DOI QR코드

DOI QR Code

Benefits and Harms of Phytoestrogen Consumption in Breast Cancer Survivors

  • Alipour, Sadaf (Department of Surgery, Arash Women's Hospital, Tehran University of Medical Sciences) ;
  • Jafari-Adli, Shahrzad (Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular - Cellular Sciences Institute, Tehran University of Medical Sciences) ;
  • Eskandari, Amirhossein (Deputy of Management and Resource Development, Ministry of Health and Medical Education)
  • Published : 2015.04.29

Abstract

Worldwide, breast cancer is the most common malignant neoplasm and the second most common cause of cancer death in women. This malignancy is recognized to be estrogen-dependent and due to this feature, hormone replacement therapy is regarded as potentially dangerous in breast cancer survivors who seek relief of their menopausal symptoms. Whereas hot flashes are detected in nearly half of postmenopausal women with a relatively high frequency and severity, botanic sources of estrogens have been proposed as an alternative treatment. Nevertheless, estrogenic properties of these compounds suggest possibility of stimulating cancer recurrence or worsening prognosis in survivors. As well, effects in improving vasomotor climacteric changes is controversial. Many studies have considered the subject, some focusing on efficacy of phytoestrogens for control of menopausal symptoms, and others discussing effects of these compounds on breast cancer outcome in terms of survival or recurrence. The present article is a concise review of the effects of consumption of phytoestrogens on menopausal symptoms, namely hot flashes, and breast cancer recurrence and mortality in survivors of the disease. Overall, the major part of the current existing literature is in favor of positive effects of phytoestrogens on breast cancer prognosis, but the efficacy on menopausal symptoms is probably minimal at the best.

