DIET AND BREAST-CANCER - REVIEW OF THE EPIDEMIOLOGIC LITERATURE

The relationship between diet and breast cancer has been analyzed by a nimal, ecologic, migrant, and epidemiologic studies. The 14 cohort and 33 case-control studies that have been published to date are reviewed in this article. Factors considered in these studies include caloric intake, as well as fat. protein, fiber, p-carotene, and vitamin E and C consumption. The results of the published studies are summarized, an d the point estimates of the risks corresponding to the highest catego ry of consumption as compared to the lowest are presented in figures. Some of the disagreements among studies could be explained by the meth odologic difficulties inherent in dietary investigations, such as the establishment of an accurate dietary history, or insufficient diversit y in exposure. Further studies taking these points into account and mi nimizing biases inherent to a case-control design might help to elucid ate the relationship between diet and breast cancer, and to define die tary recommendations. Only large long-term cohort studies such as are now in progress can help to resolve the still unanswered questions con cerning the contribution of these dietary factors to the risk of breas t cancer. We suggest the establishment of new dietary cohorts and the continued follow-up of the existing cohorts.