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Research team in maternal/child health and nutrition, Faculty of Medicine and Pharmacy of Mohammed V-Souissi University, Rabat, Morocco;
Laboratoire dImmunologie, Institut Pasteur de Maroc, Casablanca, Mdecin spcialiste en Immunologie; 3the Faculty of Medicine and Pharmacy/
Surgeon at the National Institute of Oncology, Rabat, Morocco; 4the Faculty of Medicine and Pharmacy and the Pharmacy Unit at the National
Institute of Oncology, Rabat, Morocco
Correspondence to: Amina Barkat. Research team in maternal/child health and nutrition, Faculty of Medicine and Pharmacy of Mohammed V-Souissi
University, Rabat, Morocco. Email: barakatamina@hotmail.fr.
Background: Breast cancer is a multifactorial disease. Factors most often mentioned risks are those related
to the environment, genetics, hormones and individual behaviors. Among these include alcohol, smoking,
sedentary lifestyle and eating habits. Identification of eating and the role of nutritional factors may be
involved in cancer risk have been studied extensively since nearly 40 years.
Purpose: We conducted a study of breast cancer type case-control with food frequency questionnaire to
assess the causal relationship between dietary factor, obesity and breast cancer risk.
Patients and methods: female patients with breast cancer were compared to healthy controls at the National
Institute of Oncology of Rabat during 2008-2010 and were interviewed for epidemiological information and
for their eating habits.
Results: A total of 800 women were included in this study (400 cases and 400 controls). Result of univariate
analysis showed that significant factors associated with the etiologie of breast cancer: high body mass index
(BMI) [odds ratio (OR) =1.30; 95% confidence interval (CI), 1.25-1.37], red meat (OR =1.33; 95% CI,
1.27-1.40), processed meat (OR =1.44; 95% CI, 1.35-1.54), eggs (OR =1.20; 95% CI, 1.14-1.23), poultry
(OR =0.70; 95% CI, 0.60-0.80), fish (OR =0.67; 95% CI, 0.61-0.73), fruit (OR =0.67; 95% CI, 0.62-0.72), and
vegetable (OR=0.72; 95% CI, 0.67-0.78). Multivariate analysis indicated that a significantly elevated risk of
contracting breast cancer was associated with higher BMI (OR =9.61; 95% CI, 6.1-15.15), red meat (OR =4.61; 95%
CI, 2.26-9.44) and processed meat (OR =9.78; 95% CI, 4.73-20.24). In contrast consumption of fish (OR =0.07;
95% CI, 0.02-0.24), poultry (OR =0.61; 95% CI, 0.46-0.81), fruit (OR =0.001; 95% CI, 0.00-0.004), and
vegetable (OR =0.82; 95% CI, 0.22-3.08) remained as significant beneficial factor associated with breast cancer.
Conclusions: This study is rather in favour of positive association between obesity, consumption of food
rich in fatty matter and breast cancer, which is consistent with data from the literature using the same type of
investigation. These results encourage increased cohort studies, case-control and experimentation in order to
achieve a genuine code of cancer prevention, to define with precision the positive and negative.
Keywords: Adipocyte; breast cancer; dietary; epidemiological study; food; obesity
Submitted Jan 22, 2014. Accepted for publication Jun 07, 2014.
doi: 10.3978/j.issn.2227-684X.2014.06.01
View this article at: http://dx.doi.org/10.3978/j.issn.2227-684X.2014.06.01
Introduction
Epidemiological, clinical and experimental studies have
raised a considerable amount of factors leading to the
occurrence of breast cancer whose diet which represents a
significant proportion. However, a number of controversies
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Table 1 Demographic and epidemiological characteristics of control and breast cancer patients
Characteristics
Age group (years)
N=400 [%]
Control patients
45.5111.25
45.8311.05
Menopausal status
No
Yes
BMI (kg/m2)
240 [60]
144 [36]
160 [40]
256 [64]
24.403.22
28.354.36
4 [1]
8 [2]
<0.001
<0.001
Moderate
256 [65.3]
76 [19.2]
Over weight
108 [27.6]
160 [40.4]
Obese
0.685
<0.001
BMI group
Low
P value
32 [8]
156 [39]
Values are expressed as mean standard deviation or in count and percentage. For body mass index (BMI) groups: low BMI =18.5 kg/m2;
normal BMI =18.5-25 kg/m2; overweight BMI =25-30 kg/m2; obese BMI 30 kg/m2.
age then when the next step all variables were fed into a
multiple regression model to assess the odds ratios (OR).