Keywords

References

  1. Abdulkareem IH, Zurmi IB. (2012). Review of hormonal treatment of breast cancer. Nigerian J Clin Practice, 15, 9-14. https://doi.org/10.4103/1119-3077.94088
  2. Albertazzi P, Pansini F, Bonaccorsi G, et al (1998). The effect of dietary soy supplementation on hot flushes. Obstetrics & Gynecology, 91, 6-11. https://doi.org/10.1016/S0029-7844(97)00597-8
  3. Antoine C, Liebens F, Carly B, Pastijn A, Rozenberg S (2007). Safety of alternative treatments for menopausal symptoms after breast cancer, A qualitative systematic review. Climacteric, 10, 23-26. https://doi.org/10.1080/13697130601176734
  4. Bedell S, Nachtigall M, Naftolin F (2014). The pros and cons of plant estrogens for menopause. J Steroid Biochem Mol Biol., 139, 225-236. https://doi.org/10.1016/j.jsbmb.2012.12.004
  5. Beral V, Banks E, Reeves G, Bull D (2003). Breast cancer and hormone-replacement therapy, The million women study. The Lancet, 362, 1330-1. https://doi.org/10.1016/S0140-6736(03)14595-3
  6. Biglia N, Cozzarella M, Cacciari F, et al (2003). Menopause after breast cancer, A survey on breast cancer survivors. Maturitas, 45, 29-38. https://doi.org/10.1016/S0378-5122(03)00087-2
  7. Boekhout AH, Beijnen JH, Schellens JH (2006). Symptoms and treatment in cancer therapy-induced early menopause. The oncologist, 11, 641-54. https://doi.org/10.1634/theoncologist.11-6-641
  8. Bruno D, Feeney KJ (2006). Management of postmenopausal symptoms in breast cancer survivors. Seminars in oncology, 33, 696-707. https://doi.org/10.1053/j.seminoncol.2006.08.010
  9. Brzezinski A, Adlercreutz H, Shaoul R, et al (1997). Shortterm effects of phytoestrogen-rich diet on postmenopausal women. Menopause, 4, 89-94.
  10. Burke GL, Legault C, Anthony M, Bland, et al (2003). Soy protein and isoflavone effects on vasomotor symptoms in peri-and postmenopausal women, The soy estrogen alternative study. Menopause, 10, 147-53. https://doi.org/10.1097/00042192-200310020-00006
  11. Caan BJ, Natarajan L, Parker B, et al (2011). Soy food consumption and breast cancer prognosis. Cancer Epidemiol Biomarkers Prev, 20, 854-8. https://doi.org/10.1158/1055-9965.EPI-10-1041
  12. Chen W-F, Huang M-H, Tzang C-H, Yang M, Wong M-S (2003). Inhibitory actions of genistein in human breast cancer (mcf-7) cells. Biochim Biophys Acta, 1638, 187-96. https://doi.org/10.1016/S0925-4439(03)00082-6
  13. Col NF, Hirota LK, Orr RK , et al (2001). Hormone replacement therapy after breast cancer, A systematic review and quantitative assessment of risk. J Clin Oncol, 19, 2357-63.
  14. Constantinou AI, White BE, Tonetti D, et al (2005). The soy isoflavone daidzein improves the capacity of tamoxifen to prevent mammary tumours. Eur J Cancer, 41, 647-54. https://doi.org/10.1016/j.ejca.2004.12.005
  15. Davies C, Pan H, Godwin J, et al (2013). Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer, Atlas, a randomised trial. Lancet, 381, 805-16. https://doi.org/10.1016/S0140-6736(12)61963-1
  16. Davis VL, Jayo MJ, Ho A, et al ( 2008). Black cohosh increases metastatic mammary cancer in transgenic mice expressing c-erbb2. Cancer Res, 68, 8377-83. https://doi.org/10.1158/0008-5472.CAN-08-1812
  17. Dorjgochoo T, Gu K, Zheng Y, et al (2011). Soy intake in association with menopausal symptoms during the first 6 and 36 months after breast cancer diagnosis. Breast Cancer Res Treat, 130, 879-89. https://doi.org/10.1007/s10549-010-1096-4
  18. Eden JA.(2012). Phytoestrogens for menopausal symptoms, A review. Maturitas, 72, 157-9. https://doi.org/10.1016/j.maturitas.2012.03.006
  19. Fritz H, Seely D, Flower G, et al (2013). Soy, red clover, and isoflavones and breast cancer, A systematic review. PloS One, 8, 81968. https://doi.org/10.1371/journal.pone.0081968
  20. Gold EB, Flatt SW, Pierce JP, et al (2006). Dietary factors and vasomotor symptoms in breast cancer survivors, The WHEL study. Menopause, 13, 423-33. https://doi.org/10.1097/01.gme.0000185754.85328.44
  21. Guha N, Kwan ML, Quesenberry Jr CP , et al (2009). Soy isoflavones and risk of cancer recurrence in a cohort of breast cancer survivors, The life after cancer epidemiology study. Breast Cancer Res Treat, 118, 395-405. https://doi.org/10.1007/s10549-009-0321-5
  22. Hajirahimkhan A, Dietz BM, Bolton JL (2013). Botanical modulation of menopausal symptoms, Mechanisms of action? Planta Medica, 79, 538-53. https://doi.org/10.1055/s-0032-1328187
  23. Handley AP, Williams M (2015). The efficacy and tolerability of ssri/snris in the treatment of vasomotor symptoms in menopausal women, A systematic review. J Am Assoc Nurse Practitioners, 27, 54-61 https://doi.org/10.1002/2327-6924.12137
  24. Ju YH, Doerge DR, Allred KF, Allred CD, Helferich WG (2002). Dietary genistein negates the inhibitory effect of tamoxifen on growth of estrogen-dependent human breast cancer (mcf-7) cells implanted in athymic mice. Cancer Res, 62, 2474-7.
  25. Kang X, Zhang Q, Wang S, Huang X, Jin S (2010). Effect of soy isoflavones on breast cancer recurrence and death for patients receiving adjuvant endocrine therapy. Canadian Med Association J, 182, 1857-62. https://doi.org/10.1503/cmaj.091298
  26. L'Esperance S, Frenette S, Dionne A, Dionne JY (2013). Pharmacological and non-hormonal treatment of hot flashes in breast cancer survivors, Cepo review and recommendations. Supportive Care Cancer, 21, 1461-74. https://doi.org/10.1007/s00520-013-1732-8
  27. Levis S, Strickman-Stein N, Ganjei-Azar P , et al (2011). Soy isoflavones in the prevention of menopausal bone loss and menopausal symptoms, A randomized, double-blind trial. Arch Int Med, 171, 1363-9. https://doi.org/10.1001/archinternmed.2011.330
