Background: Heterocyclic amines (HCAs) are mutagenic pro-carcinogens formed when meat is cooked using high temperature methods that involve direct heat over an open flame (i.e. pan-fried, grilled or broiled). A number of studies have reported a positive association between flame-broiled (FB) red meat intake and breast cancer (BC) incidence, however data regarding FB chicken and fish are less consistent. Therefore, we examined the associations of FB chicken, meat, and fish with BC incidence in a case-control study among women with a family history of breast or ovarian cancer and/or a BRCA1/2 mutation.
Methods: Cases and controls were identified from the BOSS cohort (N = 1400) at Johns Hopkins, a clinic-based cohort of individuals at high familial risk. Women diagnosed with incident stage 0-III BC within 2 years prior to enrollment (N = 212) were matched 1:1 to cancer-free controls on age and year of enrollment (+/-1 year). Current and past intake of FB chicken, meat, and fish were ascertained at baseline. Data was also collected on BC risk factors (age at menarche, BRCA status, family history, physical activity, hormone therapy, oral contraceptive use) and fruit/vegetable intake. Multivariable conditional logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for the association between overall FB meat intake per day and BC risk, and separately for FB chicken, meat, and fish.
Results: The mean age of cases and controls was 49 years; 55% of controls and 42% of cases were premenopausal and 16% of cases and 14% of controls were positive for a BRCA1/2 mutation. Fifty two percent of cases and 56% of controls ate FB chicken, meat, or fish ≥once/wk. In multivariable analyses, BC risk was significantly elevated among women who consumed FB fish >once/wk (O.R. 2.68, 95% CI 1.24, 5.82) compared to those who ate it <once/wk (p-trend = 0.004), particularly among women with ER+ BC (O.R. 2.07, 95% CI 1.27, 3.43). The association between FB intake and BC was significantly modified by BMI (p-interaction = 0.07). The odds of developing BC among obese women who ate FB fish ≥once/wk was 3.68 (95% CI 1.61, 8.39), and there was no association in women with a BMI<25. Additionally, there was no significant association between FB chicken and meat intake and BC in this study. Analyses are ongoing to assess concentrations of PhIP, MeIQx, and DiMeIQx. Of note, cases and controls reported a similar increase in the intake of FB fish and chicken and a decrease in FB meat consumption over the prior 2 years.
Conclusion: This is the first study to examine FB chicken, meat, and fish consumption, modifiable risk factors, in women with a familial risk of BC. Our findings that FB fish is associated with an increase in BC are consistent with laboratory findings and are particularly important given the high prevalence of frequent FB fish intake (>50%) in our high risk population. Further prospective studies are needed to validate our findings.
Citation Format: Alpana Kaushiva, Betty May, Deborah Armstrong, Jennifer Axilbund, Kala Visvanathan. Association between flame-broiled fish consumption and breast cancer: A case-control study in women with high familial risk. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2544.