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The relationship between fatty acid composition of subcutaneous adipose tissue and the risk of proliferateive benign breast disease and breast cancer

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The relationship between fatty acid composition of subcutaneous adipose tissue and the risk of proliferateive benign breast disease and breast cancer

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Content THE RELATIONSHIP BETWEEN FATTY ACID COMPOSITION OF SUBCUTANEOUS ADIPOSE TISSUE AND THE RISK OF PROLIFERATIVE BENIGN BREAST DISEASE AND BREAST CANCER \By Akiko Tomita A Thesis Presented to the FACULTY OF THE GRADUATE SCHOOL UNIVERSITY OF SOUTHERN CALIFORNIA In Partial Fulfillment of the Requirements for the Degree MASTERS IN SCIENCE (Biometry) May 1995 U N IV ERSITY O F S O U T H E R N C A L IFO R N IA T H E G R A D U A T E S C H O O L U N IV E R S IT Y PA R K L O S A N G E L E S . C A L IF O R N IA S 0 0 0 7 This thesis, written by under the direction of hHdC....Thesis Committee, and approved by all its members, has been pre sented to and accepted by the Dean of The Graduate School, in partial fulfillment of the requirements fo r the degree of Master of Science . .JlZ3l Dm * D a te F.ehruary..6+. . 19j 9 i l - . THESIS COMMITTEE Chmirm*H TABLE 07 CONTENTS Page # iv. Acknowledgements ............................... iv Chapters I. Introduction .................................. 1 II. Materials and Methods 2.1 Subjects ........... 2.2 Data Collection 2.3 Statistical Analysis III. Results......................................... 9 IV. Discussion..................................... 13 m m i i i TABLE OF CONTENTS (continued) Tables Page# 1. Medians, twentieth and eightieth percentiles of 16 fatty acids from subcutaneous adipose tissue among 953 postmenopausal women. 2. Risk factors for breast cancer in 17 postmenopausal women (N=953). 3. Adjusted odds ratios for proliferative benign 18 benign disease without atypia, for atypical hyperplasia, and for breast cancer by quintile of percentage of specific fatty acids in the subcutaneous adipose tissue of postmenopausal women. 4. Odds ratios and 95% confidence intervals for 19 breast cancer based on levels of individuals fatty acids in the subcutaneous adipose tissue among postmenopausal women. 5. Medians, twentieth and eightieth percentiles 20 from dietary intake of selected nutrients among postmenopausal women. 6. Calorie-adjusted odds ratios for proliferative 21 benign breast disease without atypia, for atypical hyperplasia, and for breast cancer by quintile of dietary intake of fatty acids among postmenopausal women. List of References 22 ACKNOWLEDGEMENTS I would like to thank Dr. Stephanie J. London for providing the data and for chairing my thesis committee, Dr. Wendy Mack for being part of my thesis committee, Dr. Joyce C. Niland and Dr. Tamara L. Odom-Maryon for their encouragement, patience and support. X would also like to express my deepest gratitude to Dr. Stanley P. Azen for giving me the opportunity to learn from a talented faculty and for providing both professional and academic guidance. 