benefit of fruits/veges in diet may vary by breast cancer type--er+ vs ER-

[Lani]

and perhaps simiilarly by her2+ vs her2-(?)--as usual, have not found (yet) evidence it has been looked at:

Breast Cancer Res Treat. 2007 Feb 21; [Epub ahead of print]
Intake of fruits, and vegetables in relation to breast cancer risk by hormone receptor status.

Lissowska J,
Gaudet MM,
Brinton LA,
Peplonska B,
Sherman M,
Szeszenia-Dabrowska N,
Zatonski W,
Garcia-Closas M.
Department of Cancer Epidemiology and Prevention, Cancer Center and M. Sklodowska-Curie Institute of Oncology, WK Roentgena 5, 02-781, Warsaw, Poland.
The inconsistent associations between fruit and vegetable intake and breast cancer risk may be due to heterogeneity of associations by estrogen (ER) and progesterone receptor (PR) status of the tumors. We evaluated this hypothesis in a large (2,386 cases and 2,503 controls) population-based case-control study in Poland, conducted between 2000 and 2003. We observed significant associations between reduced overall risk of breast cancer and increasing levels of total fruit intake (odds ratio (OR) for highest versus lowest quartile = 0.76, 95%CI = 0.63-0.91; p-trend = 0.01), but not for total vegetable intake (1.13 (0.93-1.37), p-trend = 0.25), after controlling for age, energy intake and known risk factors for breast cancer. The inverse association with total fruit intake was stronger for risk of ER+ (0.69 (0.54-0.88), p-trend = 0.01) than ER- tumors (0.89 (0.67-1.19), p-trend = 0.57) (p-heterogeneity = 0.02). In conclusion, this study suggests that fruit intake might have differential associations for breast tumor subtypes defined by ER status.
PMID: 17318377 [PubMed - as supplied by publisher]

[janet/FL]

Very interesting, Lani,
We so value your posts.
I hope that complete information on this study will be posted somewhere or come out in the news. Such as type of fruit and how much? And how would they go about controlling such a thing. Give out the fruit? What a bout the vegetable intake they mention?
I would think that they had not even tested for Her2 in 2000 when this study began. If they had tested for other markers, I would hope that they would go back to the computer and run those numbers through.
Now to make sure I don't have this backwards--it is ER+ where the fruit made a difference? And if this is true and I think we did a survey and the majority of Her2ers are ER- then it would hold true for fewer in the Her2+ group anyway. But I guess without knowing the Her2 status it could work differently for this sub group.
And further ramblings. I would think the more fruit one ate, the less overall fat intake one would tend to eat. In that case, I believe, a lower fat diet has been shown to lower the reoccurance or total rate? of breast cancer in ER-, not ER+. Sure would like to know more about that study! And would someone please tell me if my interpretation of that study re: ER status is correct!

[Lani]

Introduction
Fruits and vegetables are common sources of many candidate protective substances, including fiber and antioxidant vitamins (e.g., carotenoids, ascorbic acid, and folate), but associations between fruit and vegetable intake and breast cancer risk have been inconsistent [1–7]. A recent pooled analysis of eight prospective studies that included 7,377 incident cases of invasive breast cancer found a weak overall association between reduced breast cancer risk and high intake of fruits (pooled relative risk (95% CI) = 0.93 (0.86–1.00); p for trend = 0.08), and weaker or no evidence for an inverse association with total vegetable intake (0.96 (0.89–1.04); p for trend = 0.54) [4].

Associations between breast cancer risk and intake of fruits and vegetables may differ by hormone receptor status of the breast tumor. Evidence from the age-incidence curves for estrogen and progesterone receptor (ER and PR) tumors suggest that hormone receptor status may denote tumors with different risk factor profiles. In fact, some of the known breast cancer risk factors have been found to be more strongly associated with hormone receptor positive than negative tumors [8]. However, results for fruit and vegetable intake have been inconsistent. The three case-control studies [9–11] have all found the inverse association between fruit and vegetable intake to be stronger for ER+ than ER? breast tumors. The two prospective studies that have evaluated this question [12, 13] have provided contradictory results. One study involving 3,026 postmenopausal breast cancer cases found an inverse relationship of vegetable intake restricted to breast tumors with low to no expression of estrogen receptors (ER?) [13]. The other study, which involved only 452 breast cancer cases, found no association for intake of fruits or vegetables for ER+ or ER? tumors, but an inverse association for juices and ER? tumors [12]. To further evaluate this question, we examined whether fruit and vegetable intake associations are modified by hormone receptor status in a large population-based, case-control study conducted in Poland.

