The association between breast cancer and consumption of dairy products: a systematic review

Figures & data

Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (The PRISMA) flowchart.

Table 1. Study characteristics, exposure levels, ORs, HR, RR (95% CI), and results of published studies on dairy products intake in relation to breast cancer risk.

No.	Study title	Author’s name, and year of publication	Country	Study design	Sample size	Dairy product type	Exposure levels	ORs, HR, RR (95% CI)	Results
1.	Dairy Consumption and Incidence of Breast Cancer in the ‘Seguimiento Universidad de Navarra’ (SUN) Project [15]	Aguilera-Buenosvinos et al. (2021)	Spain	Prospective	10,930 women follow-up period of 12.1 years. confirmed 119 incident BC cases	-Total dairy	3–4 servings per day	0.49 (0.29–0.84)	Females in the 2nd and 3rd quartiles of whole dairy intake showed a significant inversely proportional relationship.
						-Whole-fat dairy	1.6 servings per day	1.09 (0.63–1.87)	They observed no associations between BC and whole-fat dairy consumption.
						-Low-fat dairy	1.7 servings per day	0.55 (0.32–0.92)	Compared with women in the low-fat dairy consumption category, women with moderate intake had significantly higher total BC.
2.	Dairy, soy, and risk of BC: those confounded milk [9]	Fraser et al. (2020)	USA	Prospective	52,795 women follow-up period of 7.9 years confirmed 1057 new BC women	-Milk	0.63 kcal/g	1.50 (1.22–1.84)	Higher dairy milk consumption was related. No relationships were found with cheese or yogurt.
						-Cheese	3.2–3.9 kcal/g	0.89 (0.69–1.14)
						-Yogurt	0.6–0.9 kcal/g	0.98 (0.82–1.17)
3.	Milk Consumption Decreases Risk for Breast Cancer in Korean Women under 50 years of Age: Results from the Health Examinees Study [16]	Shin et al. (2019)	Korea	Prospective	78,320 participant follow-up period of 6.3 years confirmed 359 BC	-Milk	≥1 serving/day	0.58 (0.35, 0.97)	In women under the age of 50, increased milk intake was related with a decreased incidence of BC (p = .0195). This interaction, however, was not statistically significant. In either age group, we found no link between BC risk and yogurt or cheese consumption.
						-Cheese	≥2 serving /week	1.43 (0.69, 2.96)
						-Yogurt	≥1 serving/day	1.03 (0.61, 1.74)
4.	Effect of dairy products intake on breast cancer risk: A case-control study in Algeria [17]	Maliou et al. (2018)	Algeria	Case control	184 BC cases and 184 controls	-Total dairy	418.97 g/d	1.50 (0.77–2.92)	Each type of dairy product may affect BC risk differently. Milk consumption was related to higher risk; however, total and fresh cheese was linked with reducing the risk of BC development.
						-Milk	254.49 g/d	2.61 (1.32–5.16)
						-Yogurt	84.87 g/d	0.60 (0.31–1.15)
						-Cheese	39.00 g/d	0.38 (0.18–0.78)
5.	Dairy Consumption in Adolescence and Early Adulthood and Risk of Breast Cancer [18]	Farvid et al. (2018)	Boston, USA	Prospective	90,503 premenopausal women follow-up confirmed 3191 cases of invasive BC were identified from 1991 through 2013. Among women with adolescent dietary intake, 1318 cases of invasive BC from 1998 through 2013.	-Total dairy	1 serving/day	1.02 (0.97–1.07)	The consumption of total dairy food in adolescence and adulthood was shown to be unrelated to the overall risk of BC (per serving per day in adolescence.
						-Low-fat dairy	1 serving/day	1.00 (0.94–1.06)
						-High-fat dairy.	1 serving/day	0.97 (0.93–1.02)
6.	Animal foods and postmenopausal breast cancer risk: a prospective cohort study [19]	Marcondes et al. (2018)	Netherlands	Prospective	3209 women follow-up period of 17 years confirmed 199 BC cases.	-Total dairy	420 (SD 229.7) g/d	0·99 (0·65, 1·50)	There was no consistent link established among dairy intake and the risk of development of BC.
						-Cheese	34 (SD 19.8) g/d	1·19 (0·79, 1·78)
						-Milk	305 (SD 212.9) g/d	1·31 (0·87, 2·00)
						-Yogurt	68 (range 1–991.3) g/d	0·97 (0·65, 1·45)
7.	Usual Consumption of Specific Dairy Foods Is Associated with Breast Cancer in the Roswell Park Cancer Institute Data Bank and Biorepository [20]	McCann et al. (2017)	USA	Case-Control	1941 BC cases and 1237 controls	-Total dairy	≥ 42 serving\month	0.85 (0.68–1.06)	Total dairy consumption and yogurt consumption had an inverse relationship with BC, whereas other cheese had a positive relationship. Our findings imply that some dairy foods may influence BC risk.
						-Milk	≥ 28 serving\month	0.96 (0.75–1.24)
						-Yogurt	≥ 14 serving\month	0.61 (0.46–0.82)
						-Cheese	≥ 14 serving\month	1.53 (0.99–2.34)
