Pre-diagnosis and early post-diagnosis dietary soy isoflavone intake and survival outcomes: A prospective cohort study of early stage breast cancer survivors

Ho, Suzanne C.; Park, Yeon Hee; Goggins, William B.; Kwok, Carol; Cheng, Ashley; Chong, Ka Chun; Lee, Roselle; Cheung, Ka Li

doi:10.1016/j.ctarc.2021.100350

Cited by 7 publications

(6 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only in the analysis of soy isoflavones was there a sufficient number of studies to conduct sensitivity analyses. For recurrence, excluding 1 study at a time, the summary hazard ratios ranged from 0.69 (95% CI = 0.59 to 0.80), when excluding the study by Ho et al ( 44 ), to 0.82 (95% CI = 0.58 to 1.15), when excluding the pooled analysis by Nechuta et al ( 47 ), suggesting that this result was driving the association ( Supplementary Figure 3 , available online).…”

Section: Resultsmentioning

confidence: 98%

“…Concerns that soy could interfere with the activity of tamoxifen, potentially reducing or inhibiting its anticancer effects on breast tissue, are not supported by findings from clinical research, which suggests a benefit for recurrence and mortality in users ( 32 , 34 , 35 , 44 , 47 ) that was confined to postmenopausal women in 1 study ( 34 ). In the current study, results for tamoxifen user and nonuser subgroups were similar for both recurrence and all-cause mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Exposure ascertainment involved a range of food frequency questionnaires, not all of which were specifically validated for the exposure under investigation or included all diet sources and variabilities ( 91 ). Intake was measured at more than 1 time point in only a minority of studies ( 33 , 35 , 36 , 38 , 40 , 44 ).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Phytonutrients and outcomes following breast cancer: a systematic review and meta-analysis of observational studies

van Die,

Bone,

Visvanathan

et al. 2023

JNCI Cancer Spectrum

View full text Add to dashboard Cite

Background Phytonutrient intakes may improve outcomes following breast cancer, but the impact of post-diagnosis introduction vs established pre-diagnostic exposure, and optimum doses, have not been established. Evidence from observational studies for key exposures was evaluated, including dosage and intake timeframes. Methods MEDLINE, EMBASE, CINAHL, Cochrane Library, ClinicalTrials.gov, ISRCTN registry and ICMJE were searched for prospective and retrospective observational studies investigating soybean, lignans, cruciferous/cabbage-family vegetables, green tea, or their phytonutrients, and breast cancer survival outcomes. A random effects model was used to calculate summary hazard ratios (HRs) and 95% confidence intervals. Nonlinear dose-response analyses were conducted using restricted cubic splines. Results Thirty-two articles were included. Soy isoflavones were associated with a 26% reduced risk of recurrence [HR 0.74 (0.60–0.92)], particularly among post-menopausal [HR 0.72 (0.55–0.94)] and estrogen-receptor (ER)+ survivors [HR 0.82 (0.70–0.97), with the greatest risk reduction at 60 mg/day. In mortality outcomes, the reduction was mostly at 20-40 mg/d. Soy protein/products were inversely associated with cancer-specific mortality for ER+ disease [HR 0.75 (0.60–0.92)]. An inverse association was observed for serum/plasma enterolactone, measured pre-diagnosis and early post-diagnosis, with cancer-specific mortality [HR 0.72 (0.58–0.90)], and all-cause mortality [HR 0.69 (0.57–0.83]. No effects were observed for cruciferous vegetables. There was a 44% reduced risk of recurrence with pre-diagnostic green tea for stages I-II breast cancer [HR 0.56 (0.38–0.83)]. Conclusions Soy, enterolactone and green tea demonstrated significant risk reductions in outcomes following breast cancer. Evidence is needed regarding the impact of post-diagnostic introduction or substantial increase of these exposures.

