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Published in: Breast Cancer Research and Treatment 2/2011

01-01-2011 | Review

Soy isoflavones consumption and risk of breast cancer incidence or recurrence: a meta-analysis of prospective studies

Authors: Jia-Yi Dong, Li-Qiang Qin

Published in: Breast Cancer Research and Treatment | Issue 2/2011

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Abstract

Numbers of epidemiologic studies assessing soy consumption and risk of breast cancer have yielded inconsistent results. We aimed to examine the association between soy isoflavones consumption and risk of breast cancer incidence or recurrence, by conducting a meta-analysis of prospective studies. We searched for all relevant studies with a prospective design indexed in PUBMED through September 1st, 2010. Summary relative risks (RR) were calculated using fixed- or random-effects models. Pre-specified stratified analyses and dose–response analysis were also performed. We identified 4 studies of breast cancer recurrence and 14 studies of breast cancer incidence. Soy isoflavones consumption was inversely associated with risk of breast cancer incidence (RR = 0.89, 95% CI: 0.79–0.99). However, the protective effect of soy was only observed among studies conducted in Asian populations (RR = 0.76, 95% CI: 0.65–0.86) but not in Western populations (RR = 0.97, 95% CI: 0.87–1.06). Soy isoflavones intake was also inversely associated with risk of breast cancer recurrence (RR = 0.84, 95% CI: 0.70–0.99). Stratified analyses suggested that menopausal status may be an important effect modifier in these associations. We failed to identify a dose–response relationship between total isoflavones intake and risk of breast cancer incidence. Our study suggests soy isoflavones intake is associated with a significant reduced risk of breast cancer incidence in Asian populations, but not in Western populations. Further studies are warranted to confirm the finding of an inverse association of soy consumption with risk of breast cancer recurrence.
Literature
1.
go back to reference American Cancer Society (2007) Global cancer facts and figures 2007. American Cancer Society, Atlanta American Cancer Society (2007) Global cancer facts and figures 2007. American Cancer Society, Atlanta
2.
go back to reference American Cancer Society (2009) Breast cancer facts and figures 2009–2010. American Cancer Society, Atlanta American Cancer Society (2009) Breast cancer facts and figures 2009–2010. American Cancer Society, Atlanta
3.
go back to reference Qin LQ, Xu JY, Wang PY, Hoshi K (2006) Soyfood intake in the prevention of breast cancer risk in women: a meta-analysis of observational epidemiological studies. J Nutr Sci Vitaminol (Tokyo) 52(6):428–436CrossRef Qin LQ, Xu JY, Wang PY, Hoshi K (2006) Soyfood intake in the prevention of breast cancer risk in women: a meta-analysis of observational epidemiological studies. J Nutr Sci Vitaminol (Tokyo) 52(6):428–436CrossRef
4.
go back to reference Trock BJ, Hilakivi-Clarke L, Clarke R (2006) Meta-analysis of soy intake and breast cancer risk. J Natl Cancer Inst 98(7):459–471CrossRefPubMed Trock BJ, Hilakivi-Clarke L, Clarke R (2006) Meta-analysis of soy intake and breast cancer risk. J Natl Cancer Inst 98(7):459–471CrossRefPubMed
5.
go back to reference Wu AH, Yu MC, Tseng CC, Pike MC (2008) Epidemiology of soy exposures and breast cancer risk. Br J Cancer 98(1):9–14CrossRefPubMed Wu AH, Yu MC, Tseng CC, Pike MC (2008) Epidemiology of soy exposures and breast cancer risk. Br J Cancer 98(1):9–14CrossRefPubMed
6.
go back to reference Helferich WG, Andrade JE, Hoagland MS (2008) Phytoestrogens and breast cancer: a complex story. Inflammopharmacology 16(5):219–226CrossRefPubMed Helferich WG, Andrade JE, Hoagland MS (2008) Phytoestrogens and breast cancer: a complex story. Inflammopharmacology 16(5):219–226CrossRefPubMed
7.
go back to reference Taylor CK, Levy RM, Elliott JC, Burnett BP (2009) The effect of genistein aglycone on cancer and cancer risk: a review of in vitro, preclinical, and clinical studies. Nutr Rev 67(7):398–415CrossRefPubMed Taylor CK, Levy RM, Elliott JC, Burnett BP (2009) The effect of genistein aglycone on cancer and cancer risk: a review of in vitro, preclinical, and clinical studies. Nutr Rev 67(7):398–415CrossRefPubMed
8.