1 Chapter I INTRODUCTION Some animal studies have suggested that certain fatty acids from the diet may cause mammary carcinogenesis (Hopkins and Carroll, 1979; Ip, 1987). Karmali (1987) has observed that some N-6 polyunsaturated fatty acids may cause carcinogenesis but the long-chain N-3 fatty acids may inhibit tumor growth. Welsch (1987) has reviewed a potential mechanism whereby low antioxidant levels may enhance the growth of mammary tumors by a diet high in polyunsaturated fats. Dietary trans fatty acids may also be associated with risk of breast cancer (Enig et al., 1978) . Direct adipose tissue measurements may be more advantageous then assessing dietary fatty acid intake from a questionnaire. This method is free from recall bias whereas the validity of self-reported intake from a questionnaire, particularly for past dietary exposures, is often questioned. Additionally, the analysis of fatty acids in adipose tissue would reflect dietary habits over a relatively long period due to the half-life of fatty acids of 2 years (Hirsch et al. , 1960) . Adipose tissue can easily measure intake of trans fatty acids and polyunsaturated fatty acids that are not endogenously synthesized (London et al., 1991). In order to examine possible associations between fatty acid composition of subcutaneous adipose tissue and the risk of breast cancer and proliferative benign breast disease, a case-control study was conducted among postmenopausal women who were evaluated for breast abnormalities. Dietary intake of nutrients was also obtained by the use of a semiquantitative food frequency questionnaire. 3 Chapter II MATERIALS AND METHODS 2.1 Subjects Postmenopausal women diagnosed with either stage I or II breast cancer between 1986 and 1988 at five Boston area hospitals were enrolled in the study. Other postmenopausal women who were evaluated by mammography or were diagnosed with breast abnormalities but were not diagnosed for breast cancer were also enrolled. Based on the histologic features recorded in the pathology report for all subjects with a breast biopsy, women who did not have breast cancer were further categorized into three groups: nonproliferative benign breast disease, proliferative benign breast disease without atypia and atypical hyperplasia. Women who did not have a biopsy and women who were categorized as having nonproliferative benign 4 breast disease acted as the control group for comparisons with each of the other outcomes -- proliferative benign breast disease without atypia, atypical hyperplasia and breast cancer. Aspiration of the subcutaneous buttocks fat and phlebotomy were performed on participating subjects. These subjects were also asked to complete a questionnaire regarding medical history and breast cancer risk factors as well as a semiquantitative food frequency questionnaire. Subjects were also enrolled into the study either before or soon after their diagnostic evaluation for benign breast cancer or breast cancer. This minimized any possible effects of breast cancer on fat composition of the aspired tissue and dietary intake. 2.2 Data Collection Subcutaneous fat aspiration was performed as described by Hirsch et al. (1960) . These samples were properly stored and were prepared and analyzed at the Lipid Research Laboratory of Brigham and Women's Hospital in Boston, Massachusetts. Capillary gas chromatography was used to identify the fatty acids. Peak areas which identify the specific fatty acid were integrated by a computer. A total of twenty-nine peaks were identified and were included in the analysis. Each individual fatty acid was quantified as the percentage of total peak area of the peaks that were identified. A listing of the individual fatty acids is shown in the first column of Table 1. A semiquantitative food frequency questionnaire, similar to the one described by Willett et al . (1985), was used to obtain dietary intake information. Subjects were asked how often, on average, they had consumed each food item during the year prior to the diagnostic evaluation. For each food item, there were nine response categories ranging from zero times to six or more time per day. The intake of nutrients was calculated by multiplying the frequency of use of each food by the nutrient content of the portions specified in the questionnaire. Specific types of fat used in cooking were considered when calculating the nutrient intake. Values for dietary fat composition were taken from the Consumer and Food Economics Institute handbook, 1976-1989. 