Associação do padrão alimentar ocidental e o câncer de mama, no norte do Estado do Ceará: estudo caso controle

Abstract

Breast cancer remains one of the major public health challenges in Brazil, particularly in the North and Northeast regions, where persistent inequalities in access to diagnosis, delays in treatment, and dietary patterns influenced by the increased consumption of ultra- processed foods contribute to a greater disease burden. This context highlights the importance of examining the role of diet in the occurrence of breast cancer, given that Western dietary patterns, characterized by high intake of sugars, saturated fats, and industrialized products, have been associated with a higher risk of mammary neoplasms, although national literature still presents gaps regarding populations from the Northeastern countryside. This study aimed to analyze the association between diet quality, assessed through the Adapted Healthy Eating Index (IASad), and the occurrence of breast cancer in women receiving care in health services in northern Ceará. It also sought to determine whether adherence to a Western dietary pattern is related to disease risk in this population and to identify reproductive, anthropometric, and clinical factors associated with the outcome. This is an observational case-control study composed of 40 women with a recent diagnosis of breast cancer and 55 women without a history of the disease, matched by age group. Data collection was conducted through face-to-face interviews using a quantitative Food Frequency Questionnaire (FFQ), in addition to sociodemographic, gynecological-obstetric, anthropometric, and clinical information. Dietary intake over the six months preceding diagnosis (or equivalent period for controls) was converted into portions and scored according to the 12 components of the IASad. Associations were analyzed using univariate and multivariate logistic regression, with calculation of Odds Ratio (OR) and 95% confidence intervals. Results showed that most participants, both in the case and control groups, presented diets classified as “needing improvement,” and no IASad category demonstrated a significant association with the outcome. Conversely, reproductive and anthropometric factors were more relevant: nulliparity increased breast cancer risk (OR = 4.32; p = 0.02), while obesity showed an inverse association (OR = 0.26; p = 0.01), a finding consistent with the literature for premenopausal women. In conclusion, for the population studied, reproductive and body composition variables exerted a greater influence on breast cancer risk than diet quality alone. The findings underscore the need for multidimensional prevention strategies that integrate dietary, reproductive, and anthropometric aspects. Larger studies are recommended to explore specific dietary patterns and enhance health promotion strategies within the regional context.