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乳腺癌的组织病理学亚型包括乳腺导管浸润癌和乳腺小叶浸润癌，其风险因素、恶化与疗效有所不同。 2020年3月28日，爱思唯尔旗下《临床乳腺癌》在线发表伊朗沙赫鲁德医科大学、拉夫桑詹医科大学、拉雷斯坦医科大学、克曼沙赫医科大学、挪威奥斯陆大学医院、挪威癌症登记中心的研究报告，对饮食模式与乳腺导管浸润癌和乳腺小叶浸润癌的风险进行了系统回顾和荟萃分析。 该研究对美国国家医学图书馆数据库、美国科学信息研究所数据库、爱思唯尔数据库截至2020年2月发表的西方饮食模式或地中海饮食模式与乳腺导管浸润癌或乳腺小叶浸润癌风险相关研究进行检索。通过随机效应荟萃分析，对西方饮食模式与地中海饮食模式的多因素校正后乳腺导管浸润癌或乳腺小叶浸润癌相对风险和95%置信区间进行比较。 结果，对数据库进行检索后，10项研究符合分析条件，其中饮食与乳腺导管浸润癌研究7项、饮食与乳腺小叶浸润癌研究3项。 地中海饮食摄入量最高与最低相比：
西方饮食摄入量最高与最低相比：
因此，该研究结果表明，地中海饮食可以减少乳腺导管浸润癌和乳腺小叶浸润癌的发病风险，西方饮食可以增加乳腺导管浸润癌和乳腺小叶浸润癌的发病风险，故有必要对饮食模式如何影响乳腺癌常见亚型（包括乳腺导管浸润癌和乳腺小叶浸润癌）的具体机制开展进一步研究。 相关链接 Clin Breast Cancer. 2020 Mar 28. [Epub ahead of print] Dietary Patterns and Risk of Invasive Ductal and Lobular Breast Carcinomas: A Systematic Review and Meta-analysis. Mostafa Dianatinasab, Marjan Rezaian, Elmira HaghighatNezad, Zahra Bagheri-Hosseinabadi, Sasan Amanat, Shahab Rezaeian, Alireza Masoudi, Reza Ghiasvand. Shahroud University of Medical Sciences, Shahroud, Iran; Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Larestan University of Medical Sciences, Larestan, Iran; Kermanshah University of Medical Sciences, Kermanshah, Iran; Oslo University Hospital, Oslo, Norway; Cancer Registry of Norway, Oslo, Norway. AIM: The histopathological subtypes of breast cancer including invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC) differ in terms of risk factors, progression, and response to treatment. METHOD: PubMed/ Medline, Web of Science (ISI), and SCOPUS databases were searched up to February 2020 for published studies on the association between dietary patterns (Western or Mediterranean) and the risk of IDC/ILC of breast. Multivariable adjusted relative risks (RRs) and 95% confidence intervals (CIs) comparing the highest and lowest categories of Western and Mediterranean dietary patterns were combined by using the random-effects meta-analyses. RESULTS: After searching the databases, 10 eligible studies on the association of diet and IDC (seven articles) and ILC (three articles) were included in the analysis. A significantly adverse association was observed between MD and IDC in case-control studies (RR=0.47, 95% CI: 0.39, 0.55, I2=85.1%, P<0.001). However, the association was non-significant in cohort studies (RR=0.98, 95% CI: 0.92, 1.05, I2=88.8%, P=0.003). The pooled analysis also suggested a significant and direct association between the WD and the risk of IDC (RR=1.36, 95% CI: 1.18, 1.53, I2=63.7%, P=0.017). The risk of ILC for the highest compared with the lowest category of MD was highly protective (RR=0.76, 95% CI: 0.64, 0.87, I2=89.2%, P<0.001) and marginally significant association was found between the WD and risk of ILC (RR=1.45, 95% CI: 1.04, 1.86), with no heterogeneity (I2=0.0%, P=0.52). CONCLUSION: This meta-analysis provides supporting evidence for the association between MD decreased risk of IDC and ILC of the breast and the association between a WD and increased risk of IDC and ILC. Further investigations are needed to better understand the etiological mechanisms on how dietary patterns affect patients differently by common breast cancer subtypes including IDC and ILC. KEYWORDS: Western Diet, Mediterranean Diet, Ductal Breast Neoplasm, Lobular Breast Neoplasm, Meta-analysis DOI: 10.1016/j.clbc.2020.03.007
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