Methods
Study population
The study population included women participating in a case-control study conducted during 2000–2003 in the two largest cities of Poland (Warsaw and Lód?). The design of this study has been described in detail elsewhere [14]. Briefly, the study included 2,386 women (20–74 years of age) newly diagnosed with invasive (94%) or in situ (6%) breast cancers that were histologically or cytologically confirmed. A total of 2,503 randomly selected population controls frequency-matched to cases by study site (Warsaw, and Lód?) and age in 5-year categories were identified using a study protocol, reviewed and approved by local and NCI Institutional Review Boards. All participants provided written informed consent.

Personal interviews, obtained from 79% of eligible cases and 69% of eligible controls, included a standardized structured questionnaire to obtain information on demographic characteristics and known or suspected risk factors. As part of the questionnaire, a 93-item food frequency questionnaire (FFQ) was administrated by trained interviewers to assess usual dietary and alcohol intake. The FFQ was modified from the Block questionnaire to include Polish-specific foods and dishes [15, 16].

Medical records for cases were obtained and abstracted for diagnostic and treatment procedures and ER and PR status of the tumors. ER and PR status was detected by immunohistochemistry for 90% of cases and by biochemical methods for 10% of cases. Tumor blocks were obtained from hospitals. A single pathologist in the US (M.E.S) performed a microscopic review of tumor slides to provide standardized diagnoses.

A total of 200 (8.4%) cases and 195 (7.8%) controls were excluded from diet/nutrient analyses because they skipped more than 15% of questionnaire items or they reported consuming more than 30 different food items per day. We further excluded 598 cases that did not have ER and PR data available. Thus, a total of 1,588 cases (66.6%) and 2,318 controls (92.6%) remained in the current analyses.

Statistical analysis
Responses regarding intake frequencies of dietary variables were coded as per month, week or day and then converted to grams per day. Intake of individual fruits and vegetables were categorized into six food groups: total fruits and vegetables, total fruits (including juices), total vegetables, yellow vegetables, leafy green vegetables, and cruciferous vegetables (Appendix A details the food groupings). Intake for each food group was obtained by summing the grams per day for individual food items in the group.

Unconditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between breast cancer risk and dietary intakes of fruit and vegetable food groups. All models included the following adjustment variables: age (5-years age-groups), study site (Warsaw or Lodz), years of education, age at menarche, number of full-term births, age at first full-term birth, age at menopause, body mass index (BMI = weight(kg)/height(m)2), family history of breast cancer, prior benign breast biopsy, use of oral contraceptives, and use of hormone replacement therapy (HRT).

[Lani]

they found that the inverse relationship between intake and breast cancer only held in postmenopausal not premenopausal breast cancer patients and only held for fruit intake, not vegatable intake.

It was based on a questionnair, not giving out of food (this is Poland, you know)


Her2 testing was not done, as it was not done in most of continental Europe in 2000 as the only drug(?approved) for her2 at that time was for metastatic patients only--just putting it in a Geographic and historical perspective.

That said, at least someone tried to do a study, no matter how flawed.
Food group

Individual foods

Total fruits & juices

Apples, applesauce; bananas; pears (in season); grapes; oranges, grapefruits, tangerines; plums (in season); peaches, nectarines, apricots (fresh/canned); cherries (in season); strawberries (in season); other berries such as currants, blueberries (in season); tomatoes, tomato juice, tomato sauce, tomato soup; orange juice, grapefruit juice; apple juice; blackcurrant juice; fruit compote; pierogi/pancake w/fruit

Total vegetables

String beans; green peas; dried beans; red beets; spinach (cooked); green salad; coleslaw; cabbage; sauerkraut (raw); cabbage (boiled); sauerkraut (boiled); hunter’s stew; cabbage stew; pierogi/pancake w/cabbage; cauliflower; brussel sprouts; carrots or mixed vegetables containing carrots (cooked); carrots (raw); cucumbers; onion; leek; garlic; pepper; pickled vegetables; vegetable soup; potatoes, potato pancake, french fries, other potatoes

Leafy vegetables

Spinach (cooked); green salad

Yellow vegetables (and fruits)

Peaches, nectarines, apricots (fresh or canned); carrots or mixed vegetables containing carrots (cooked); carrots (raw); tomatoes, tomato soup, tomato sauce; pepper

Cruciferous vegetables

Coleslaw; cabbage; sauerkraut (raw); cabbage (boiled); sauerkraut (boiled); hunter’s stew; cabbage stew; pierogi/pancake w/cabbage; cauliflower; brussel sprouts

[heblaj01]

The slight advantage of fruits over vegetables in some studies may also reflect the fact that fruits are more likely to be consumed raw while vegetables tend to be cooked or harshly processed(& may be less easy to made free of pollutants).
Freezing,boiling,microwaving,cooking at high temperature & especially frying with the wrong fats may impair the nutritive value of veggies.

