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.
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Introduction: Carotenoids are natural orange-red food pigments (found in such foods 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.
Studies of dietary intake of carotenoids
Findings from cohort and case-control studies on dietary carotenoid intake and breast cancer risk are mixed. Although some studies have shown a high intake of carotenoids may lower breast cancer risk, most have found no link between the two.
Studies of blood levels of carotenoids
Blood levels of carotenoids are a good marker for the amount of carotenoids a person has consumed. Findings from studies on blood levels of carotenoids and breast cancer risk have been mixed. A few studies suggest women with higher blood levels of carotenoids have a lower risk of breast cancer than women with lower levels, but most show no difference in risk. This topic is still under study.
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 [1-3].
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 dietary intake studies: Prospective cohort studies and nested case-control studies with at least 400 breast cancer cases and meta-analyses. For blood level studies: Prospective cohort studies and nested case-control studies with at least 100 breast cancer cases and pooled analyses.
Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.
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 [4]
|
288,776
(6,478 cases)
|
8.8
|
Among premenopausal women:
1.04 (0.85-1.27)
Among postmenopausal women:
0.93 (0.82-1.04)
|
Women’s Health Initiative Observational Study [5]
|
84,805
(2,879 cases)
|
7.6
|
0.86 (0.75-0.99)
|
| Nurses' Health Study [6] |
83,234
(2,697 cases)
|
14
|
0.83 (0.66-1.04)*
|
Swedish Mammography Cohort [7]
|
59,036
(1,271 cases)
|
10
|
1.01 (0.84-1.22)
|
Diet, Cancer and Health [8]
|
26,224
(1,072 cases)
|
10.6
|
0.91 (0.75-1.11)
|
| Iowa Women's Health Study [9] |
34,387
(879 cases)
|
6
|
1.17 (0.87-1.56)
|
Nurses' Health Study II [10]
|
90,655
(714 cases)
|
8
|
0.96 (0.75-1.22)
|
Nested case-control studies
|
| |
Cases
|
Controls
|
|
|
Canadian National Breast Screening Study [11]
|
1,452
|
5,239
|
9.5
|
1.01 (0.70-1.33)
|
Netherlands Cohort Study [12]
|
650
|
1,066
|
4.3
|
1.01 (0.72-1.42)
|
Pooled and meta-analyses
|
Zhang et al. [13]
|
1,028,438
(33,380 cases)
|
7-26
|
1.00 (0.97-1.04)
|
Hu et al. [14]
|
7 cohort studies
|
|
0.94 (0.88-1.00)
|
* Premenopausal women only
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 [15]
|
5,450
(153 cases)
|
8
|
0.78 (0.49-1.24)
|
Nested case-control studies
|
| |
Cases
|
Controls
|
|
|
Nurses' Health Study [16]
|
969
|
969
|
22
|
0.73 (0.53-1.02)†
|
Women's Health Study [17]
|
508
|
508
|
9.9
|
1.36 (0.79-2.33)
|
E3N Cohort [18]
|
366
|
720
|
7
|
0.85 (0.53-1.35)
|
Shanghai Women's Health Study [19]
|
365
|
726
|
7.5
|
1.47 (0.92-2.35)
|
Sato et al. [20]
|
295
|
295
|
4.3
|
0.41 (0.22-0.79)
|
Multiethnic Cohort Study [21]
|
286
|
535
|
up to 2.5
|
0.73 (0.46-1.15)
|
New York University Women's Health Study [22}
|
270
|
270
|
up to 10
|
0.45 (0.26-0.77)
|
Hulten et al. [23]
|
201
|
290
|
up to 10
|
0.8 (0.5-1.4)
|
Pooled analyses
|
Eliassen et al. [24]
|
3,055
|
3,956
|
|
0.83 (0.70-0.98)
|
† 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.
References
- 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.
- 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.
- Druesne-Pecollo N, Latino-Martel P, Norat T, et al. Beta-carotene supplementation and cancer risk: a systematic review and metaanalysis of randomized controlled trials. Int J Cancer. 127(1):172-84, 2010.
- Nagel G, Linseisen J, van Gils CH, et al. Dietary beta-carotene, vitamin C and E intake and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Breast Cancer Res Treat. 119(3):753-65, 2010.