2.3 Statistical Analysis Subjects with an inadequate adipose tissue sample were excluded from the analysis (22 of the 402 women with breast cancer and 24 of the 597 women without breast cancer who completed a questionnaire). A total of 380 women with breast cancer and 573 women without breast cancer were included in the fatty acid analysis. The 573 women without breast cancer included 397 (70%) women who did not require a biopsy or whose biopsy revealed normal or nonproliferative benign breast disease (controls), 122 (21%) women with proliferative benign breast disease without atypia, and 54 (19%) women with atypical hyperplasia. In the dietary intake analysis, women who did not return a food frequency questionnaire (53 women with breast cancer and 55 women without breast cancer) and women whose daily caloric intake (estimated by the food frequency questionnaire) was less than 800 calories or greater than 4500 kilocalories (13 women with breast cancer and 14 women without breast cancer) were excluded. With this exclusion, a total of 314 women with breast cancer and 504 women without breast cancer were left for the dietary intake analysis. Among the 504 women without breast cancer, 342 (68%) women did not require a biopsy or the biopsy revealed normal or nonproliferative benign breast disease, 115 (23%) women had proliferative benign breast disease without atypia, and 47 (9%) women had atypical hyperplasia. The data were analyzed using unconditional logistic regression (Breslow and Day, 1980). Separate odds ratios were calculated for the three outcomes -- proliferative benign breast disease without atypia, atypical hyperplasia, and breast cancer. Odds ratios were adjusted for known risk factors for breast cancer from the literature (Dupont and Page, 1985; Howe et al., 1990). The first column of Table 2 contains each risk factor and its categories that were included in the final logistic regression model. In addition to these risk factors, other possible confounders such as estrogen use, weight change in the previous six months and the technician who analyzed the peak areas for the fatty acids in the adipose tissue were also included in the analyses. Women with nonproliferative benign breast disease and women who did not have a biopsy acted as the control group for all analyses. It has been hypothesized that polyunsaturated fat intake might be a risk factor for breast cancer in an environment of low intake of antioxidants. The associations and interactions between the risk of breast cancer and the polyunsaturated fatty acids in adipose tissue within tertiles of serum ot- tocopherol, total tocopherol, /3-carotene, a-carotene, lycopene and glutathione peroxidase and intakes of a-tocopherol and carotenoids were also tested. The dispersion of the specific fatty acids in the adipose tissue and dietary nutrients among all subjects were utilized to compute quintiles. Prior to computing quintiles, the fatty acid data from the adipose tissue and the dietary nutrient data were normalized by the log transformation. Additionally, in the analysis involving the dietary nutrients, an adjustment for total energy intake (by including total calories as a covariate) was accomplished by regression analysis (Willett, 1990; Willett and Stampfer, 1986). Correlations between fatty acid levels in the adipose tissue and intake of fatty acids (determined by the food frequency questionnaire) among women free from breast cancer were calculated using Spearman correlation methods. 