  28. Liu B, Edgerton S, Yang X, et al (2005). Low-dose dietary phytoestrogen abrogates tamoxifen-associated mammary tumor prevention. Cancer Res, 65, 879-86.
  29. Loprinzi CL, Barton DL, Rhodes D (2001). Management of hot flashes in breast-cancer survivors. Lancet Oncol, 2, 199-204. https://doi.org/10.1016/S1470-2045(00)00289-8
  30. MacGregor C, Canney P, Patterson G, McDonald R, Paul J (2005). A randomised double-blind controlled trial of oral soy supplements< i> versus placebo for treatment of menopausal symptoms in patients with early breast cancer. Eur J Cancer, 41, 708-14. https://doi.org/10.1016/j.ejca.2005.01.005
  31. Mense SM, Hei TK, Ganju RK, Bhat HK (2008). Phytoestrogens and breast cancer prevention, possible mechanisms of action. Environment Hlth Perspect, 116, 426. https://doi.org/10.1289/ehp.116-a426
  32. Murkies A, Lombard C, Strauss B , et al (1995). Dietary flour supplementation decreases post-menopausal hot flushes, Effect of soy and wheat. Maturitas, 21, 189-95. https://doi.org/10.1016/0378-5122(95)00899-V
  33. Nechuta SJ, Caan BJ, Chen WY, et al (2012). Soy food intake after diagnosis of breast cancer and survival, An in-depth analysis of combined evidence from cohort studies of us and chinese women. Am J Clin Nutr, 96, 123-32. https://doi.org/10.3945/ajcn.112.035972
  34. Nikander E, Kilkkinen A, Metsa-Heikkila M, et al (2003). A randomized placebo-controlled crossover trial with phytoestrogens in treatment of menopause in breast cancer patients. Obstets Gynecol, 101, 1213-20. https://doi.org/10.1016/S0029-7844(03)00232-1
  35. Pinkerton JV, Stovall DW, Kightlinger RS (2009). Advances in the treatment of menopausal symptoms. Women's health (London, England), 5, 361-384; quiz 383-364. https://doi.org/10.2217/whe.09.31
  36. Pitkin J (2012). Alternative and complementary therapies for the menopause. Menopause Int, 18, 20-27.
  37. Pruthi S, Qin R, Terstreip SA, et al (2012). A phase iii, randomized, placebo-controlled, double-blind trial of flaxseed for the treatment of hot flashes, Ncctg n08c7. Menopause, 19, 48. https://doi.org/10.1097/gme.0b013e318223b021
  38. Quella SK, Loprinzi CL, Barton DL, et al (2000). Evaluation of soy phytoestrogens for the treatment of hot flashes in breast cancer survivors, A north central cancer treatment group trial. J Clin Oncol, 18, 1068-74.
  39. Scambia G, Mango D, Signorile PG, et al (2000). Clinical effects of a standardized soy extract in postmenopausal women, A pilot study. Menopause, 7, 105-111. https://doi.org/10.1097/00042192-200007020-00006
  40. Secreto G, Chiechi LM, Amadori A, et al (2004). Soy isoflavones and melatonin for the relief of climacteric symptoms, A multicenter, double-blind, randomized study. Maturitas, 47, 11-20. https://doi.org/10.1016/S0378-5122(03)00219-6
  41. Shu XO, Zheng Y, Cai H, et al (2009). Soy food intake and breast cancer survival. JAMA, 302, 2437-43. https://doi.org/10.1001/jama.2009.1783
  42. St Germain A, Peterson CT, Robinson JG, Alekel DL (2001). Isoflavone-rich or isoflavone-poor soy protein does not reduce menopausal symptoms during 24 weeks of treatment. Menopause, 8, 17-26. https://doi.org/10.1097/00042192-200101000-00005
  43. Taku K, Melby MK, Kronenberg F, Kurzer MS, Messina M (2012). Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity, Systematic review and meta-analysis of randomized controlled trials. Menopause, 19, 776-90. https://doi.org/10.1097/gme.0b013e3182410159
  44. Thomas A, Ismail R, Taylor-Swanson L, et al (2014). Effects of isoflavones and amino acid therapies for hot flashes and co-occurring symptoms during the menopausal transition and early post menopause, A systematic review. Maturitas. 78, 263-76. https://doi.org/10.1016/j.maturitas.2014.05.007
  45. Upmalis DH, Lobo R, Bradley L, et al (2000). Vasomotor symptom relief by soy isoflavone extract tablets in postmenopausal women, A multicenter, double-blind, randomized, placebo-controlled study. Menopause, 7, 236-242. https://doi.org/10.1097/00042192-200007040-00005
  46. Van Patten CL, Olivotto IA, Chambers GK, et al (2002). Effect of soy phytoestrogens on hot flashes in postmenopausal women with breast cancer, A randomized, controlled clinical trial. J Clin Oncol, 20, 1449-1455. https://doi.org/10.1200/JCO.20.6.1449
  47. Washburn S, Burke GL, Morgan T, Anthony M (1999). Effect of soy protein supplementation on serum lipoproteins, blood pressure, and menopausal symptoms in perimenopausal women. Menopause, 6, 7-13.
  48. Weber L, Thacker HL (2014). Paroxetine, A first for selective serotonin reuptake inhibitors - a new use, Approved for vasomotor symptoms in postmenopausal women. Women's Health, 10, 147-54. https://doi.org/10.2217/whe.14.3
  49. Wong VC, Lim CE, Luo X, Wong WS (2009). Current alternative and complementary therapies used in menopause. Gynecological Endocrinol, 25, 166-74. https://doi.org/10.1080/09513590802549866
  50. Wu AH, Pike MC, Williams LD, et al (2007). Tamoxifen, soy, and lifestyle factors in asian american women with breast cancer. J Clin Oncol, 25, 3024-30. https://doi.org/10.1200/JCO.2006.10.5023
  51. Zhang Y-F, Kang H-B, Li B-L, Zhang R-M (2012). Positive effects of soy isoflavone food on survival of breast cancer patients in China. Asian Pac J Cancer Prev, 13, 479-82. https://doi.org/10.7314/APJCP.2012.13.2.479

Cited by

  1. The phytoestrogens daidzein and equol inhibit the drug transporter BCRP/ABCG2 in breast cancer cells: potential chemosensitizing effect pp.1436-6215, 2017, https://doi.org/10.1007/s00394-017-1578-9
  2. Phytoestrogens: The current state of research emphasizing breast pathophysiology vol.32, pp.9, 2018, https://doi.org/10.1002/ptr.6115
  3. Hormonal effects of Chinese Herbs vol.33, pp.2, 2018, https://doi.org/10.1007/s00052-018-0183-1