show abstract

Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Phytonutrients and outcomes following breast cancer: a systematic review and meta-analysis of observational studies

van Die,

Bone,

Visvanathan

et al. 2023

JNCI Cancer Spectrum

View full text Add to dashboard Cite

show abstract

“…Specifically, for breast cancer, the effects of soy are thought to be modulated by menopause status, age of consumption and type of breast cancer (Zhao et al, 2019). Recent observational studies have associated higher soybean intake with 64 % less risk of death from breast cancer in women without disease, and 51 % less risk of death after cancer diagnosis, compared to participants with very low or no soybean consumption (Ho et al, 2021). Clinical trials that have assessed the effect of isoflavone supplementation on breast cancer progression have not been able to demonstrate a beneficial effect (Finkeldey et al, 2021).…”

Section: Legumesmentioning

confidence: 99%

Report of the Scientific Committee of the Spanish Agency for Food Safety and Nutrition (AESAN) on sustainable dietary and physical activity recommendations for the Spanish population

García,

Lesmes,

Perales

et al. 2023

EFS4

View full text Add to dashboard Cite

“…Eight studies were included in the analysis of soy and soy isoflavones intake with risk of cancer mortality in cancer patients (i.e., cancer survival) (91)(92)(93)(94)(95)(96)(97). All these studies reported nonsignificant associations.…”

Section: Intake Of Soy Soy Isoflavones and Risk Of Cancer Mortality I...mentioning

confidence: 99%

Intake of Soy, Soy Isoflavones and Soy Protein and Risk of Cancer Incidence and Mortality

Fan

Wang

et al. 2022

Front. Nutr.

View full text Add to dashboard Cite

Background and AimsAssociations between soy intake and risk of cancer have been evaluated in prospective observational studies with inconsistent results. Whether the potential anticancer effects offered by soy were attributed to soy isoflavones and soy protein still needs to be elucidated. This study aimed to comprehensively quantify the association of soy, soy isoflavones and soy protein intake with risk of cancer incidence and cancer mortality by conducting a meta-analysis of all available studies.MethodsPubMed, Embase, Web of Science, and Cochrane Library databases were searched up to 16 September 2021. Prospective cohort studies that examined the effect of soy, soy isoflavones and soy protein on cancer incidence and cancer mortality were identified. Random-effects models were used to pool the multivariable-adjusted relative risks (RRs) and corresponding 95% confidence intervals (CIs). The potential dose-response relations were explored by using generalized least-squares trend estimation.ResultsEighty one prospective cohort studies were included in the meta-analysis. A higher intake of soy was significantly associated with a 10% reduced risk of cancer incidence (RR, 0.90; 95% CI, 0.83–0.96). Each additional 25 g/d soy intake decreased the risk of cancer incidence by 4%. Intake of soy isoflavones was inversely associated with risk of cancer incidence (RR, 0.94; 95% CI, 0.89–0.99), whereas no significant association was observed for soy protein. The risk of cancer incidence was reduced by 4% with each 10 mg/d increment of soy isoflavones intake. Similar inverse associations were also found for soy in relation to site-specific cancers, particularly lung cancer (RR, 0.67; 95%CI, 0.52–0.86) and prostate cancer (RR, 0.88; 95%CI, 0.78–0.99). However, high intake of soy, soy isoflavones and soy protein were not associated with cancer mortality.ConclusionsHigher intake of soy and soy isoflavones were inversely associated with risk of cancer incidence, which suggested that the beneficial role of soy against cancer might be primarily attributed to soy isoflavones. These findings support recommendations to include soy as part of a healthy dietary pattern for the prevention of cancer.

show abstract

Pre-diagnosis and early post-diagnosis dietary soy isoflavone intake and survival outcomes: A prospective cohort study of early stage breast cancer survivors

Cited by 7 publications

References 44 publications

Phytonutrients and outcomes following breast cancer: a systematic review and meta-analysis of observational studies

Phytonutrients and outcomes following breast cancer: a systematic review and meta-analysis of observational studies

Report of the Scientific Committee of the Spanish Agency for Food Safety and Nutrition (AESAN) on sustainable dietary and physical activity recommendations for the Spanish population

Intake of Soy, Soy Isoflavones and Soy Protein and Risk of Cancer Incidence and Mortality

Contact Info

Product

Resources

About