Multivitamin supplement use associated with reduced risk of invasive breast cancer mortality
Tuesday, October 15, 2013. The journal Breast Cancer Research and Treatment published an article this month which reported a lower risk of mortality from invasive breast cancer among patients who used multivitamin/mineral supplements. "Our study offers tentative but intriguing evidence that multivitamin/mineral supplements may help older women who develop invasive breast cancer survive their disease," commented lead author Sylvia Wassertheil-Smoller, PhD, who is a distinguished university professor emerita of epidemiology and population health at Albert Einstein College of Medicine of Yeshiva University.
Dr Wassertheil-Smoller and her associates analyzed data from 7,728 women diagnosed with invasive breast cancer following enrollment in the Women's Health Initiative. The subjects' use of nutritional supplements was ascertained upon enrollment and at the visit closest to the time of diagnosis. The women, who were between the ages of 50 and 79 years at enrollment, were followed for 7.1 years after diagnosis, during which 518 deaths were documented.
Adjusted analysis of the data uncovered a 30% lower risk of dying from invasive breast cancer among women who used multivitamin/mineral supplements in comparison with those who did not report their use. Further adjustment for additional factors failed to significantly modify the association. "Controlling for these other factors strengthens our confidence that the association we observed – between taking multivitamin/mineral supplements and lowering breast-cancer mortality risk among postmenopausal women with invasive breast cancer – is a real one," stated Dr Wassertheil-Smoller. "But further studies are needed to confirm whether there truly is a cause-and-effect relationship here."
Elizabeth M. Poole of Harvard University and her associates analyzed data from 12,019 breast cancer survivors enrolled in one of four studies included in the After Breast Cancer Pooling Project. The analysis examined the use of supplements at least one year after diagnosis. Over follow-up, 1,298 deaths occurred, of which 65 percent were due to breast cancer.
Sixty percent of the women reported using supplements from one to five years following diagnosis. The use of any antioxidant supplement, categorized as vitamins C, E or a multivitamin supplement in this study, was associated with a 16% lower adjusted risk of dying from any cause over follow-up, and for those who used all three supplements, the risk was 21% lower. Supplementation with vitamin C was associated with a 19% lower risk of death and a 10% reduction in the risk of breast cancer occurrence, and for vitamin E, the risk of dying of any cause was lowered by 15% and of recurrence by 12%, however; these associations were reduced after adjustment for other antioxidant use. The risk of recurrence was 36% lower in association with the use of vitamin D among women with estrogen receptor-positive tumors.
"In this large consortium of breast cancer survivors, post-treatment use of vitamin supplements was not associated with increased risk of recurrence or death," the authors write. "Post-treatment use of antioxidant supplements was associated with improved survival, but the associations with individual supplements were difficult to determine."
"Future studies should take dose and duration into account, and specifically evaluate the associations with supplement use during active treatment," they conclude.
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