Antioxidant supplement use after breast cancer diagnosis and mortality in the Life after Cancer Epidemiology (LACE) cohort

Heather Greenlee, Marilyn L. Kwan, Lawrence H. Kushi, Jun Song, Adrienne Castillo, Erin Weltzien, Charles P. Quesenberry, Bette J. Caan

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Background: There is concern that antioxidant supplement use during chemotherapy and radiation therapy may decrease treatment effects, yet the effects of such supplements on recurrence and survival are largely unknown. Methods: The authors prospectively examined the associations between antioxidant use after breast cancer (BC) diagnosis and BC outcomes in 2264 women in the Life After Cancer Epidemiology (LACE) cohort. The cohort included women who were diagnosed with early stage, primary BC from 1997 to 2000 who enrolled, on average, 2 years postdiagnosis. Baseline data were collected on antioxidant supplement use since diagnosis and other factors. BC recurrence and mortality were ascertained, and hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using delayed entry Cox proportional hazards models. All tests of statistical significance were 2-sided. Results: Antioxidant supplement use after diagnosis was reported by 81% of women. Among antioxidant users, frequent use of vitamin C and vitamin E was associated with a decreased risk of BC recurrence (vitamin C: HR, 0.73; 95% CI, 0.55-0.97; vitamin E: HR, 0.71; 95% CI, 0.54-0.94); and vitamin E use was associated with a decreased risk of all-cause mortality (HR, 0.76; 95% CI, 0.58-1.00). Conversely, frequent use of combination carotenoids was associated with increased risk of death from BC (HR, 2.07; 95% CI, 1.21-3.56) and all-cause mortality (HR, 1.75; 95% CI, 1.13-2.71). Conclusions: Frequent use of vitamin C and vitamin E in the period after BC diagnosis was associated with a decreased likelihood of recurrence, whereas frequent use of combination carotenoids was associated with increased mortality. The effects of antioxidant supplement use after diagnosis likely differ by type of antioxidant.

Original languageEnglish (US)
Pages (from-to)2048-2058
Number of pages11
JournalCancer
Volume118
Issue number8
DOIs
StatePublished - Apr 15 2012
Externally publishedYes

Fingerprint

Epidemiology
Antioxidants
Breast Neoplasms
Mortality
Confidence Intervals
Vitamin E
Neoplasms
Ascorbic Acid
Recurrence
Carotenoids
Proportional Hazards Models
Radiotherapy
Drug Therapy
Survival

Keywords

  • antioxidants
  • breast cancer
  • dietary supplements
  • epidemiology
  • mortality

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Greenlee, H., Kwan, M. L., Kushi, L. H., Song, J., Castillo, A., Weltzien, E., ... Caan, B. J. (2012). Antioxidant supplement use after breast cancer diagnosis and mortality in the Life after Cancer Epidemiology (LACE) cohort. Cancer, 118(8), 2048-2058. https://doi.org/10.1002/cncr.26526

Antioxidant supplement use after breast cancer diagnosis and mortality in the Life after Cancer Epidemiology (LACE) cohort. / Greenlee, Heather; Kwan, Marilyn L.; Kushi, Lawrence H.; Song, Jun; Castillo, Adrienne; Weltzien, Erin; Quesenberry, Charles P.; Caan, Bette J.

In: Cancer, Vol. 118, No. 8, 15.04.2012, p. 2048-2058.

Research output: Contribution to journalArticle

Greenlee, H, Kwan, ML, Kushi, LH, Song, J, Castillo, A, Weltzien, E, Quesenberry, CP & Caan, BJ 2012, 'Antioxidant supplement use after breast cancer diagnosis and mortality in the Life after Cancer Epidemiology (LACE) cohort', Cancer, vol. 118, no. 8, pp. 2048-2058. https://doi.org/10.1002/cncr.26526
Greenlee, Heather ; Kwan, Marilyn L. ; Kushi, Lawrence H. ; Song, Jun ; Castillo, Adrienne ; Weltzien, Erin ; Quesenberry, Charles P. ; Caan, Bette J. / Antioxidant supplement use after breast cancer diagnosis and mortality in the Life after Cancer Epidemiology (LACE) cohort. In: Cancer. 2012 ; Vol. 118, No. 8. pp. 2048-2058.
@article{4d7c3e1501e944eea89b9b320a4de1e9,
title = "Antioxidant supplement use after breast cancer diagnosis and mortality in the Life after Cancer Epidemiology (LACE) cohort",
abstract = "Background: There is concern that antioxidant supplement use during chemotherapy and radiation therapy may decrease treatment effects, yet the effects of such supplements on recurrence and survival are largely unknown. Methods: The authors prospectively examined the associations between antioxidant use after breast cancer (BC) diagnosis and BC outcomes in 2264 women in the Life After Cancer Epidemiology (LACE) cohort. The cohort included women who were diagnosed with early stage, primary BC from 1997 to 2000 who enrolled, on average, 2 years postdiagnosis. Baseline data were collected on antioxidant supplement use since diagnosis and other factors. BC recurrence and mortality were ascertained, and hazard ratios (HRs) and 95{\%} confidence intervals (CIs) were estimated using delayed entry Cox proportional hazards models. All tests of statistical significance were 2-sided. Results: Antioxidant supplement use after diagnosis was reported by 81{\%} of women. Among antioxidant users, frequent use of vitamin C and vitamin E was associated with a decreased risk of BC recurrence (vitamin C: HR, 0.73; 95{\%} CI, 0.55-0.97; vitamin E: HR, 0.71; 95{\%} CI, 0.54-0.94); and vitamin E use was associated with a decreased risk of all-cause mortality (HR, 0.76; 95{\%} CI, 0.58-1.00). Conversely, frequent use of combination carotenoids was associated with increased risk of death from BC (HR, 2.07; 95{\%} CI, 1.21-3.56) and all-cause mortality (HR, 1.75; 95{\%} CI, 1.13-2.71). Conclusions: Frequent use of vitamin C and vitamin E in the period after BC diagnosis was associated with a decreased likelihood of recurrence, whereas frequent use of combination carotenoids was associated with increased mortality. The effects of antioxidant supplement use after diagnosis likely differ by type of antioxidant.",
keywords = "antioxidants, breast cancer, dietary supplements, epidemiology, mortality",
author = "Heather Greenlee and Kwan, {Marilyn L.} and Kushi, {Lawrence H.} and Jun Song and Adrienne Castillo and Erin Weltzien and Quesenberry, {Charles P.} and Caan, {Bette J.}",
year = "2012",
month = "4",
day = "15",
doi = "10.1002/cncr.26526",
language = "English (US)",
volume = "118",
pages = "2048--2058",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "8",

