| ω-3 PUFAs |
|
| Phase II clinical trial (n = 25 breast cancer patients, 31 months follow-up) |
|
| 1.8 g DHA/day anthracycline |
|
| Improvement of chemo-therapy outcome: median TTP = 6 months (95% CI, 2.8–8.7 months); median OS = 22 months (95% CI, 17–33 months) |
| No severe adverse side effects (grade 3 or 4 toxicity only for neutropenia and alopecia, 80%) |
|
[99]
|
[64]
|
| Pilot study (n = 38 postmenopausal breast cancer patients) |
|
| 4 g/day EPA + DHA for 3 months AI therapy |
|
| Inhibition of bone resorption in the fish oil responders vs. placebo (p < 0.05) |
|
[100]
|
[65]
|
| Controlled clinical trial (n = 249 postmenopausal breast cancer patients) |
|
| 3.3 g/day ω3 PUFA (560 mg EPA + DHA, 40:20 ratio) 24 weeks AI therapy |
|
| Reduction of arthralgia (4.36 vs. 5.70, p = 0.02) obese BC patients vs. placebo |
|
[101]
|
[66]
|
| Red meat |
|
| Controlled clinical trial (n = 20 breast cancer patients) |
|
| Meta-analysis (13 cohort, 3 case-control, 2 clinical trials) |
|
| RR = 1.06 (95%CI, 0.99–1.14) unprocessed red meat, highest vs. lowest intake |
|
| EPA (0.19 g/day) + DHA (1.04 g/day) paclitaxel |
| RR = 1.09 (95%CI, 1.03–1.16) processed red meat, highest vs. lowest intake |
|
|
| Reduction of paclitaxel-induced peripheral neuropathy incidence (OR = 0.3; 95% CI, 0.10–0.88, p[28] |
|
= 0.029), but not severity (0.95% CI = (−2.06–0.02), | p | = 0.054) EPA + DHA vs. placebo |
|
[102]
|
[67]
|
| Cohort study (262,195 women, 7 years follow-up) Meta-analysis |
|
| Green tea |
|
| HR = 1.21 (95% CI, 1.08–1.35, p = 0.001), >9 g/day processed red meat |
|
| Prospective cohort study (n = 1160 breast cancer patients, 8 years follow-up) | RR = 1.09 (95% CI 1.03–1.15, p = 0.662), >9 g/day processed red meat in post-menopausal women |
| RR = 0.99 (95% CI 0.88–1.10, p = 0.570), >9 g/day processed red meat in pre-menopausal women |
|
|
[29]
|
| Regular consumption of green tea |
|
| Inverse association between regular green tea consumption (≥3 cups/day) and BC recurrence for stage I/II patients (HR = 0.69; 95% CI, 0.47–1.00, p < 0.05) |
|
[103]
|
[68]
|
| Dietary Fat |
|
| Prospective cohort study (n = 472 breast cancer patients, 7 years follow-up) |
| Randomized controlled trial (48,835 post-menopausal women, 8.1 years follow-up) |
|
| HR = 0.91 (95% CI, 0.83–1.01, NS) intervention group vs. control group |
|
| Regular consumption of green tea |
|
| Inverse association between regular green tea consumption (≥5 cups/day) and BC recurrence for stage I/II patients (RR = 0.564; 95% CI, 0.350–0.911, p < 0.05) |
|
[30]
|
| [ | 104 | ]
|
[69]
|
| Meta-analysis (cohort + case-control studies) |
|
| Prospective cohort study (n = 5042, 9.1 years follow-up) |
|
| RR = 1.091 (95% CI, 1.001–1.184) cohort PUFA |
| RR = 1.042 (95%CI, 1.013–1.073) case-control total fat |
| RR = 1.22 (95% CI, 1.08–1.38) case-control PUFA |
|
| Regular consumption of green tea |
|
[31]
|
| Reduced risk of total mortality (HR = 0.57; 95% CI: 0.34–0.93) and recurrence (HR = 0.54; 95% CI: 0.31–0.96) for the first 60-month post-diagnosis period |
|
[105]
|
[70]
|
| Systematic review (18 studies) |
|
| 45–78% increased risk of death with increased intake of |
| Vitamin C |
| trans fats |
|
|
| Controlled clinical trial (n[32] |
|
= 54 post-menopausal breast cancer patients) |
|
| Vitamin C (500 mg) and E (400 mg) +tamoxifen (10 mg twice a day) for 90 days |
|
| Decrease of total cholesterol, TG, VLDL (p < 0.001) and LDL (p < 0.01) vs. tamoxifen alone |
| Increase of HDL ( p < 0.01) vs. tamoxifen alone |
|
[106]
|
[71]
|
| EPIC study (337,327 women, 11.5 years follow-up) |
