Studies have shown inconsistent results regarding the association between dietary factors across the lifespan and breast density and breast cancer in women. Breast density is a strong risk factor for breast cancer, and the mechanism through which it influences cancer risk remains unclear. Breast density has been shown to be modifiable, potentially through dietary modifications. The goal of this paper is to summarize the current studies on diet and diet-related factors across all ages, determine which dietary factors show the strongest association with breast density, the most critical age of exposure, and identify future directions. We identified 28 studies, many of which are cross-sectional, and found that the strongest associations are among vitamin D, calcium, dietary fat, and alcohol in premenopausal women. Longitudinal studies with repeated dietary measures as well as the examination of overall diet over time are needed to confirm these findings. 1. Introduction Breast cancer (BC) is the most commonly diagnosed cancer and the second leading cause of cancer death among women [1]. Alcohol consumption, physical activity, elevated after menopausal body mass index (BMI) [2], age at menarche and menopause [3], and family history and genetic mutations [4] are a few of the well-established BC risk factors. In addition, breast density (BD), or the amount of dense fibroglandular tissue present in the breast, has been related to BC risk; women who have breast densities of 75% or more have up to a 4-5-fold increase in BC risk [5]. Consequently, BD is often thought of as an intermediate on the BC development continuum that can be measured, assessed, and targeted for potential cancer prevention strategies [5–8]. Even so, little is known about the mechanism through which BD may affect breast cancer risk [9]. Breast tissue develops mostly during puberty and continues to undergo changes throughout several life stage events, such as pregnancy [3, 10, 11]. This paper will examine research on diet and diet-related factors captured across the lifespan and the association with adult BD. 2. Methods A literature search of the PubMed database of the United States National Library of Medicine was conducted to find human studies that evaluated the associations between BD measures and diet isn the form of either single nutrients or whole dietary patterns. Both observational and diet intervention studies conducted at any stage of the lifespan were considered. Observational studies were included if they had recorded individual’s dietary intake of foods or energy with dietary
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