8 The continuous form of the data were used in the test for trend. P values for trend were based on Wald's Chi-Square test. All significance testing was performed at a two-sided alpha level of 0.05. The SAS software (version 6.04) running under DOS was used to manage the data and for any data transformations. PROC LOGREG from the EPILOG PLUS software was used for the unconditional logistic regression for multivariate analyses. 9 Chapter III RESULTS Postmenopausal women in the study ranged in age from 36 to 93 years old (with a median of 61 years). From Table 1, the distribution of the fatty acids in the subcutaneous adipose tissue did not differ among the four outcomes. Table 2 shows the distribution of each risk factor for breast cancer and its categories. These risk factors were included in the logistic regression models. Models that were only adjusted for age had similar results to those that were adjusted for all other risk factors. Other risk factors such as estrogen use, weight change in the previous six months and the technician who analyzed the peak areas for the fatty acids in the adipose tissue were used for further adjustments; however, these did not alter the magnitude of any associations. Table 3 shows associations between saturated, monounsaturated, polyunsaturated, long-chain N-3 and trans fatty acids in relation to the three outcomes. For proliferative benign breast disease without atypia, statistically significant results were observed with saturated and monounsaturated fatty acids. This inverse trend with increasing percentage of saturated fatty acids and the trend associated with increasing levels of monounsaturated fatty acids were based on small cell sizes. Although there was a statistically significant result for monounsaturated fatty acids, the odds ratios did not consistently increase across the categories. No consistent associations were observed between the fatty acids with the risk of atypical hyperplasia or breast cancer. The association between individual fatty acids in subcutaneous adipose tissue and all three breast disease outcomes were also examined. An inverse trend with increasing level of some saturated fatty acids (for 12:0, 14:0, 15:0 and 16:0) for proliferative benign breast disease without atypia was observed but no other saturated fatty acid showed this association. Even though we observed an increasing trend in risk of proliferative benign breast disease without atypia with total monounsaturated fatty acids in adipose tissue (Table 3), we did not observed the same trend with individual monounsaturated fatty acids. 11 Table 4 shows the odds ratios for the risk of breast cancer associated with specific individual fatty acids. A statistically significant Atypicai hyperplasia n»54 Breast Cancer :n-36D Saturated fatty acids 24 26 .19 73 -2? 22 23 117 04 - 26 5 3 24 2 ^ 15 91•I" 19 23 52 (19 49-27 72 > 12 0 C . 30 .0 :o-o.:': : oc C . SC-C . C2: 0 0 0 c : ;s o. sc iC OO-S.C'. 14 ■ D 13 3 ■ : ie- 2 1? : 6S '012-1.55: 0 "9 c 12-i c 69 iC 16-2.331 IS c 0 .29 0 15-0 30. ; 22 '.0 S7-C . 34' C . 3C : 15-: 39 C 26 : 0 li-c.Dfl: 16 0 IB 99 :15 • "6-21 .26 ie is ■14.U-2C.46 19 . 19 15 44-20 54 18 67 '15 31-21.621 17-0 3 24 •0.19-1 29 0 22 . o.ie-s 30, 0.24 : i5-: 29 C . 24 •0.19-0 30, 10.0 3 22 2.42-4 IS ; 97 2.2C-4 04: 3 .24 2 62-4 14 1 1C '2-32-4 2SJ 39 = 0 o ce :0 05-: 12. ; :a 0.00-0 12, 0 07 : : :: & 00 IC.C0-C 13, 22 . 0 c oc c oc-; Cl ; sc 2 ZZ -0 . 01. c SC : co-o :i z . oc iO.SC-C Cl: Monounsaturated fatty acids 55 ?6 ■ 51■43 - SB 55 56 2^ ■52 61-59 53 54 00 SI 3 6 - Be 54 55 37 ' ! 