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Home > Understanding Breast Cancer > Breast Cancer Research > Table 14: Fruits and vegetables and breast cancer risk

  


Table 14: Fruits and vegetables and breast cancer risk

This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.

Introduction: Findings from individual studies on fruits and vegetables and breast cancer risk have been mixed. However, large pooled and meta-analyses (that combine data from many studies) have shown that eating fruits and vegetables may have a modest effect on breast cancer risk.  

Eating vegetables may slightly lower the risk of some breast cancers. A pooled analysis that combined data from 20 studies found that eating vegetables lowered the risk of estrogen receptor-negative breast cancers, but not estrogen receptor-positive breast cancers [1].  

Eating fruits may also help lower breast cancer risk. A meta-analyses that combined the results of 15 studies found that women who at the most fruit had a slightly lower risk of breast cancer compared to women who ate the least fruit [2].  

Learn more about fruits and vegetables and breast cancer risk.

Learn about the strengths and weaknesses of different types of studies

See how this risk factor compares with other risk factors for breast cancer. 

Study selection criteria: Prospective cohort studies with at least 400 breast cancer cases, pooled analyses and meta-analyses

Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.

Study 

Study Population
(number of participants)
 

Follow-up
(years)
 

Fruit and Vegetable Intake
(categories compared)
 

Relative Risk of Breast Cancer of Women with the Highest Fruit and/or Vegetable Intake versus Women with the Lowest Intake
RR (95% CI)
 

Prospective cohort studies 

EPIC [3,4]

285,526
(3,659 cases)

5

Highest vs. lowest
fruit intake

1.09 (0.94-1.25)

     

Highest vs. lowest
vegetable intake

0.98 (0.84-1.14)*

Nurses' Health Study [5,6]

83,234
(2,697 cases)

14

Highest vs. lowest
fruit and vegetable intake

1.03 (0.81-1.31)

     

Highest vs. lowest
fruit intake

0.84 (0.64-1.09)

     

Highest vs. lowest
vegetable intake

Overall breast cancer:
1.02 (0.85-1.24)† 

Estrogen receptor-negative
breast cancer:
0.68 (0.51-0.91)

Swedish Mammography Cohort [7]

61,463
(1,932 cases)

13

Highest vs. lowest
vegetable intake

0.91 (0.79-1.05)

Black Women’s Health Study [8]

51,928
(1,268 cases)

12

4 or more vs. less than 1
serving/day fruits and vegetables  

0.87 (0.71-1.07)

     

 2 or more servings/day vs.
fewer than 2 servings/week fruits

0.91 (0.74-1.11)

     

 2 or more servings/day vs.
fewer than 4 servings/week vegetables

Overall breast cancer:
0.87 (0.73-1.05)

Estrogen receptor-negative
breast cancer:
0.57 (0.38-0.85)

Iowa Women's Health Study [9,10]

34,406
(1,130 cases)

9

Increase fruit and vegetable intake
by 1 serving/day

1.00 (0.98-1.02)‡

Netherlands Cohort Study [10,11]

62,412
(937 cases)

6

Increase fruit and vegetable intake
by 1 serving/day

0.96 (0.91-1.01)‡

Melbourne Collaborative Cohort Study [12]

20,967
(815 cases)

14

Highest vs. lowest
fruit and salad intake 

0.81 (0.63-1.03)

     

Highest vs. lowest
vegetable intake

Overall breast cancer:
0.98 (0.76-1.28)

Estrogen receptor-negative
breast cancer:
0.55 (0.32-0.93)

Singapore Chinese Health Study [13]

34,028
(629 cases)

11

Highest vs. lowest
fruit intake 

1.03 (0.77-1.38)

     

Highest vs. lowest
vegetable intake

0.86 (0.63-1.16)

Diet, Cancer and Health Cohort-Denmark [14]

23,798
(425 cases)

5

 Increase fruit and vegetable intake
by 1 serving/day

Overall breast cancer:
1.02 (0.98-1.06) 

Estrogen receptor-negative
breast cancer:
0.90 (0.81-0.99)

Canadian National Breast Screening Study [15]

56,837
(419 cases)

5

Increase fruit and vegetable intake
by 1 serving/day

0.98 (0.94-1.03)

Pooled and meta-analyses  

Jung et al. [1]

993,466
(24,690 cases)

 

Highest vs. lowest
fruit and vegetable intake

0.98 (0.93-1.02)

     

Highest vs. lowest
fruit intake 

0.99 (0.95-1.03)
     

Highest vs. lowest
vegetable intake

Overall breast cancer:
0.99 (0.95-1.04)

Estrogen receptor-negative
breast cancer:
0.82 (0.74-0.90)

Smith-Warner, et al. [10]

