Messaggi chiave
- Gli autori del presente studio si sono proposti di valutare l’impatto di modelli alimentari che promuovono l’infiammazione sul rischio di carcinoma mammario (BC). A questo scopo, hanno seguito prospetticamente 76.386 donne del Nurses’ Health Study (1984-2018) e 92.886 donne del Nurses’ Health Study II (1991-2019). Per valutare il potenziale infiammatorio della dieta, è stato utilizzato il punteggio validato EDIP, basato sui livelli plasmatici di CRP, IL-6 e TNFα-R2.
- Durante 4.490.842 persone-anno di follow-up, sono stati documentati 11.026 casi di BC. Il rischio di malattia è risultato significativamente più alto nelle donne nel quintile EDIP più alto (hazard ratio [HR] per Q5 vs Q1, 1,12; IC 95%, 1,05-1,19; p-trend <0,001). L’associazione è stata più forte per i tumori ER- (HR Q5 vs Q1, 1,29; IC 95%, 1,09-1,53; p-trend = 0,003) e con sottotipo molecolare basal-like (HR Q5 vs Q1, 1,80; IC 95%, 1,20-2,71; p-trend = 0,004).
- Punteggi EDIP più alti sono stati associati a un aumento del rischio di BC complessivamente modesto, ma più pronunciato per i tumori ER- e basal-like. Questi risultati supportano l’ipotesi che l’infiammazione correlata alla dieta possa giocare un ruolo nell’eziologia del carcinoma mammario, soprattutto per quanto riguarda la malattia ormono-negativa.
Abstract
Background
- Dietary patterns promoting chronic inflammation, including the empirical dietary inflammatory pattern (EDIP), have been associated with certain cancers.
- Investigating whether this dietary pattern is associated with breast cancer-where the role of inflammation is less well-defined-could provide valuable insights and potentially improve strategies for preventing this cancer.
Methods
- We prospectively followed 76,386 women from Nurses’ Health Study (NHS, 1984-2018) and 92,886 women from Nurses’ Health Study II (NHSII, 1991-2019).
- Diet was assessed by food frequency questionnaires (FFQs) every 4 years, starting at baseline.
- The inflammatory potential of diet was evaluated using the validated EDIP based on plasma CRP, IL-6, and TNFα-R2.
- Higher scores indicate higher dietary inflammatory potential.
- Hazard ratios and 95%CIs of overall and subtypes of breast cancer were estimated using multivariable-adjusted Cox regression models.
Results
- During 4,490,842 person-years of follow-up, we documented 11,026 breast cancer cases.
- Women in the highest, compared with the lowest, EDIP quintile were at higher breast cancer risk (HRQ5vs.Q1 = 1.12; 95% CI, 1.05, 1.19; p-trend<0.001).
- The association was stronger for ER-negative tumors (HRQ5vs.Q1 = 1.29; 95% CI, 1.09, 1.53; p-trend = 0.003).
- Also, we observed that the association of EDIP with breast cancer risk differed by molecular subtype, with the strongest association observed with basal-like tumors (HRQ5vs.Q1 = 1.80; 95% CI, 1.20, 2.71; p-trend = 0.004).
Conclusions
- Higher EDIP scores were associated with a modestly increased risk of breast cancer, which was more pronounced for ER-negative and basal-like breast tumors. These results support the hypothesis that diet-related inflammation plays a role in breast cancer etiology, particularly tumors lacking hormone receptors.