Changes in vitamin and mineral supplement use after breast cancer diagnosis in the Pathways Study: A prospective cohort study

Heather Greenlee, Marilyn L. Kwan, Isaac J. Ergas, Garrett Strizich, Janise M. Roh, Allegra T. Wilson, Marion Lee, Karen J. Sherman, Christine B. Ambrosone, Dawn L. Hershman, Alfred I. Neugut, Lawrence H. Kushi

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Background: Vitamin and mineral supplement use after a breast cancer diagnosis is common and controversial. Dosages used and the timing of initiation and/or discontinuation of supplements have not been clearly described.Methods: We prospectively examined changes in use of 17 vitamin/mineral supplements in the first six months following breast cancer diagnosis among 2,596 members (28% non-white) of Kaiser Permanente Northern California. We used multivariable logistic regression to examine demographic, clinical, and lifestyle predictors of initiation and discontinuation.Results: Most women used vitamin/mineral supplements before (84%) and after (82%) diagnosis, with average doses far in excess of Institute of Medicine reference intakes. Over half (60.2%) reported initiating a vitamin/mineral following diagnosis, 46.3% discontinuing a vitamin/mineral, 65.6% using a vitamin/mineral continuously, and only 7.2% not using any vitamin/mineral supplement before or after diagnosis. The most commonly initiated supplements were calcium (38.2%), vitamin D (32.01%), vitamin B6 (12.3%) and magnesium (11.31%); the most commonly discontinued supplements were multivitamins (17.14%), vitamin C (15.97%) and vitamin E (45.62%). Higher education, higher intake of fruits/vegetables, and receipt of chemotherapy were associated with initiation (p-values <0.05). Younger age and breast-conserving surgery were associated with discontinuation (p-values <0.05).Conclusions: In this large cohort of ethnically diverse breast cancer patients, high numbers of women used vitamin/mineral supplements in the 6 months following breast cancer diagnosis, often at high doses and in combination with other supplements. The immediate period after diagnosis is a critical time for clinicians to counsel women on supplement use.

Original languageEnglish (US)
Article number382
JournalBMC Cancer
Issue number1
StatePublished - May 29 2014
Externally publishedYes


  • Breast cancer
  • Cohort studies
  • Dietary supplements
  • Multivitamins
  • Vitamins

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Genetics
  • Medicine(all)


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