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Home > Understanding Breast Cancer > Breast Cancer Research > Table 15: Carotenoids and breast cancer risk

  


Table 15: Carotenoids 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: Carotenoids are natural orange-red food pigments (found in foods such as carrots, sweet potatoes, squash and melons). Many carotenoids are antioxidants that can be converted into vitamin A. Beta-carotene is one example of a carotenoid.

Researchers can study carotenoids by measuring levels of carotenoids in the blood or through a person’s diet.

Studies of blood levels of carotenoids

A pooled analysis of data from eight studies found that women with higher blood levels of carotenoids had a reduced risk of breast cancer compared to women with lower levels [1].

Studies of dietary intake of carotenoids

Although most studies have found no link between eating a diet high in foods that contain carotenoids and overall breast cancer risk, carotenoids appear to lower the risk of certain breast cancers. A pooled analysis of data from over one million women in 18 studies found that a diet high in carotenoids lowered the risk of estrogen receptor-negative breast cancers [2]. However, there was no benefit for estrogen receptor-positive breast cancers [2].

Learn more about carotenoids and breast cancer risk.

Note of caution on carotenoid supplements

Eating too much of certain carotenoids may have some health risks. A few studies have found that taking a daily supplement of the carotenoid beta-carotene can increase the risk of lung cancer and premature death in smokers [3-5].

In general, fruits and vegetables are the best sources of carotenoids (rather than supplements) and are part of a healthy diet.

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: For blood level studies: Prospective cohort studies and nested case-control studies with at least 100 breast cancer cases and pooled analyses. For dietary intake studies: Prospective cohort studies and nested case-control studies with at least 400 breast cancer cases and meta-analyses.

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

Blood Levels of Carotenoids 

Study 

Study Population
(number of participants)
  

Follow-up
 (years)
 

Relative Risk of Breast Cancer in Women with Higher Blood Levels of Beta-Carotene
Compared to Women with Lower Levels,
RR (95% CI)
 

Prospective cohort studies 

Women's Health Initiative [6]

5,450
(153 cases)

8

0.78 (0.49-1.24)

Nested case-control studies 

 

Cases 

Controls 

   

Nurses' Health Study [7]

969

969

22

0.73 (0.53-1.02)*

Women's Health Study [8]

508

508

10

1.36 (0.79-2.33)

E3N Cohort [9]   

366

720

7

0.85 (0.53-1.35)

Shanghai Women's Health Study [10]

365

726

8

1.47 (0.92-2.35)

Sato et al. [11] 

295

295

4

0.41 (0.22-0.79)

Multiethnic Cohort Study [12]

286

535

up to 3

0.73 (0.46-1.15)

New York University Women's Health Study [13}

270

270

up to 10

0.45 (0.26-0.77)

Hulten et al. [14]

201

290

up to 10

0.8 (0.5-1.4)

Pooled and meta-analyses 

Eliassen et al. [1]

3,055

3,956

Various

Overall breast cancer:
0.83 (0.70-0.98)

Estrogen receptor-negative breast cancer:
0.52 (0.36-0.77)  

Aune et al. [14]

12 studies
(3,609 cases)

Various

0.82 (0.65-1.04)

* Highest vs. lowest level of total carotenoid intake also did not reduce breast cancer risk (0.76 (0.55-1.05)). However, there was a significant trend of decreasing breast cancer risk with increasing levels of both beta-carotene intake and total carotenoid intake.  

 

Dietary Intake of Carotenoids 

Study 

Study Population
(number of participants)
 

Follow-up
(years)
 

Relative Risk of Breast Cancer in
Women with a High Intake of Beta-Carotene Compared to
Women with a Low Intake,
RR (95% CI)
 

Prospective cohort studies  

EPIC Study [16]

288,776
(6,478 cases)

9

Among premenopausal women:
1.04 (0.85-1.27)

Among postmenopausal women:
0.93 (0.82-1.04)

Women’s Health Initiative Observational Study [17]

84,805
(2,879 cases)

8

0.86 (0.75-0.99)

Nurses' Health Study [18]

83,234
(2,697 cases)

14

0.83 (0.66-1.04)†

Swedish Mammography Cohort [19,20]

59,036
(1,271 cases)

10

1.01 (0.84-1.22)

Diet, Cancer and Health [21]

26,224
(1,072 cases)

11

0.91 (0.75-1.11)

Iowa Women's Health Study [22]

34,387
(879 cases)

6

1.17 (0.87-1.56)

Nurses' Health Study II [23]

90,655
(714 cases)

8

0.96 (0.75-1.22)

Nested case-control studies 

 

Cases 

Controls 

   

Canadian National Breast Screening Study [24]

1,452

5,239

10

1.01 (0.70-1.33)

Netherlands Cohort Study [25]

650

1,066

4

1.01 (0.72-1.42)

Pooled and meta-analyses 

Zhang et al. [2]

1,028,438
(33,380 cases)

7-26

Overall breast cancer:
1.00 (0.97-1.04)

Estrogen receptor-negative breast cancers:
0.86 (0.78-0.94)

Aune et al. [15]

10 cohort and nested case-control studies
(18,191 cases)
 

0.93 (0.88-0.98)

Hu et al. [26]

  7 cohort studies 

 

0.94 (0.88-1.00)

† Premenopausal women only  

 

References  

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  2. Zhang X, Spiegelman D, Baglietto L, et al. Carotenoid intakes and risk of breast cancer defined by estrogen receptor and progesterone receptor status: a pooled analysis of 18 prospective cohort studies. Am J Clin Nutr. 95(3):713-25, 2012.
  3. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med. 330:1029 –35, 1994.
  4. Omenn GS, Goodman G, Thornquist M, et al. Chemoprevention of lung cancer: the beta-Carotene and Retinol Efficacy Trial (CARET) in high-risk smokers and asbestos-exposed workers. IARC Sci Publ: 67-85, 1996.
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Updated 11/12/13