To the Editor: A recent pooled analysis of cohort studies by Dr Smith-Warner and colleagues1 found that fruit and vegetable consumption might be not associated with breast cancer risk. However, there remains speculation that consumption of certain subcategories of vegetables, such as brassica vegetables (eg, broccoli, cauliflower, and cabbage), might decrease the risk.2 Among postmenopausal women, brassica vegetable consumption significantly increases the urinary ratio of 2-hydroxyestrone to 16-α-hydroxyestrone,3 which is inversely associated with breast cancer risk. In agreement with previous animal experiments,3 indole-3-carbinol found in brassica vegetables was recently shown to arrest the growth of human breast cancer cells.4 We examined this association in a nationwide population-based case-control study in Sweden, a country with a relatively wide range of brassica vegetable consumption.5
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