52 16-56 .77, 16;in- i trans 0 60 ■ 3.10-: 34 0 65 0 10-0 93 o s: 0 0 9-: 51 0 44 id 09-0 92 16:ln-7 c is 5 43 3 60-" 11 5 54 3 26-6 97. 5 S'* 3 -- 5 41 [3 53-7 31i, 16 1 trans : 94 2 25-3 67 2 92 '2.26-3 72, 2 .63 : i:-j =4 2 92 (2 37-3 7fl- lfl.ln-7 cis 2 4*» 2 13-3 03 ; 65 .2.14-3 17;. 2 5S 2 03- ■ : • 2 52 (2.O0-3.C3' lijln-9 cis 42 . 50 .39 69-46 :: 44 11 ' 41 21 ■ a"7. 5C • 43 OS 40 51-45 60 42 99 140 03-46.56. 20 1n-9 : 41 0 3 2 -C 52 Z 40 ■ ; 31-0 53. 0 35 0 34- : 4 = C 42 fO.33-: 54: Polyunsaturated fatty acids 21 24 . I"* . 6 " - *4 36 21 .10 52 -24 62 20 '? 10 56-24 j 4 22.91 £17.94-24 15: la 2n-6 cis.cis 17 72 ■14 60-20 S3 1' 96 IS 14-20 36. 1 " ■ 13 15 36-20 60 17 39 : 14 59-20 15' I* 2C'6 trar.s. trans 0 .50 •0 33-0 65 C 50 .1.40-064: : 44 0 3"-: 62 0.51 • 0 3 9 -C 6 5 18 2n-€ cis,trans 0 55 iZ 43-0 '0 0 57 ■: .46-0■72■ 0 .49 : 45-: 66 0.56 •0 .45-0 *»&■ 10.2n-6 trans.cis 3 23 i3 1*-C 30 C 24 •S 10-G 31' : .19 o ie*: i: C .23 i.e. 17-; 30' IB 3n-3 : 70 0 62-0 56 0 77 f0 64-: 95 : ~3 ; 5 9-2 55 C 74 ■.0.6 0-3 92 13 In-6 0 . 03 ;G 06-; ii 0 C9 ■V.06-: 14, 0 16 ; :s : .4 C C0 10 .06-0 13: 20:2n-6 3 2C 0 16-0 25- : 2i C 16 -C 2* 0.19 ; 16-1 24 0.21 :S 16*0 25. 20 3n-6 0 31 0 21-: 45 : 35 ■C 24-0 S3, c 3 3 ; 2 3-: 4] 0.33 ■0 2 3-0.45.- 20 : 4n-6 C 53 •; 39-: : sc ■0 42-0 83. 0 53 ; 4i : C .55 (S 39-0 70 224H-6 c c: is ; :: ■: :s-s i9 o ; 0 GC ■:o 00-0 19, Long-chain N-3 polyunsaturated fatty acids o. ie : ii*: 3: : 18 : , 0 19 • C . 11 - C . 3 0 ' • 20:5n3 : :s : 03-: :b 0 06 :s. 0 0 5 : :: •: :~ ■: os ■ :c 0 --0 00 22 :6n3 0 13 0 00-0 2 3 ; :s : :e - * j : . 14 ■: 00-0 23 Total trans fatty acids 3 J"1 .3 :"-4 92 4 02 .3 16-4 93 3 65 2 66-4 60 4 c: 3 10-4 94 Table 2. Risk factor* for breast cancer in postmenopausal women (N-953 Risk Factor* Category of breast pathclogy Non■proiiSerative or no biopsy S \ : Proliferative benign breast disease without atypia N I Atypical hyperplasia K 4 Breast N Cancer % Alcohol consultation □ever 164 '41: 50 (41) 29 52 164 14 3! l-l times per month 55 14 21 (17) 5 9 55 <14.' once per week 3 7 • 9 9(7) 3 6 24 : 6) 2-4 times per week 54 14 19 (16) 13 46 <13; 5-6 times per week 16 • . 5 6(5; 4 15 ( 4; once per day or more 29 i f- 6 4 4 29 i e; unknown 4: • i: ■ a: n o 3 • 6 45 (12 Age at first birth none 66 ;; 29 (24. 11 2C 70 ;is- less than or equal to 20 years 51 :13 13 (11. 9 40 fu. 21-24 years 112 .26. 40 03) 9 ' I'’ 106 ;2s, 25-26 years 91 '.23: 21 (17) 14 26 64 (22 . 29 years and older 57 £14. 19 (16) i: i: 76 ' 21, Rarity none 64 21 29 (24.i 11 2 C 71 • ; 19. one child 36 9, B ( 7; f. - - 43 ill; two children ICC :25; 29 (24.i :2 :: 101 .27: three or more children 1*7 ;45: 56 (46) 25 '46 165 (43) Family history of breast cancer no 3 34 64 2C4 : 05 ) • 42 '“9 309 '61 i yes £3 '16- IS U5> 12 22 71 : 19 1 Age at menopause less than or equal to 4? years ’1 19 21 (17; 7 13 47 ' . 12 ’ 41-46 years Si 22' 25 (20; 14 2% 62 s 22 • ; 47-49 years 65 16 26 :il: is 70 (10) 50-53 years 142 36 26 (301 19 35 115 !3C: 54 year* and older sa i j • 24 (l2i 4 66 '.17) Prior history of benign breast disease no 2 64 "2 66 (721 3" 65. 294 ; 7“; yes l.a za 34 .2 f t ' • 1" 31 66 !23'. Age at menarche less than or equal to 12 years 162 4: 57 (47) 19 3 5 1S6 142: 13 years 116 :29 35 i29. 21 3" 106 2 6 14 years and older 121 31 3 3 125) 15 26 114 ;32. weight 5 years prior to enrollment less than or equal to 124 lbs 66 17 2C (16J it IS 5T US; 125-134 lb* 65 '21' 16 '!&■ 11 21 6B (16' 135-144 IPS sc -:c 26 <23' 66 (1’j 145-165 lbs 1C9 27. 26 :23, 14 26 116 31.' 165 lbs and greater 56 14. 26 :2 2• £ 73 19; unknown i • :. 