[Rich66]

Blueberries May Shrink Tumors in Babies

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January 21, 2009 — Substances found in blueberries may inhibit the growth of blood vessel tumors in infants and children, a new study suggests.
Ohio State University researchers say they found that feeding a blueberry extract to mice with blood vessel tumors safely decreased the size of the tumors and improved survival.
The tumors in question are among the most common tumors in infants, according to the report in the journal Antioxidants & Redox Signaling. In infants, the tumors can be disfiguring and in some cases threaten the health of a child.
Mice with blood vessel tumors that were fed the blueberry extract lived twice as long as mice that did not get the substance and had tumors 60% smaller than mice that did not receive blueberry extract treatment, the authors say.
Tumors made from the types of cells in question are found in blood vessels and affect 3% of children, the researchers say. The tumors, they add, usually occur within four weeks of birth and often affect premature infants.
"This work provides the first evidence demonstrating that blueberry extract can limit tumor formation by inhibiting the formation of blood vessels and inhibiting certain signaling pathways," Gayle Gordillo, MD, principal investigator of the Ohio State team, says in a news release. "Oral administration of blueberry extract represents a potential therapeutic strategy for treating endothelial cell tumors in children."
Gordillo says the tumors are similar to a large, blood-filled sponge. Current treatments can suppress the immune system, she says, and cause developmental delays.
Removing the tumors surgically is generally avoided because that process could cause patients to bleed to death, she says. Thus, many families opt to accept deformities caused by the tumors.
"Our hope is that if we feed blueberry juice to a child with this type of tumor, we can intervene and shrink the tumor before it becomes a big problem," she says.
"Our next step is a pilot study with humans to see if we can measure response to the treatment using imaging techniques and the monitoring of chemical changes in the urine."
The findings could have implications in other cancers, including breast, melanoma, ovarian, and head and neck, Gordillo says.

[Rich66]

<table width="100%" align="center" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2">Quercetin shown to help protect against colon cancer by reducing inflammation

</td> </tr> </tbody> </table> <table style="border: 1px solid rgb(204, 204, 204); background-color: rgb(255, 255, 212);" width="100%" align="center" border="0" cellpadding="5" cellspacing="0"><tbody><tr> <td valign="top"> <table align="left" border="0" cellpadding="5" cellspacing="0"> <tbody> <tr> <td>http://www.lef.org/images/homepage/art_whot_032808_mod.jpg</td> </tr></tbody></table> In research published in the January, 2009 issue of the Journal of Nutrition (http://jn.nutrition.org/), scientists at Texas A & M University report their finding of a mechanism for quercetin against the development of colon cancer. Quercetin is a molecule found in plant foods such as onions, apples and peppers which has previously shown a protective effect against the disease.
For their research, Texas AgriLife Research scientist Dr Nancy Turner and her colleagues gave 40 rats diets supplemented with or without quercetin. During the second and fourth weeks of the experiment, the animals were injected with azoxymethane, a carcinogen used to induce colon cancer in rodents, or with saline as a control. Four weeks following the last injection, the rats’ colons were examined.
Animals that received quercetin had fewer high multiplicity aberrant crypt foci, a marker or predictor of tumor formation that had previously been shown to be reduced by quercetin. "Early lesions in a colon are some of the first true changes in the colon that can be observed visually," Dr Turner remarked. "This is not just something you see in our animal model. You see it in human patients as well."
Quercetin was also associated with a reduction in cell proliferation and an increase in apoptosis compared with that observed in animals that received unsupplemented diets. "We were able to decrease the number of cells that were proliferating in the colon,” stated Dr Turner. “And we were able to increase the number of cells that were undergoing apoptosis. So the net effect of that is, we were able to maintain almost a normal number of cells."
The team found a reduction in proinflammatory enzymes known as COX-1 and COX-2 in rats that received quercetin. An increase in COX-1 has been observed prior to the elevation of COX-2 that occurs in colon cancer. The authors concluded that “It is possible the effects on proliferation and apoptosis resulted from the tendency for quercetin to suppress the expression of proinflammatory mediators.”
"COX-2 is an inducible protein that is expressed in the body when there is some kind of external stimulus to a cell,” Dr Turner explained. “We think of high levels of COX-2 as being a bad thing. We did see that both groups – both the control groups and the carcinogen-injected groups that were consuming quercetin in their diets – had lower levels of both COX-1 and COX-2. So that would tend to suggest that there may be opportunity for quercetin to suppress tumor development."
"The nice thing is that albeit high relative to what you see in the American diet, the level used in this study is actually similar to what can be achieved in diets around the world such as in, say, the Mediterranean-style diets," Dr Turner commented. "So it's not an unachievable goal for us good ol' Americans if we do the right thing with our food consumption."