|
| HR = 1.20 (95% CI, 1.0–1.45, p = 0.05), highest vs. lowest quintile of total fat intake (ER+PR+ BC) |
| HR = 1.2 (95% CI, 1.09–1.52, p = 0.009), highest vs. lowest quintile of saturated fat intake (ER+PR+ BC) |
| HR = 1.29 (95% CI, 1.01–1.64, p = 0.04), highest vs. lowest quintile of saturated fat intake (HER2− BC) |
|
[33]
|
| Controlled clinical trial (n = 40 breast cancer patients) |
|
| Vitamin C (500 mg) and E (400 mg) + 5-fluorouracil (500 mg/m2) + doxorubicin (50 mg/m2) + cyclophosphamide (500 mg/m2) (every 3 weeks for six cycles) |
|
| Increase of SOD, CAT, GST, GPx, GSH (p < 0.01) vs. chemotherapy alone |
| Decrease of MDA, DNA damage ( p < 0.01) vs. chemotherapy alone |
|
[107]
|
[72]
|
| Meta-analysis (6 cohort studies + 3 case-control studies) |
|
|
| Vitamin E |
| RR = 1.29 (95% CI, 1.06–1.56), highest vs. lowest cholesterol intake |
|
| Prospective cohort study (n = 7 breast cancer patients, 30 days follow-up) |
|
[34]
|
| Vitamin E (400 mg) + tamoxifen (20 mg daily) for 30 days |
|
| Vitamin E supplement interferes with the therapeutic effects of tamoxifen (increase expression of biomarkers of estrogen-stimulation (ER, PR, p-ERK in breast biopsies) |
|
[108]
|
[73] |
| Dairy products |
|
| Pooled analysis (8 prospective cohort studies) (351,041 women, 15 years follow-up) |
|
| NS |
|
[35]
|
| Meta-analysis (18 prospective cohort studies, n = 1,063,471) |
|
| RR = 0.91 (95% CI, 0.80–1.02, p = 0.003), milk consumption |
| RR = 0.85 (95% CI, 0.76–0.95, p = 0.01), highest vs. lowest total dairy food |
|
[36]
|
| Meta-analysis (22 cohort + 5 case-control studies) |
|
| RR = 0.90 (95% CI, 0.83–0.98, p = 0.111), highest vs. lowest dairy products |
| RR = 0.91 (95% CI, 0.83–0.99, p = 0.991), yogurt consumption |
| RR = 0.85 (95% CI, 0.75–0.96, p = 0.121), low-fat dairy consumption |
|
[37]
|
|
| Vitamin D |
|
| Prospective cohort study (n = 232 post-menopausal breast cancer patients, 1-year follow-up) |
|
| Calcium (1 g) + vitamin D3 (800 IU/d and additional 16,000 IU, every 2 weeks) + AI therapy for 1 year |
|
| Reduction of AI-associated lumbar spine bone loss: 1.70% (95% CI, 0.4–3.0%; p = 0.005) (women with 25(OH)D serum levels ≥40 ng/ml vs. women with serum levels <30 ng/ml) |
|
[109]
|
[74]
|
| Prospective cohort study (n = 60 post-menopausal breast cancer patients, 16 weeks follow-up) |
|
| 50,000 IU/week + AI therapy for 12 weeks |
|
| Decrease of disability from joint pain (52 vs. 19%; p = 0.026); reduction of fatigue (BFI scores 1.4 vs. 2.9; NS); reduction of menopausal symptoms (MENQOL scores 2.2 vs. 3.2, p = 0.035) (women with 25OHD levels > 66 ng/ml vs. women with levels < 66 ng/ml) |
|
[110]
|
[75]
|
| Carbohydrate, Glycaemic Index |
|
| Meta-analysis (19 prospective studies) |
|
| RR = 1.04 (95% CI, 1.00–1.07, p = 0.19), 10 units/d for glycemic index |
| RR = 1.01 (95% CI, 0.98–1.04, p = 0.07), 50 units/d for glycemic load |
| RR = 1.00 (95% CI, 0.96–1.05, p = 0.01), 50 g/d for carbohydrate intake |
|
[38]
|
| Soy products, isoflavones |
|
| Meta-analysis (14 case-control + 7 cohort studies) |
|
| RR = 0.75 (95% CI, 0.59–0.95, p = 0.023), soyfood intake |
| RR = 0.81 (95% CI, 0.67–0.99), isoflavone intake |
|
[39]
|
| Meta-analysis (1 cohort + 7 case-control studies) |
|
| OR = 0.71 (95% CI, 0.60–0.85, p = 0.023), highest vs. lowest soy intake in Asians |
| OR = 0.88 (95% CI, 0.78–0.98, p = 0.60), moderate vs. lowest soy intake in Asians |
| OR = 1.04 (95% CI, 0.97–1.11, p = 0.42), highest vs. lowest soy isoflavone intake in Western populations |
|
[40]
|
| Meta-analysis (18 prospective studies) |
|