0 . C: 2 4 0 ' • 18 Table 3- Adjusted odds rat lot Cor proliferative benign breast disease without atypia, Cor atypical hyperplasia, and for breast cancer by quintile of percentage of specific fatty acids in the subcutaneous adipose tissue of postmenopausal women in the greater Boston Area, 1946-1964 tN-96J) Odds Ratios (95% r u 1 Quintile median |% of total peak area!' Proliferative benign breast disease without atypia Atypical hyperplasia Be east Cancer (n-122 ) < n . S 4 ) ( n - 380 ) S a t u r a t e d f a t t y acids I S 57 1 . 0 1 0 1 0 21 32 1 1 (0 6 2 0 ) 1 2 10 .4-3 41 1 1 (0 7-1 8 ) 23 . 69 0 6 (0 3 1 2 ) U 7 (0 3 2 1 ) 1 1 (0 7 1 8 ) 26 04 0 5 10 3 1 0 ) 1 2 ( 0 5 3 2 ) 0 8 (0 5 - 1 . \) 29 20 0 4 i O 2 0 7 ) 0 a (0 3-2 1 ) 1 0 (0 b • 1 / > p , r r e n d J 0 001 0 62 0 64 M < i n n u n o a t u r a t e d F a t t y a c i d s s o i y ] (l I 1 ) I U S I 17 1 J ( 0 B I 7 ) 1 1 ) t r> 4 2 b > 1 1 7 1 H 1 S S J f i 2 1 <1 0 4 6 ) 0 0 (0 3 2 1 ) 1 1 10 1 I 8 ) 57 49 1 9 (0 9 4 1 ) 1 4 (0 5 i 1 ) 1 2 I (J 6 2 \> 1 60 7 B 2 8 (1 4 6 8 ) 1 1 f O 5 ) 2 ) 1 2 ) 0 7 I 9 ) P , i r e n d 0 0 1 0 4 '' (J P o l y u n s a t u r a t e d f a t t y a c i d B 16 62 1 0 ] 0 1 0 19 19 1 5 (0 7 3 2 ) 1 6 {0 5 4 2 ) 1 0 10 . 6 1 6 ) 21 11 I 7 t o B J 6 ) 1 5 i t > 5 4 3 ) I 2 t o . 7 1 9 ) 22.89 I 8 t o . 9 I B ) 0 9 (0 J 2 7 | 0 y ( 0 6 1 5 ) 26 I B 1 6 (0 8 1 5 ) 1 3 10 S • 3 9 ) 1 0 (0 6 - 1 6 ) P , t r e n d 0 19 0 96 0 76 L o n g - c h a i n N 3 f a t t y a c i d s 0 06 1 0 1 . 0 1 0 0 . 14 0 8 to 4 1 0 ) 0 5 ( 0 . 2-1 4 ) 1 1 (0 7 - 1 9 ) 0 19 1 2 (0 6-2 5 ) 0 9 (0 4 2 2 ) 1 1 (0 7 : a ) 0 2 S 1 1 (0 5 - 2 .2 ) 0 5 (0 2 1 4 ) 1 2 (0 a • 2 . Q 1 0 41 1 8 (0 9 ? 5 ) 0 4 (0 1 1 . 2 ) 1 0 (0 6 1 6 ) P , t r e n d 0 06 0 12 0 71 T r a n s f a t t y a c i d s 2 74 1 0 1 0 1 . 0 1 41 1 u 4 0 5 2 0 ) 0 s (0 2 1 4 ) 1 . 7 1 1 1-2 6 ) J 98 0 9 (0 5-1 9 ) 0 B (0 3 1 9 ) 1 0 ! 0 6 1 6 \ 4 58 1 1 (0 5 2 2 ) 0 5 (0 2-1 4 :• 1 2 (0 8 2 0 ) S 42 1 3 (0 6 2 6 ) 0 5 t 0 2 1 4 ) 1 2 (0 7 1 9 ) P , t r e n d 0 47 0 I B 0 94 i ) s t i; i . y * i * i i i n f i i i a r i c * i n l « i v i l i M l a r i i a i i i n H l o l v < ■ 1 c f U l III 1 l i n ( i | j ■ 1 • ! 1 f *1 l « t f c * n 1 911 f l * * • t li 1 a * * « a i - n ' ■ • ' f a r " f r h u «■■ J u i i * r * i ■ a U 1 I [ r . 1 1 i f z , i i , | j 1 i . . - i ^ i » | l > . m a I S I . I a 1 ■ 1 4 l i * w a | * 1 - 1 ] , j * t * - 1 | 1 . | j * t 1 1 j r ■ r n l Ma a a l 1 4 1 1 c * | a q a * 1 ■ a n a i i h a 1 4 * a l a m i - f j a u B * t u l e u i , l t ^ . i l l l l l l f l i1l > 4* * » . I I m l ■ • i q h t 4 1 « * • > « ! ■ * I t a • a l l , 1* .1.a t a h * l n t t l n r < F v * * * a ' | | 1 + i a \ i l w i t I f | « K > !*! ‘ r - n i l V w a i n * # l u t i t a i n l a t * t i a a a i i i.ii l i l ' l * : ' M > q i i i i t T * * t 19 Table 4. Odds ratios and 951 confidence Intervals for breast cancer based on the levels of individual fatty acids in the subcutaneous adipose tissue among postmenopausal women in the greater Boston Area, 1986-1980 in«95J) Fatty acid Quint H e Groups' Saturated 12 . 0 14 : 0 1 5 0 16. o 17 : 0 18 0 2 0 . C l 2 2 I I Me m u u n s e t u t a t *»ii 16, i n ! n s 16 In 7 nans 18 l n 7 tts 16 1n 9 c i s 20 In 9 P o l y u n s a t u r a t e d 18 2n-6 ciB.cis I B 2 n - 6 t j « r j s , t t * n s 18 2 n 6 c j s , t u n s 18 2 n - 6 11 ariB, c is I B i n i 18 I n 6 20 2 n 6 20 in b 20 4 n 6 2U: 6 n 1 22 4n 6 22 6n ) l 0’ 1 0 1 0 1 o 1 0 1 . 0 1 0 1 I ! 1 4 t 0 9 2 01 1 1 10 8 -2 . 1 } 0 9 1 0 6 1 . 6 ) 1 1 (0 7 - 1 . 8 ) 1 0 1 0 6 1 6 1 1 0 ( 0 6 1 6 1 C l 6 1 0 4 1 U 1 1 (tia i n (0 9 2 0 ) I 0 6-1 0 0 0 5 1 o a (0 5-1 0 9 t o 6 1 0 7 (0 4 1 0 7 (I) 4 1 (0 0 9 ( 0 5 1 4 ) 0 . 9 {0 5 1 4 1 0 . 