Table 16: Fruits and vegetables and breast cancer risk

Introduction: Eating fruits and vegetables seems to have little, if any, impact on overall breast cancer risk. However, eating vegetables may help reduce the risk of certain types of breast cancer.

A pooled analysis of data from 20 cohort studies found no difference in the risk of breast cancer between women who ate the most fruits and vegetables and those who ate the least. Women who ate the most vegetables, however, had a lower risk of estrogen receptor-negative breast cancers than women who ate the least vegetables. A high intake of vegetables did not lower the risk of estrogen receptor-positive breast cancers [1].

Findings also showed no difference in risk of breast cancer between women who ate the most fruits compared to those who ate the least [1].   

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.

* Highest vs. lowest intake: more than 367 vs. 114 or fewer grams of fruit per day and more than 309 vs. 109 or fewer grams of vegetables per day.

† 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 breast cancer. For premenopausal women, fruit and vegetable intake and fruit intake alone did not affect breast cancer risk. However, women who ate 5 or more vs. fewer than 2 servings of vegetables per day had a decreased risk of premenopausal breast cancer, with a relative risk of 0.64 (0.43-0.95).

§ Fruit and vegetable intake and fruit intake alone did not affect breast cancer by hormone status. However, women who at 2 or more servings of vegetables per day vs. fewer than 4 servings per week had a decreased risk of hormone receptor-negative breast cancer, with a relative risk of 0.57 (0.38-0.85).

¶ Highest vs. lowest intake: average of 357 vs. 39 grams of fruit per day and an average of 174 vs. 51 grams of vegetables per day.

** Vegetable intake alone did not affect breast cancer by hormone status. However, women who ate the most fruit and salad vs. those who ate the least had a decreased risk of hormone receptor-negative breast cancers, with a relative risk of 0.55 (0.32-0.93).

†† Women who ate the most vegetables vs. those who ate the least had a decreased risk of estrogen receptor-negative breast cancers, with a relative risk of 0.82 (0.74-0.90).

‡‡ Results for total fruit and vegetable intake from references 9 and 10 were calculated by Smith Warner, et al. and do not appear in the original papers. 

 

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. 2013 Jan 24. [Epub ahead of print]. 
2. Fung TT, Hu FB, Holmes MD, et al. Dietary patterns and the risk of postmenopausal breast cancer. Int J Cancer. 116(1):116-21, 2005.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. Kushi LH, Fee RM, Sellers TA, et al. Intake of vitamin A, C, and E and postmenopausal breast cancer. Am J Epidemiol. 144:165-174, 1996.
10. 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.
11. Baglietto L, Krishnan K, Severi G, et al. Dietary patterns and risk of breast cancer. Br J Cancer. 104(3):524-31, 2011.
12. 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.
13. 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.
14. 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. 
15. 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.
16. 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.

Updated 02/12/13