8.	Breast cancer - Analysis of the selected risk factors [21]	Plagens-Rotman et al. (2017)	Poland	Cross-Sectional	762 women (79 BC cases and 683 healthy women).	-Total dairy products	125 g/day	0.58 (0.30, 1.11)	Women who consumed 125 g of dairy food per day had a lower risk compared to women who did not consume it.
9.	Dietary patterns and breast cancer risk in a prospective Japanese study [22]	Kojima et al. (2016)	Japan	Prospective	23,172 women follow-up period of 16.9 years confirmed 119 incidences of BC	-Total dairy	High	1.32 (0.70–2.49)	Dairy consumption was not associated with an increased risk of BC development.
10.	Dietary Patterns and Risk of Breast Cancer in Women in Guilan Province, Iran [23]	Ahmadnia et al. (2016)	Iran	Case-Control	225 BC cases and 225 controls	-Milk and dairy products	2–3 glass/day	0.6 (0.4–0.9)	Daily intake of two to three cups of milk and milk food, as opposed to more than three glasses of milk products, lowered BC risk by 40%.
11.	Dietary habits contributing to breast cancer risk among Iranian women [24]	Mobarakeh et al. (2014)	Iran	Case-Control	53 BC cases and 40 controls	-Milk	High intake	17.45 (2.19–138.98)	Women who consume full-fat dairy products, including milk and cheese, have a significantly increased the risk of development of BC than women who did not consume.
						-Yogurt		6.8 (2.08–22.17)
						-Cheese		6.88 (1.44–32.77)
12.	Is dairy intake associated to breast cancer? A case-control study of Iranian women [25]	Bahadoran et al. (2014)	Iran	Case-Control	275 women (100 cases and 175 controls).	-Total dairy	> 680 g/d	0.14 (0.04–0.38)	As overall dairy consumption increased, the risk of development of BC decreased (p < .001).
						-Low-fat dairy	> 680 g/d	0.10 (0.03–0.34)	A decreased incidence of BC was also observed when low-fat dairy consumption was increased (p < .001).
						-High-fat dairy	< 224g/d	0.22 (0.07–062)	Reduced the risk of BC was linked to a lesser consumption of high-fat dairy products.
13.	Calorie intake, olive oil consumption, and mammographic density among Spanish women [26]	García-Arenzana et al. (2014)	Spain	Cross-Sectional	3548 women (Premenopausal (n = 811); Postmenopausal (n = 2737)	-Whole milk	> 200 g/d	1.10 (1.00-1.20)	Higher whole milk consumption was linked to a higher mammography density associated with BC risk.
14.	Consumption of dairy and meat in relation to breast cancer risk in the Black Women’s Health Study [27]	Genkinger et al. (2013)	Boston, USA	Prospective	52,062 women follow-up period of 12 years confirmed 1,268 incident BC cases	-Whole milk	≥ 250 g/week	0.96 (0.73–1.26)	Association of BC with whole milk was not statistically significant. Furthermore, there was a moderate not significant inverse association between hard cheese and yogurt consumption and BC risk.
						-Cheese	≥ 75 g/week	0.88 (0.68–1.12)
						-Yogurt	≥ 454 g/week	0.91 (0.71–1.17)
15.	Dairy products, calcium intake, and breast cancer risk: a case-control study in China [28]	Zhang et al. (2011)	China	Case-Control	438 BC cases and 438 controls	-Total dairy	8.15 g/d	0.73 (0.52–1.02)	High consumption of whole milk and low-fat milk products was found to be inversely related to the risk of BC development (based on whole milk and low-fat milk dry weight, respectively).
						-High-fat dairy	5.17 g/d	0.84 (0.60–1.17)
						-Low-fat dairy	2.98 g/d	0.76 (0.56–1.03)
16.	Adolescent diet in relation to breast cancer risk among premenopausal women [29]	Linos et al. (2010)	USA	Prospective	39,268 premenopausal women follow-up period of 7.8 years confirmed 455 incident cases of invasive BC	-Full-fat milk	High intake	1.09 (0.73–1.63)	There was no significant correlation found between total milk or dairy consumption.
						-Total dairy		0.90 (0.64–1.27)
						-High-fat milk		0.95 (0.68–1.35)
17.	Meat, eggs, dairy products, and risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort [30]	Pala et al. (2009)	Denmark, France, Germany, Greece, Italy, Norway, Spain, Sweden, the Netherlands, and the United Kingdom	Prospective	319,826 women follow-up period of 8.8 years confirmed 7119 BC cases	-Whole milk	150 g/d	1.06 (0.97, 1.15)	There was no consistent link established between BC risk and dairy product usage.
						-Cheese	82.1 g/d	0.97 (0.89, 1.06)
18.	Dietary factors and breast cancer risk: a case-control study among a population in Southern France [31]	Bessaoud et al. (2008)	Southern France	Case-Control	437 BC cases and 922 controls	-Total dairy	134.3 and 271.2 g/day	1.57 (1.06–2.32)	Compared to the risk linked with decreased intake (134.3 g/d), the risk of developing BC is associated with higher intake, between 134.3 and 271.2 g/d.

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Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.