6 ( 0 .4-1 0 ) 0 7 ( 0 4 1 21 0 b 10 4 1 0 ) 1 2 0 8b (0 7 1.9) 0 8 0 5 1 (0 5 1 4 1 0 6 0 51 (0 6- 1 41 1 1 0 58 (0 6 •1 7) 1 u 07 5 {tl b 1 7 J 1 i [J H ( o a 2 i ) I 0 < (! a u h l 4 1 (0 1 1 7 1 H ) 10 0 4 r 1 1 } i 0 1 LI fa 1 7 1 " ! 1 0 (0 0 7 6 1 2 ) (0 0 7 4 1 1 1 i 0 0 4 ; 1 1 ) (o fa 6 ) 0 6 1 1) fa L 1 o (0 0 9 6 ] 5 1 1 0 1 2 . a 2 01 i t) 1 6 0 i 6] (0 Cl 8 6 1 3 1 11 6 8 1 0 t 0 1 I . 7 1 81 (0 1 2 7 1 9) (0 1 6 0 1 7 1 i 0 1 2 7 1 9) 0 fa ? 1 tl tQ 1 0 7 1 71 (0 1 4 8 2 2 I (0 1 6 . 0 1 6 1 to 1 2 7 1 9 I (J fa Cl 1 0 (0 . 1 . 1 7 1 7) (0 1 I 7 1 8) 10 1 8 2 2 01 to U 4 b 1 . 5} 0 9b 1 . o (0 1 1 7 1 6) to 1 4 9 • 2 21 to. 1 a 2 -2 o> (0 1 . 0 b i 75 0 7 9 1 0 C 0 1 1 7 1 9) 10 1 .0 6 1 7 J ( 0 . i 7 1 1 81 (0 I o fa 1 7 | 0 96 1 0 (0 1 1 7 1 8) 10 1 1 6 2 1) (0 1 9 4 2 . 1) 10 1 2 7 1 91 0 j 3 1 0 (0 1 1 7 i 8] to 0 . 9 6 1 61 (0 1 6 0 1 71 1 0 0 9 6 1 6) tl 69 1 . 0 to 0 8 6 • 1 (0 0 7 4 1 2 > to 0 b 9 1 5 1 to 1 4 9 2 0 lb 1 D to 0 B 5 1 2) (0 1 1 7 1 81 (0 i a 4 2 2 i (0 1 o 7 1 71 0 2 1 1 0 (0 1 0 6 1 6) to L 4 0 2 2 1 (0 l 9 6 2 4 ) to 1 ) 7 1 7 ) fa 38 1 (J to 0 6 5 1 2 ) (0 LJ 9 6 1 5) 10 1 fa 0 1 fa 1 (0 1 !> 6 1 fa 1 fa I. fa 1 0 (0 . 0 8 6 1 1) to 0 8 5- 1 1) to 0 fa 9 1 5) to 0 7 4 1 1 1 fa 2 2 1 0 (0 1 4 9-2 . 2] to 1 2 a -1 7 1 0 1 7 1 0 (0 1 . 0 6 1 .5) ( 0 i i 8-2 .1) (a 1 7- 2 1 9) (0 1 1 6-1 7 J u .59 9icii*p « « i a u**,1 ot h«i |pa* i ifti I |«« **(• «.*■• r XI f i l l y I t, iH i 1J 0 it n anrl Ji 4l, I ,1u+ 1 ,> l a n j * |, 1 1 1, n |t4 * n ^ t I n t i i v i l i I* v i l i i t i i#n-1 • haa*-i M a id 'a 1 Th* I<,«••*i 'n iln i I I * va a ua«,| a * th a aa lh a i « ( * i a i i t <ri> pu|' r * i * n . a ^aijui1 iLit,)*ci§ ■ • • u l t a n < a a . l l u a t a l (, y i r t i ii> npi ik] 11 * t a t 1 v* ban nth b i a a a l <ii* aaa* an,I i h „ n *h,,a* «K>, 11,1 i ,| 1 ha f 'll n wl iij i uii (ciynJa ■ a a?a ■( iithc, I iiitaka, a<|* at I n a l l,till,. |j i t ■ ■ a h l i i i > i r ,:■ ( b*iil*ri h i a a a l H l i « i * « . iJui w a l ^ h ' a t * > ■ 20 Table 5. Medians, twentieth m-953) and eightieth percentile* from dietary intake of selected nutrients among postmenopausal women it the greater Boston Area, 1906-1906 Category of breast pathology Daily Dietary Intake (9 of fatty acid) Non-proliferative or no biopsy (n-342) Proliferative benign breast disease without atypia in-llS; Atypical hyperplasia ;n-4". Breast Cancer (n-314' Saturated 20 30 (14.73-29.59) 22 29 .15 . ''4-3C 71. 21 . 06 15 36-29 19 21.16 1.14 01-312 5 Monounaaturated 2 C 16 i14 45-29 79) 23 26 -.16.20-31 15: 20 64 ' 14 S 3 - 2 e :> 21.25 115.01-3C 66: Polyunsaturated 11. 81 >9 OS -16.91i 13 :: 9 SC-17 3« r u 6i ■- 65-14 :: 12.03 '7.94-16 13 j Long-chain N-3 0 19 {0.09*0.37) : 23 C ,12-C 3 6' C 21 !0 11-: 34 0.10 I c . oe - C 35, Total trana 3 10 <1 93-4.60) 3 .40 2 14-5 15: 3 22 2 20-3 5: 3 24 (2.27-4.9i: Total 52 51 (36 62-76.43) 50.57 '42.92-70 5 B 1 55 IS '39.66-69 £5 55.30 137.99-77 OS: T hi« * r « « t 4 i u * u i - m < ic t s * » r* 1--.6, fcJ.4 f t t : » r . ' . . , « i * * p * r i - t « . 21 Table 6 Cs Ions - *d) ust ed odds ratios Cor proliferativm benign breast disease without atypia, for atypical hyperplasia, and Cor breast cancer by quintlle of dietary intake oC Catty acids among postmenopause 1 women in the greater Boston Area. 1906 L9BB Odds RatioB i9St C l )1 QuintiLe median (g/d) Proliferative benign breaat disease without atypla In-115) A t y p i c a l h y p e r p l a s l a I n - 4 7 ) Breast Cancer In- 114) Saturated fatty acida 1 1 1 1 0 1 0 1 0 16 7 0 9 <0 * 1 91 1 0 10 1 ) 0 ) 1 2 (0 7 -2 0) 20 7 1 . 