Found a Quercetin supplement endorsed by Lance Armstrong. Makes mention of helping cancer patients with fatigue:
https://secure.frs.com/freetrial/ctrl/how.aspx?cid=0&mid=0&uid=0&jid=0
</td></tr></tbody></table>

[Rich66]

<dl class="AbstractPlusReport"><dt class="head">1: Anticancer Res. (javascript:AL_get(this,%20'jour',%20'Anticancer%2 0Res.');) 2007 Mar-Apr;27(2):937-48.http://www.ncbi.nlm.nih.gov/corehtml/query/egifs/http:--highwire.stanford.edu-icons-externalservices-pubmed-standard-anticanres_full.gif (http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3051&itool=AbstractPlus-def&uid=17465224&db=pubmed&url=http://ar.iiarjournals.org/cgi/pmidlookup?view=long&pmid=17465224) <script language="JavaScript1.2"><!-- var Menu17465224 = [ ["UseLocalConfig", "jsmenu3Config", "", ""], ["Compound (MeSH Keyword)" , "window.top.location='/sites/entrez?Db=pccompound&DbFrom=pubmed&Cmd=Link&LinkName=pubmed_pccompound_mesh&LinkReadableName=Compound%20(MeSH%20Keyword)&IdsFromResult=17465224&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus' ", "", ""], ["Substance (MeSH Keyword)" , "window.top.location='/sites/entrez?Db=pcsubstance&DbFrom=pubmed&Cmd=Link&LinkName=pubmed_pcsubstance_mesh&LinkReadableName=Substance%20(MeSH%20Keyword)&IdsFromResult=17465224&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus' ", "", ""], ["LinkOut", "window.top.location='/sites/entrez?Cmd=ShowLinkOut&Db=pubmed&TermToSearch=17465224&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus' ", "", ""] ] --></script>Links (javascript:PopUpMenu2_Set(Menu17465224);)
</dt><dd class="abstract"> Inhibition of cancer cell proliferation and suppression of TNF-induced activation of NFkappaB by edible berry juice.

<!--AuthorList-->Boivin D (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Boivin%20D%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Blanchette M (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Blanchette%20M%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Barrette S (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Barrette%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Moghrabi A (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Moghrabi%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Béliveau R (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22B%C3%A9liveau%20R%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus).
Laboratoire de Médecine Moléculaire, Hôpital Ste-Justine-UQAM, Centre de Cancérologie Charles-Bruneau, Centre de Recherche de l'Hôpital Sainte-Justine, 3175, Chemin Côte-Sainte-Catherine, Montréal, Québec, Canada.
BACKGROUND: Berries contain several phytochemicals, such as phenolic acids, proanthocyanidins, anthocyanins and other flavonoids. There has been growing interest in a variety of potential chemopreventive activities of edible berries. The potential chemopreventive activity of a variety of small berries cultivated or collected in the province of Québec, Canada were evaluated here. MATERIALS AND METHODS: Strawberry, raspberry, black currant, red currant, white currant, gooseberry, high-bush blueberry, low-bush blueberry, velvet leaf blueberry, serviceberry, blackberry, black chokeberry, sea buckthorn and cranberry were evaluated for antioxidant capacity, anti-proliferative activity, anti-inflammatory activity, induction of apoptosis and cell cycle arrest. RESULTS: The growth of various cancer cell lines, including those of stomach, prostate, intestine and breast, was strongly inhibited by raspberry, black currant, white currant, gooseberry, velvet leaf blueberry, low-bush blueberry, sea buckthorn and cranberry juice, but not (or only slightly) by strawberry, high-bush blueberry, serviceberry, red currant, or blackberry juice. No correlation was found between the anti-proliferative activity of berry juices and their antioxidant capacity (p > 0.05). The inhibition of cancer cell proliferation by berry juices did not involve caspase-dependent apoptosis, but appeared to involve cell-cycle arrest, as evidenced by down-regulation of the expression of cdk4, cdk6, cyclin D1 and cyclin D3. Of the 13 berries tested, juice of 6 significantly inhibited the TNF-induced activation of COX-2 expression and activation of the nuclear transcription factor NFkappaB. CONCLUSION: These results illustrate that berry juices have striking differences in their potential chemopreventive activity and that the inclusion of a variety of berries in the diet might be useful for preventing the development of tumors.
</dd></dl>