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Alicja Wolk, PhD; Reinhold Bergström, PhD; David Hunter, MD; Walter Willett, MD; Håkan Ljung, MSc; Lars Holmberg, MD; Leif Bergkvist, MD; Åke Bruce, MD; Hans-Olov Adami, MD

Arch Intern Med. 1998;158:41-45.

Background  Animal studies suggest that monounsaturated and polyunsaturated fat may have opposite effects on the risk of breast cancer.

Methods  We performed a population-based prospective cohort study, including 61471 women aged 40 to 76 years from 2 counties in central Sweden who did not have any previous diagnosis of cancer; 674 cases of invasive breast cancer occurred during an average follow-up of 4.2 years. All subjects answered a validated 67-item food frequency questionnaire at baseline. Cox proportional hazards models were used to obtain adjusted rate ratio (RR) estimates with 95% confidence intervals (CIs).

Results  After mutual adjustment of different types of fat, an inverse association with monounsaturated fat and a positive association with polyunsaturated fat were found. The RR for each 10-g increment in daily intake of monounsaturated fat was 0.45 (95% CI, 0.22-0.95), whereas the RR for a 5-g increment of polyunsaturated fat was 1.69 (95% CI, 1.02-2.78); the increments correspond to approximately 2 SDs of intake in the population. Comparing the highest quartile of intake with the lowest, we found an RR of 0.8 (95% CI, 0.5-1.2) for monounsaturated fat and 1.2 (95% CI, 0.9-1.6) for polyunsaturated fat. Saturated fat was not associated with the risk of breast cancer.

Conclusions  Our results indicate that various types of fat may have specific opposite effects on the risk of breast cancer that closely resemble the corresponding effects in experimental animals. Research investigations and health policy considerations should take into account the emerging evidence that monounsaturated fat might be protective for risk of breast cancer.

From the Department of Medical Epidemiology, Karolinska Institute, Stockholm, Sweden (Drs Wolk, Bergström, and Adami, and Mr Ljung); the Department of Surgery, University Hospital (Dr Holmberg), the Department of Statistics, Uppsala University (Dr Bergström), and the National Food Administration (Dr Bruce), Uppsala, Sweden; the Departments of Epidemiology (Drs Hunter, Willett, and Adami) and Nutrition (Dr Willett), Harvard School of Public Health, and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (Drs Hunter and Willett), Boston, Mass; and the Department of Surgery, Central Hospital, Västerås, Sweden (Dr Bergkvist).

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