- Cui Y, Shikany JM, Liu S, Shagufta Y, Rohan TE. Selected antioxidants and risk of hormone receptor-defined invasive breast cancers among postmenopausal women in the Women's Health Initiative Observational Study. Am J Clin Nutr. 87(4):1009-18, 2008.
- 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(6):547-56, 1999.
- Michels KB, Holmberg L, Bergkvist L, et al. Dietary antioxidant vitamins, retinol, and breast cancer incidence in a cohort of Swedish women. Int J Cancer. 91(4):563-7, 2001.
- Roswall N, Olsen A, Christensen J, Dragsted LO, Overvad K, Tjønneland A. Micronutrient intake and breast cancer characteristics among postmenopausal women. Eur J Cancer Prev. 19(5):360-5, 2010.
- Kushi LH, Fee RM, Sellers TA, et al. Intake of vitamins A, C, and E and postmenopausal breast cancer. The Iowa Women's Health Study. Am J Epidemiol. 144(2):165-74, 1996.
- Cho E, Spiegelman D, Hunter DJ, Chen WY, Zhang SM, Colditz GA, Willett WC. Premenopausal intakes of vitamins A, C, and E, folate, and carotenoids, and risk of breast cancer. Cancer Epidemiol Biomarkers Prev. 12(8):713-20, 2003.
- Terry P, Jain M, Miller AB, Howe GR, Rohan TE. Dietary carotenoids and risk of breast cancer. Am J Clin Nutr. 76(4);883-8, 2002.
- 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(1):149-55, 1997.
- 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.
- Hu F, Wang Yi B, Zhang W, et a. Carotenoids and breast cancer risk: a meta-analysis and meta-regression.Breast Cancer Res Treat. 131(1):239-53, 2012.
- Kabat GC, Kim M, Adams-Campbell LL, et al. for the Women’s Health Initiative Investigators. Longitudinal study of serum carotenoid, retinol, and tocopherol concentrations in relation to breast cancer risk among postmenopausal women. Am J Clin Nutr. 90(1):162-9, 2009.
- Tamimi RM, Hankinson SE, Campos H, et al. Plasma carotenoids, retinol, and tocopherols and risk of breast cancer. Am J Epidemiol. 161(2):153-60, 2005.
- Sesso HD, Buring JE, Zhang SM, et al. Dietary and plasma lycopene and the risk of breast cancer. Cancer Epidemiol Biomarkers Prev. 14(5):1074-81, 2005.
- Maillard V, Kuriki K, Lefebvre B, et al. Serum carotenoid, tocopherol and retinol concentrations and breast cancer risk in the E3N-EPIC study. Int J Cancer. 127(5):1188-96, 2010.
- Dorjgochoo T, Gao YT, Chow WH, et al. Plasma carotenoids, tocopherols, retinol and breast cancer risk: results from the Shanghai Women Health Study (SWHS). Breast Cancer Res Treat. 117(2):381-9, 2009.
- Sato R, Helzlsouer KJ, Alberg AJ, et al. Prospective study of carotenoids, tocopherols, and retinoid concentrations and the risk of breast cancer. Cancer Epidemiol Biomarkers Prev. 11:451-457, 2002.
- Epplein M, Shvetsov YB, Wilkens LR, et al. Plasma carotenoids, retinol, and tocopherols and postmenopausal breast cancer risk in the Multiethnic Cohort Study: a nested case-control study. Breast Cancer Res. 11(4):R49, 2009.
- Toniolo P, Van Kappel AL, Akhmedkhanov A, et al. Serum carotenoids and breast cancer. Am J Epidemiol. 153(12):1142-7, 2001.
- Hulten K, Van Kappel AL, Winkvist A, et al. Carotenoids, alpha-tocopherols, and retinol in plasma and breast cancer risk in northern Sweden. Cancer Causes Control. 12: 529-537, 2001.
- Eliassen AH, Hendrickson SJ, Brinton LA, et al. Circulating carotenoids and risk of breast cancer: pooled analysis of eight prospective studies. J Natl Cancer Inst. 104(24):1905-16, 2012.
Updated 02/12/13
