A Prospective Study of Multivitamin Supplement Use and Risk of Breast Cancer

Ishitani, Ken; Manson, JoAnn E.; Buring, Julie E.; Zhang, Shumin M.

doi:10.1093/aje/kwn027

Cited by 28 publications

(25 citation statements)

References 32 publications

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“…Previous analyses of dietary supplementation with specific dietary micronutrients showed mixed results [3], and recent results from a prospective study do not support an association between dietary multivitamin supplement use and breast cancer risk [43]. In our study, no substantial change of the risk estimates was observed by additional adjustment for supplement use (Supplementary Tables 2, 3).…”

Section: Discussioncontrasting

confidence: 73%

Dietary β-carotene, vitamin C and E intake and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Nagel

Linseisen

Gils

et al. 2009

Breast Cancer Res Treat

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So far, studies on dietary antioxidant intake, including beta-carotene, vitamin C and vitamin E, and breast cancer risk are inconclusive. Thus, we addressed this question in the European Prospective Investigation into Cancer and Nutrition. During a median follow-up time of 8.8 years, 7,502 primary invasive breast cancer cases were identified. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). All analyses were run stratified by menopausal status at recruitment and, additionally, by smoking status, alcohol intake, use of exogenous hormones and use of dietary supplements. In the multivariate analyses, dietary intake of beta-carotene, vitamin C and E was not associated with breast cancer risk in premenopausal [highest vs. lowest quintile: HR, 1.04 (95% CI, 0.85-1.27), 1.12 (0.92-1.36) and 1.11 (0.84-1.46), respectively] and postmenopausal women [0.93 (0.82-1.04), 0.98 (0.87-1.11) and 0.92 (0.77-1.11), respectively]. However, in postmenopausal women using exogenous hormones, high intake of beta-carotene [highest vs. lowest quintile; HR 0.79 (95% CI, 0.66-0.96), P (trend) 0.06] and vitamin C [0.88 (0.72-1.07), P (trend) 0.05] was associated with reduced breast cancer risk. In addition, dietary beta-carotene was associated with a decreased risk in postmenopausal women with high alcohol intake. Overall, dietary intake of beta-carotene, vitamin C and E was not related to breast cancer risk in neither pre- nor postmenopausal women. However, in subgroups of postmenopausal women, a weak protective effect between beta-carotene and vitamin E from food and breast cancer risk cannot be excluded.

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Section: Discussioncontrasting

confidence: 73%

Dietary β-carotene, vitamin C and E intake and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Nagel

Linseisen

Gils

et al. 2009

Breast Cancer Res Treat

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“…Only limited support has been found for the hypothesis that vitamin use is associated with breast cancer [19][20][21][22]. The role of individual nutrients in etiology of BRCA-related breast cancer has not been studied extensively, but researchers have recommended that carriers consider a daily supplement regimen containing agents that may ultimately enhance DNA repair since the BRCA gene is involved in DNA damage repair, among other functions [23].…”

Section: Vitamin Usementioning

confidence: 99%

Health behaviors among Ashkenazi Jewish individuals receiving counseling for BRCA1 and BRCA2 mutations

et al. 2009

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Little of the research involving individuals undergoing testing for BRCA1/2 mutations has examined the effect of genetic counseling and testing on diet, exercise, and vitamin use. This study examined diet, exercise, and vitamin use among 120 Ashkenazi Jewish individuals with a personal and/or family history of breast and/or ovarian cancer who presented for BRCA1/2 genetic counseling and testing. Health behaviors were measured at pre-counseling and 6 months post-results. T-tests or ANOVAs were used to test for association of health behaviors with potential predictors: personal cancer history, anxiety, perceived cancer risk, gene status, and perceived efficacy of health behaviors. Multivariable linear regression analysis found gender (P = .007) and perceived efficacy of a healthy diet (P = .005) to be significantly associated with healthy food consumption; gender (P = .003), education (P = .01), and personal cancer history (P = .02) were significantly associated with unhealthy food consumption; higher age (P < .001) and perceived efficacy (P < .001) were significantly associated with higher vitamin use. Paired t-tests found no significant changes in diet, vitamin use, and exercise as a result of genetic counseling and testing. We conclude that genetic counseling and testing had little impact on health behaviors. Rather, perceived efficacies of certain health behaviors to prevent or delay cancer may be more reliable predictors of those behaviors. Clinicians should assess perceived efficacies of health behaviors in their interventions to improve healthy practices in the BRCA1/2 genetic testing population.

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“…In 1998, the United States and Canada mandated the folic acid fortification of foods. Moreover, supplements are a major source of folic acid, and '50% of US adults take multivitamins (15)(16)(17). In one small study, 78% of postmenopausal women had unmetabolized synthetic folate in their blood (18).…”

Section: Introductionmentioning

confidence: 99%

Folate and one-carbon metabolism nutrients from supplements and diet in relation to breast cancer risk

Maruti

Ulrich

White

2009

The American Journal of Clinical Nutrition

103

114

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Background: Few epidemiologic studies have examined very high intakes of folate and whether consumption of nutrients involved in one-carbon metabolism is associated with breast cancer risk. Objective: We prospectively examined whether the consumption of folate and nutrients involved in one-carbon metabolism (methionine, riboflavin, and vitamins B-6 and B-12) from self-reported intakes of diet (in year before baseline) and supplements (averaged over 10 y before baseline) were associated with the incidence of breast cancer and breast cancer tumor characteristics. Design: Participants were 35,023 postmenopausal women aged 50-76 y in the VITamins And Lifestyle (VITAL) cohort study; breast cancer was diagnosed in 743 of these women between baseline (2000-2002) and 2006. Cox proportional hazards models were used to estimate multivariable-adjusted relative risks (RRs) and 95% CIs. Results: Women consuming !1272 dietary folate equivalents (DFE)/d of total folate (10-y average) had a 22% decrease in breast cancer risk compared with women consuming 345 DFE/d (RR: 0.78; 95% CI: 0.61, 0.99; P for trend ¼ 0.05). A greater benefit was observed for estrogen-receptor (ER) negative than for ER1 breast cancers (RR: 0.38; 95% CI: 0.18, 0.80; P for trend ¼ 0.02; P ¼ 0.02 for the difference between ER2 and ER1). Neither current intakes of folate nor current or long-term intakes of other one-carbon nutrients were significantly associated with breast cancer risk. Multivitamin use attenuated the increased risk of breast cancer associated with alcohol drinking (P for interaction ¼ 0.02). Conclusions: Our study of predominantly supplement users suggests that high intakes of folate averaged over 10 y do not increase breast cancer risk, but may be protective, particularly against ER2 breast cancers.

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A Prospective Study of Multivitamin Supplement Use and Risk of Breast Cancer

Cited by 28 publications

References 32 publications

Dietary β-carotene, vitamin C and E intake and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Dietary β-carotene, vitamin C and E intake and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Health behaviors among Ashkenazi Jewish individuals receiving counseling for BRCA1 and BRCA2 mutations

Folate and one-carbon metabolism nutrients from supplements and diet in relation to breast cancer risk

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