There is little agreement among the numerous studies which have investigated the link between dietary fat components and human breast cancer developement. This may result from the fact that all human studies have necessarily relied upon the subject's memory and self-reporting as well as the accuracy of the U.S. Food Tables. The proposed study intends to investigate the fatty acid composition of adipose tissue of women with breast cancer, and of women at high and average risk for the disease. As an objective index of long-term average dietary fat intake, fatty acid composition of body fat stores is a physiologic intermediate between dietary fats and breast cancer and is clearly the mandatory next-step. Simple, quick, and painless aspiration of fat by 18 gauge needles will be employed on 150 women with breast cancer, 50 women with strictly defined criteria for high risk and 150 women with average risk for breast cancer. Adipose from the breast --both near to, and remote from, the biopsy site -- and adipose from the abdomen will be sampled while the patient is undergoing breast surgery. An extensive food frequency questionnaire will be administered. State-of-the-art capillary gas chromatography will precisely quantify the major fatty acids (with less than 1% coefficient of variation), as well as the 30 or more rare fatty acids, including geometric and positional isomers. Fatty acid composition reflects dietary fat either precisely, as in those fatty acids which cannot be synthesized by the body, or generally, as in those fatty acids which can be synthesized. The study as proposed allows detection of possible differences in the precise fatty acid composition of adipose tissue between women with early breast cancer and those at average and high risk for the disease. The adipose tissue fatty acid analysis will be compared to the fatty acid intake assessed on the dietary recall questionnaire. The breast fat near the malignancy will be compared to the percutaneous aspirate of the opposite quadrant to evaluate site differences, if any, within the breast. In women with and without breast cancer, the subcutaneous abdominal fat will be aspirated, analyzed and compared to breast fat in order to delineate any special role of breast adipose tissue.