A threshold of P<0.05 was considered significant.
Ethical considerations
Respect for the anonymity and confidentiality of information
was strictly adhered to. Informed consent was signed before
the inclusion of women in the study.
Results
General settings of the population (Table 1)
In this study we included eight hundred women who were
divided into two populations, a population of 400 women
with breast cancer and a population of 400 women who
were breast cancer-free. Table 1 shows that there does not
exist statistically significant difference in the average age
of the two populations (45.5111.25 years in the group of
controls and 45.8311.05 years in the group of patients
P=0.685). BMI was significantly higher in the patient group
(28.354.36 vs. 24.43.22 kg/m2, P<0.001). The percentage
of postmenopausal women was statistically significantly
higher in the patient group (64% vs. 40%, P<0.001).
Analysis of information tumor patient women shows
that the mode of the lesion was discovered by palpation in
180 cases (45%) and after a mammogram in 220 cases (55%).
Histological size lesion was higher than 1 cm in 150 cases
(37.5%) and the degree of Scarff-Bloom-Richardson (SBR)
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patient population
population
Characteristics
Control
Breast cancer
patients,
patients,
N=400 [%]
N=400 [%]
Red meat
Never
Less than once a week
<0.001
Characteristics
52 [13]
32 [8]
128 [32]
160 [40]
116 [29]
208 [52]
Poultry
patients,
N=400 [%]
N=400 [%]
4 [1]
40 [10]
12 [3]
88 [22]
384 [96]
272 [68]
Fruit
<0.001
Never
99 [24.5]
60 [15]
Processed meat
36 [9]
364 [91]
40 [10]
116 [29.8]
244 [61]
Cereal
<0.001
Never
204 [51]
80 [20]
Never
8 [2]
48 [12]
108 [27]
92 [23]
80 [20]
200 [50]
100 [25]
100 [66]
8 [2]
28 [7]
292 [73]
252 [63]
<0.001
Never
Less than once a week
2 to 3 times per week
Above 3 times per week
4 [1]
40 [10]
32 [8]
72 [18]
348 [87]
264 [66]
16 [4]
24 [6]
28 [7]
24 [6]
30 [5]
40 [10]
Egg
Never
Less than once a week
0.380
144 [36]
156 [39]
P value
<0.001
Breast cancer
patients,
Vegetable
Never
104 [26]
Never
Control
P value
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Breast cancer
patients,
patients,
N=400 [%]
N=400 [%]
Milk
P value
0.158
Never
Less than once a week
16 [4]
28 [7]
134 [33.5]
136 [34]
250 [62.5]
236 [59]
Milk products
0.860
Never
28 [7]
228 [57]
224 [56]
144 [36]
144 [36]
32 [8]
120%
100%
80%
60%
40%
20%
0%
moderate group
obese group
A
above 3 times per week
Figure 1 Frequency of consumption of red meat in both populations of women according to body mass index (BMI). BMI groups: low BMI
=18.5 kg/m2; normal BMI =18.5 to 25 kg/m2; overweight BMI =25 to 30 kg/m2; obese BMI 30 kg/m2.
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120%
100%
80%
60%
40%
20%
0%
controls patients controls patients controls patients controls patients
low group
obese group
A
above 3 times per week
Figure 2 Frequency consumption of processed meat in both populations of women according to body mass index (BMI). BMI groups: low
BMI =18.5 kg/m2; normal BMI =18.5 to 25 kg/m2; overweight BMI =25 to 30 kg/m2; obese BMI 30 kg/m2.
Odds ratio
95% CI
1.30
1.25-1.37*
Red meat
1.33
1.27-1.40*
Processed meat
1.44
1.35-1.54*
Poultry
0.70
0.60-0.80*
Fish
0.67
0.61-0.73*
Egg
1.20
1.14-1.23*
Fruit
0.67
0.62-0.72*
Vegetable
0.72
0.67-0.78*
Cereal
0.88
0.84-0.92*
Milk
0.93
0.89-0.98*
Milk products
0.99
0.94-1.05
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Odds ratio
95% CI
9.61
6.1-15.15*
Red meat
4.61
2.26-9.44*
Processed meat
9.78
4.73-20.24*
Poultry
0.61
0.46-0.81*
Egg
1.19
0.65-2.19
Fish
0.07
0.02-0.24*
Fruit
0.001
0.00-0.004*
Vegetable
0.82
0.22-3.08*
Cereal
0.83
0.32-2.14
Milk
1.01
0.35-2.97
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