351,825
(7,377 cases)

 

Increase fruit and vegetable intake
by 1 serving/day

0.99 (0.98-1.00)

Aune et al. [2]

15 studies

 

Highest vs. lowest
fruit and vegetable intake

 0.89 (0.80-0.99)
     

Highest vs. lowest
fruit intake

0.92 (0.86-0.98)

     

Highest vs. lowest
vegetable intake

0.99 (0.92-1.06)

Liu et al. [16]

13 studies

 

Highest vs. lowest
vegetable intake

0.85 (0.77-0.94)§

 
* Data from the EPIC Italy study found women with the highest vs. lowest total vegetable intake had a decreased risk of breast cancer, with a relative risk of 0.65 (0.53-0.81).
 
† Relative risks for postmenopausal women. Premenopausal women who ate 5 or more vs. fewer than 2 servings of vegetables per day had a decreased risk of breast cancer, with a relative risk of 0.64 (0.43-0.95).
 
‡ Results for total fruit and vegetable intake from references 9 and 11 were calculated by Smith Warner, et al. and do not appear in the original papers.
 
§ Cruciferous vegetable (such as broccoli, cauliflower, cabbage and brussels sprouts) intake only.

References  
  1. Jung S, Spiegelman D, Baglietto L, et al. Fruit and vegetable intake and risk of breast cancer by hormone receptor status. J Natl Cancer Inst. 105(3):219-36, 2013.
  2. Aune D, Chan DS, Vieira AR, et al. Fruits, vegetables and breast cancer risk: a systematic review and meta-analysis of prospective studies. Breast Cancer Res Treat. 134(2):479-93, 2012.
  3. van Gils CH, Peeters PHM, Bueno-de-Mesquita HB, et al. Consumption of vegetables and fruits and risk of breast cancer. JAMA. 293(2):183-93, 2005.
  4. Masala G, Assedi M, Bendinelli B, et al. Fruit and vegetables consumption and breast cancer risk: the EPIC Italy study. Breast Cancer Res Treat. 132(3):1127-36, 2012.
  5. Zhang S, Hunter DJ, Forman MR, et al. Dietary carotenoids, and vitamins A, C, and E and risk of breast cancer. J Natl Cancer Inst. 91:547-556, 1999.
  6. Fung TT, Hu FB, McCullough ML, et al. Diet quality is associated with the risk of estrogen receptor-negative breast cancer in postmenopausal women. J Nutr. 136(2):466-72, 2006.
  7. Männistö S, Dixon LB, Balder HF, et al. Dietary patterns and breast cancer risk: results from three cohort studies in the DIETSCAN project. Cancer Causes Control. 16(6):725-33, 2005.
  8. Boggs DA, Palmer JR, Wise LA, et al. Fruit and vegetable intake in relation to risk of breast cancer in the Black Women's Health Study. Am J Epidemiol. 172(11):1268-79, 2010.
  9. Kushi LH, Fee RM, Sellers TA, Zheng W, Folsom AR. Intake of vitamin A, C, and E and postmenopausal breast cancer. The Iowa Women’s Health Study. Am J Epidemiol. 144:165-174, 1996.
  10. Smith-Warner SA, Spiegelman D, Yaun SS, et al. Intake of fruits and vegetables and risk of breast cancer: a pooled analysis of cohort studies. JAMA. 285(6): 769-76, 2001.
  11. Verhoeven DT, Assen N, Goldbohm RA, et al. Vitamins C and E, retinol, beta-carotene and dietary fibre in relation to breast cancer risk: a prospective cohort study. Br J Cancer. 75:149-155, 1997.
  12. Baglietto L, Krishnan K, Severi G, et al. Dietary patterns and risk of breast cancer. Br J Cancer. 104(3):524-31, 2011.
  13. Butler LM, Wu AH, Wang R, Koh WP, Yuan JM, Yu MC. A vegetable-fruit-soy dietary pattern protects against breast cancer among postmenopausal Singapore Chinese women. Am J Clin Nutr. 91(4):1013-9, 2010.
  14. Olsen A, Tjonneland A, Thomsen BL, Loft S, Stripp C, Overvad K, Moller S, Olsen JH. Fruits and vegetables intake differentially affects estrogen receptor negative and positive breast cancer incidence rates. J Nutr. 133(7);2342-7, 2003.
  15. Rohan TE, Howe GR, Friedenreich CM, et al. Dietary fiber, vitamins A, C, and E, and risk of breast cancer: a cohort study. Cancer Causes Control. 4:29-37, 1993.
  16. Liu X, Lv K. Cruciferous vegetables intake is inversely associated with risk of breast cancer: A meta-analysis. Breast. 22(3):309-13, 2013.

Updated 11/12/13