0 40 5 2 2) 1 4 10 5 4 IV i 6 10 9 2 7) 26 4 1 0 Id 5 2 1) 1 0 10 11 01 1 5 {0 9 2 7) 17 4 1 2 (0 (, 2 4 ) 1 2 (0 4 15) 1 2 1 0 7 1 1 ) J, tiend1 0 6 1 0 7 ) a 2H H o n o u i i B a t u i d t r i t f a t l y j i ' K l a 11 2 I i) 1 1’ i (i 17 I 1 * 0 ) 6) 1 O t f ) 4 1 0! l 6 1 ( 1 U J ! 2 1 2 2 1 [ 1 ( j 4 71 1 \ (0 4 t 7 ) J 5 t C ) 7 2 2b 1 2 I ( 1 1 4 V ) 0 6 ro 2 2 n i 1 5 in 7 2 I . 14 7 2 I ) 4 0 ' J 4 4 1 1 ( J ^ t i 1 \ l ) 1 i , <0 ' * 2 ! P, t t end 0 0 6 [ 1 69 0 1 S P o l y u n s a t u r a t e d f a t t y a c i d s 6 6 9 6 1 0 1 5 (0 7 J L 1 l n 0 8 (0 ! 2 i) 1 0 1 0 i c > 6 7 I 12 1 L 2 ( 0 6 2 6) 1 6 4 r ) 5 4 1 1 L L (i) 6 B} 14 7 1 2 10 6 2 b) 1 2 (0.4 i i 1 i a to 6 7) 20 1 ] 6 (0 7 0) 0 4 (0 V 1 6 ) 1 o to 6 7) P trend 0 58 ( } 56 0 97 Longrhain K - I f a t t y acids 0 06 1 0 i 0 1 0 0 1) 1 i (0 6 2 7) l 0 10 1-1 2) n 7 10 4 1 2) 0 21 o a (0 1 1 7) 0 a tO 2 2 6! 0 9 to 6 1 6 > 0 10 1 7 to a -1 5) i 0 (0 ) 1 1 1 o 6 to 4 1 D) 0 51 L 1 to 6 2 ai i 4 to 5 -4 11 l 0 (0 6 1 7) t rend 0 29 n 56 1 3 82 TiAnit f a t t y a c i d s 1 6 ) o 1 0 1 0 2 4 i a 10 a \ 1 1 1 B 10 6 4 B) 1 6 to 9 2 7 ) ) 2 l 2 to 6 2 6 I o a (0 1 2 6 1 1 S 1 0 9 2 6 1 4 1 2 2 11 0 4 5) 1 2 to 4 1 4) 1 6 to 9 2 6 1 S 9 1 a 10 a ) 9) 0 6 to 2 2 2 ) 1 6 to 9 2 7 k P. t rend 0 11 0 42 0 11 T o t a l f a t 1 L a 44 a 1 0 j a 1 U .4 1 8 j I 0 g 7 to 1 2 n> t 0 1 1 ((J 7 ] 1 64 a 0 6 to 6 2 5) 1 6 to 6 4 6) L 9 ( 1 t ) 2 1 6b 4 1 2 to 6 ■2 )) 0 6 to 2 i £•: I 2 (0 7 2 0) 90 1 1 2 (0 6 2 6) 0 6 (0 2 I B ) I 6 \ 0 9 2 6 1 P. t r e n d 0 40 Q 29 0 2) ilul . f t h - *4 1 » u h ] a r ) < f ( • «a — h'l— ( * l - - p l i * E * all'1 f a ‘ l " t ifil a * t I ‘■■III* L ■ • — ■ ■ a ' i I • -I * i1 fllirrl f i •vjil-di. f i|u— <l l n hiii j i • — i * n h l y * v* | j j « <m * 1* t u b j a i t # 1M • t • * M i . i p r i f l a h i * l n t i i » l iiilrl- o ' U f a i a I n i irw * •* > i ng i}u k ni I I *# I a I aM v- i n | h* 1 ■** * l <|u i lit 11* W>«k*u w i t h hutip t u l I I t i t l I • • b - n l f n t>i**pi ill* * * * * on liUifiay in -h«' -■■■ ni.i t u i t> ii^*y — t* u*-.l *m I h i i i i f i l i o l g r o u p f o r a l l t ■■**•* I I ■'•»* O dd - — —r* ■ It'i a g « . ■ Icu h'tl i n t a l * . ■! I I i - t hi 11 fi . p « i l t y , l a n k l y f ik tU -iy i't b i - # - t r * r u * i . »i|« a t M n * i < h i , »q« ml M in>p*u»a yi j . j h i * ' ni ( nl ki—hiifn (>■***( d | #— * —. and - a t grit a> % y— a t * l> a |n j* <>n - r m l y & Howell information Company 300 Nortn Zeeb Road Ann Arbor. M l 48106-1346 USA 313/761-4700 800/521-0600 UMI Number: 1376526 UMI Microform 1376525 Copyright 1995, by UMI Coapany. All rights reserved. This aicrofora edition is protected against unauthorized copying under Title 17, United States Code. UMI 300 North ieeb Road Ann Arbor, MI 48103

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Asset Metadata

Creator Tomita, Akiko (author)

Core Title The relationship between fatty acid composition of subcutaneous adipose tissue and the risk of proliferateive benign breast disease and breast cancer

School Graduate School

Degree Master of Science

Degree Program Biometry

Degree Conferral Date 1995-05

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag health sciences, obstetrics and gynecology,OAI-PMH Harvest

Language English

Contributor Digitized by ProQuest (provenance)

Advisor Mack, Wendy (committee chair), Azen, Stanley P. (committee member), London, Stephanie J. (committee member)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c18-5808

Unique identifier UC11357962

Identifier 1376526.pdf (filename),usctheses-c18-5808 (legacy record id)

Legacy Identifier 1376526-0.pdf

Dmrecord 5808

Document Type Thesis

Rights Tomita, Akiko

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus, Los Angeles, California 90089, USA