Vitamin supplement use during breast cancer treatment and survival: a prospective cohort study.
Cancer Epidemiol Biomarkers Prev. 2010 Dec 21. Epub 2010 Dec 21. PMID: 21177425
1Medicine, Vanderbilt University.
BACKGROUND: Antioxidants may protect normal cells from the oxidative damage that occurs during radiotherapy and certain chemotherapy regimens, however, the same mechanism could protect tumor cells and potentially reduce effectiveness of cancer treatments. We evaluated the association of vitamin supplement use in the first six-months after breast cancer diagnosis and during cancer treatment with total mortality and recurrenceMETHODS: We conducted a population-based prospective cohort study of 4,877 women aged 20-75 years diagnosed with invasive breast cancer in Shanghai, China between March 2002 and April 2006. Women were interviewed approximately six-months after diagnosis and followed-up by in-person interviews and record linkage with the vital statistics registry. RESULTS: During a mean follow-up of 4.1 years, 444 deaths and 532 recurrences occurred. Vitamin use shortly after breast cancer diagnosis was associated with reduced mortality and recurrence risk, adjusted for multiple lifestyle factors, sociodemographics, and known clinical prognostic factors. Women who used antioxidants (vitamin E, vitamin C, multivitamins) had 18% reduced mortality risk (hazard ratio (HR) = 0.82, 95% confidence interval (CI): 0.65-1.02) and 22% reduced recurrence risk (HR = 0.78, 95% CI: 0.63-0.95). The inverse association was found regardless of whether vitamin use was concurrent or non-concurrent with chemotherapy, but was only present among patients who did not receive radiotherapy. CONCLUSIONS: Vitamin supplement use in the first six months after breast cancer diagnosis may be associated with reduced risk of mortality and recurrence. Impact: Our results do not support the current recommendation that breast cancer patients should avoid use of vitamin supplements.