}

TY - JOUR

T1 - Antioxidant supplement use after breast cancer diagnosis and mortality in the Life after Cancer Epidemiology (LACE) cohort

AU - Greenlee, Heather

AU - Kwan, Marilyn L.

AU - Kushi, Lawrence H.

AU - Song, Jun

AU - Castillo, Adrienne

AU - Weltzien, Erin

AU - Quesenberry, Charles P.

AU - Caan, Bette J.

PY - 2012/4/15

Y1 - 2012/4/15

N2 - Background: There is concern that antioxidant supplement use during chemotherapy and radiation therapy may decrease treatment effects, yet the effects of such supplements on recurrence and survival are largely unknown. Methods: The authors prospectively examined the associations between antioxidant use after breast cancer (BC) diagnosis and BC outcomes in 2264 women in the Life After Cancer Epidemiology (LACE) cohort. The cohort included women who were diagnosed with early stage, primary BC from 1997 to 2000 who enrolled, on average, 2 years postdiagnosis. Baseline data were collected on antioxidant supplement use since diagnosis and other factors. BC recurrence and mortality were ascertained, and hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using delayed entry Cox proportional hazards models. All tests of statistical significance were 2-sided. Results: Antioxidant supplement use after diagnosis was reported by 81% of women. Among antioxidant users, frequent use of vitamin C and vitamin E was associated with a decreased risk of BC recurrence (vitamin C: HR, 0.73; 95% CI, 0.55-0.97; vitamin E: HR, 0.71; 95% CI, 0.54-0.94); and vitamin E use was associated with a decreased risk of all-cause mortality (HR, 0.76; 95% CI, 0.58-1.00). Conversely, frequent use of combination carotenoids was associated with increased risk of death from BC (HR, 2.07; 95% CI, 1.21-3.56) and all-cause mortality (HR, 1.75; 95% CI, 1.13-2.71). Conclusions: Frequent use of vitamin C and vitamin E in the period after BC diagnosis was associated with a decreased likelihood of recurrence, whereas frequent use of combination carotenoids was associated with increased mortality. The effects of antioxidant supplement use after diagnosis likely differ by type of antioxidant.

AB - Background: There is concern that antioxidant supplement use during chemotherapy and radiation therapy may decrease treatment effects, yet the effects of such supplements on recurrence and survival are largely unknown. Methods: The authors prospectively examined the associations between antioxidant use after breast cancer (BC) diagnosis and BC outcomes in 2264 women in the Life After Cancer Epidemiology (LACE) cohort. The cohort included women who were diagnosed with early stage, primary BC from 1997 to 2000 who enrolled, on average, 2 years postdiagnosis. Baseline data were collected on antioxidant supplement use since diagnosis and other factors. BC recurrence and mortality were ascertained, and hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using delayed entry Cox proportional hazards models. All tests of statistical significance were 2-sided. Results: Antioxidant supplement use after diagnosis was reported by 81% of women. Among antioxidant users, frequent use of vitamin C and vitamin E was associated with a decreased risk of BC recurrence (vitamin C: HR, 0.73; 95% CI, 0.55-0.97; vitamin E: HR, 0.71; 95% CI, 0.54-0.94); and vitamin E use was associated with a decreased risk of all-cause mortality (HR, 0.76; 95% CI, 0.58-1.00). Conversely, frequent use of combination carotenoids was associated with increased risk of death from BC (HR, 2.07; 95% CI, 1.21-3.56) and all-cause mortality (HR, 1.75; 95% CI, 1.13-2.71). Conclusions: Frequent use of vitamin C and vitamin E in the period after BC diagnosis was associated with a decreased likelihood of recurrence, whereas frequent use of combination carotenoids was associated with increased mortality. The effects of antioxidant supplement use after diagnosis likely differ by type of antioxidant.

KW - antioxidants

KW - breast cancer

KW - dietary supplements

KW - epidemiology

KW - mortality

UR - http://www.scopus.com/inward/record.url?scp=84859628264&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859628264&partnerID=8YFLogxK

U2 - 10.1002/cncr.26526

DO - 10.1002/cncr.26526

M3 - Article

C2 - 21953120

AN - SCOPUS:84859628264

VL - 118

SP - 2048

EP - 2058

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 8

ER -