Study: Vegetables reduces the risk of another breast cancer again

Reference

thompson CA, Rock Cl, Thompson Pa, et al. The consumption of vegetables is associated with a lower recurrence of breast cancer in tamoxifen users: a secondary analysis of the Womens Healthy Eating and Living Study. Treatment of breast cancer online published on July 6, 2010.

Design

Secondary analysis from the Women’s Healthy Eating and Living Study (Whhel-Study)

participant

3,080 female breast cancer survivors aged 18–70 years, who were on average 23.5 months after the diagnosis at the time of enrollment. All participants lived in four western states, and the Whel study was carried out between 1995 and 2006. Invasiving breast cancer in stage I, II or III was diagnosed with the participants and the treatment was complete without signs of a disease. The majority of the participants were educated, non -smoking, sedentary Caucasian women.

study parameters

The intervention diet of the Whel study included a daily diet with 5 vegetables (a vegetable portion was defined as any ½-cup of raw or cooked vegetables or 1 cup of raw leafy vegetables, except iceberg salad and white potatoes), 3 fruit, 16 oz. Vegetable juice, 30 g fiber and 20 % energy from fat. The Whhel Study Protocol included a visit to the clinic at the beginning of the course of assessing the starting features. The food intake was then evaluated as part of 24-hour feedback recalls in four previously agreed telephone calls. At the beginning of the study, the participants filled questionnaires on the history of menopause, the use of hormone therapy in menopause, other lifestyle behavior and the occurrence of cancer. The cancer results were assessed on the basis of annual self -filled questionnaires, with 93 % of cancer being confirmed by checking the pathological reports.

In this secondary analysis, a separate subgroup analysis for the effect of the vegetable consumption was carried out on the recurrence in women who took tamoxifen, compared to women who do not take a tamoxifen. In addition, the effect of the intake of cross-flowers on the recurrence rate for tamoxifen users was examined.

most important knowledge

Whel participants reported an average basic recording of 3.1 portions total vegetables and 0.5 portions of cross-flowered vegetables. At the beginning of the study, women in the highest tertil of vegetable intake had a significantly lower risk of a re-occurrence of breast cancer (HR 0.69, 95 %KI: 0.55–0.87). The consumption of cross -flowers did not lead to a statistically significant decline in the risk of a new occurrence at the start of the course. This secondary analysis showed that the risk of a new occurrence in stratification after tamoxifen use in women in the highest tertile of vegetable consumption was even lower compared to non-tamoxifen users (HR 0.56, 95 %AI: 0.41–0.77). p ≤0.001). In addition, a statistically significant reduction in the risk of a new occurrence by consuming cross-flowers in the tamoxifen users was observed (HR 0.65, 95 %-KI: 0.47–0.89, p = 0.006).

effects on practice

This secondary analysis complements the growing number of secondary analyzes of the Whhel study, which illustrate the benefits of the vegetable absorption in partial populations of the participants. Although the Whel study ultimately found no benefit from the consumption of vegetables when reducing the risk of a new occurrence of breast cancer, the following secondary analyzes of different cohorts show a benefit.

In this study, women with the highest reported intake of vegetables had a lower risk of a new occurrence and a lower risk of developing a new primary breast cancer.

In this study, women with the highest reported intake of vegetables at the beginning of the study had a lower risk of a new occurrence and a lower risk of developing a new primary breast cancer. This effect was the most pronounced and strongest in Tamoxifen users who consumed the largest amount of cross-flowers in women who revenue. Essentially, this study suggests that a vegetable intake that is above the average US intake increases the likelihood of disease-free survival in women that take tamoxifen. This beneficial effect is reinforced by consuming cross -flowers.

The postulated mechanisms on which this observed relationship is based is the synergistic role of Indol-3-Carbinol (i3c) in broccoli with tamoxifen in the induction of apoptosis to tamoxifen alone. In addition, diindolylmethane (DIM), a metabolic end product of i3c, influences the metabolism of tamoxifen away from tamoxifen-n-oxide, a relatively inactive metabolite, and to its active metabolites, 4-hydroxy-tamoxifen. Other studies have shown that sulfurophan, another component of broccoli, apoptosis in breast cancer stem cells.

The results of this secondary analysis match with another current study that showed that the consumption of 1 portion of raw broccoli, but not cooked broccoli or vegetables overall, at least once a month the risk of dying from bladder cancer (HR for disease-specific death: 0.43; 95 %-KI: 0.25–0.74) 2 . This effect was attributed to isothiocyanates that are destroyed when broccoli cooked.

The data from this secondary analysis are the latest addition to several studies that show the benefits of consumption of vegetables, especially cross -flowers, to reduce the risk of a new occurrence of cancer. It is remarkable to the benefits of the regular consumption of cross-flowers and in particular broccoli for reducing the risk of renewed breast cancer in tamoxifen users. Tamoxifen has quickly become part of the standard treatment for women with estrogen receptor-positive breast cancer, which represents the majority of breast cancer. Therefore, the inclusion of cross -flowers in the daily diet of these women is important. The amount required for this survival advantage is appropriate for most - a base value of 0.5 portions per day - which makes this strategy an acceptable strategy.

restrictions

This study was restricted by the dependence on self -reported data and thus the possibility of a memory distortion. In addition, the data of this study cannot be transferred to other cohorts. Finally, the conclusions should be checked as a secondary analysis in an independent study.

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