12% increase in risk compared with those in the lowest quintile (HR=1.12; 95% CI 1.04–1.21) with a signifcant trend. The association was strongest among premenopausal women, with an 8% increased risk for 1-Sd increase in the score (HR=1.08; 95% CI 1.01–1.14). The pattern of the association was quite homogeneous by BC subtypes based on hormone receptor status. There were no signifcant interactions between ISD and body mass index, physical activity, or alcohol consumption. Women consuming more pro-infammatory diets as measured by ISD are at increased risk for BC, especially premenopausal women.