go back to reference Boyapati SM, Shu XO, Ruan ZX, Dai Q, Cai Q, Gao YT, Zheng W (2005) Soyfood intake and breast cancer survival: a followup of the Shanghai Breast Cancer Study. Breast Cancer Res Treat 92(1):11–17CrossRefPubMed Boyapati SM, Shu XO, Ruan ZX, Dai Q, Cai Q, Gao YT, Zheng W (2005) Soyfood intake and breast cancer survival: a followup of the Shanghai Breast Cancer Study. Breast Cancer Res Treat 92(1):11–17CrossRefPubMed
9.
go back to reference Fink BN, Steck SE, Wolff MS et al (2007) Dietary flavonoid intake and breast cancer survival among women on Long Island. Cancer Epidemiol Biomarkers Prev 16(11):2285–2292CrossRefPubMed Fink BN, Steck SE, Wolff MS et al (2007) Dietary flavonoid intake and breast cancer survival among women on Long Island. Cancer Epidemiol Biomarkers Prev 16(11):2285–2292CrossRefPubMed
10.
go back to reference Guha N, Kwan ML, Quesenberry CP Jr, Weltzien EK, Castillo AL, Caan BJ (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(2):395–405CrossRefPubMed Guha N, Kwan ML, Quesenberry CP Jr, Weltzien EK, Castillo AL, Caan BJ (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(2):395–405CrossRefPubMed
11.
go back to reference Shu XO, Zheng Y, Cai H, Gu K, Chen Z, Zheng W, Lu W (2009) Soy food intake and breast cancer survival. JAMA 302(22):2437–2443CrossRefPubMed Shu XO, Zheng Y, Cai H, Gu K, Chen Z, Zheng W, Lu W (2009) Soy food intake and breast cancer survival. JAMA 302(22):2437–2443CrossRefPubMed
12.
13.
go back to reference Greenland S, Longnecker MP (1992) Methods for trend estimation from summarized dose–response data, with applications to meta-analysis. Am J Epidemiol 135(11):1301–1309PubMed Greenland S, Longnecker MP (1992) Methods for trend estimation from summarized dose–response data, with applications to meta-analysis. Am J Epidemiol 135(11):1301–1309PubMed
14.
go back to reference Berlin JA, Longnecker MP, Greenland S (1993) Meta-analysis of epidemiologic dose–response data. Epidemiology 4(3):218–228CrossRefPubMed Berlin JA, Longnecker MP, Greenland S (1993) Meta-analysis of epidemiologic dose–response data. Epidemiology 4(3):218–228CrossRefPubMed
15.
go back to reference Butler LM, Wu AH, Wang R, Koh WP, Yuan JM, Yu MC (2010) A vegetable-fruit-soy dietary pattern protects against breast cancer among postmenopausal Singapore Chinese women. Am J Clin Nutr 91(4):1013–1019CrossRefPubMed Butler LM, Wu AH, Wang R, Koh WP, Yuan JM, Yu MC (2010) A vegetable-fruit-soy dietary pattern protects against breast cancer among postmenopausal Singapore Chinese women. Am J Clin Nutr 91(4):1013–1019CrossRefPubMed
16.
go back to reference Lee SA, Shu XO, Li H et al (2009) Adolescent and adult soy food intake and breast cancer risk: results from the Shanghai Women’s Health Study. Am J Clin Nutr 89(6):1920–1926CrossRefPubMed Lee SA, Shu XO, Li H et al (2009) Adolescent and adult soy food intake and breast cancer risk: results from the Shanghai Women’s Health Study. Am J Clin Nutr 89(6):1920–1926CrossRefPubMed
17.
go back to reference Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634PubMed Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109):629–634PubMed
18.
go back to reference den Tonkelaar I, Keinan-Boker L, Veer PV, Arts CJ, Adlercreutz H, Thijssen JH, Peeters PH (2001) Urinary phytoestrogens and postmenopausal breast cancer risk. Cancer Epidemiol Biomarkers Prev 10(3):223–228 den Tonkelaar I, Keinan-Boker L, Veer PV, Arts CJ, Adlercreutz H, Thijssen JH, Peeters PH (2001) Urinary phytoestrogens and postmenopausal breast cancer risk. Cancer Epidemiol Biomarkers Prev 10(3):223–228
19.
go back to reference Horn-Ross PL, Hoggatt KJ, West DW et al (2002) Recent diet and breast cancer risk: the California Teachers Study (USA). Cancer Causes Control 13(5):407–415CrossRefPubMed Horn-Ross PL, Hoggatt KJ, West DW et al (2002) Recent diet and breast cancer risk: the California Teachers Study (USA). Cancer Causes Control 13(5):407–415CrossRefPubMed
20.
go back to reference Yamamoto S, Sobue T, Kobayashi M, Sasaki S, Tsugane S (2003) Soy, isoflavones, and breast cancer risk in Japan. J Natl Cancer Inst 95(12):906–913CrossRefPubMed Yamamoto S, Sobue T, Kobayashi M, Sasaki S, Tsugane S (2003) Soy, isoflavones, and breast cancer risk in Japan. J Natl Cancer Inst 95(12):906–913CrossRefPubMed
21.
go back to reference Grace PB, Taylor JI, Low YL et al (2004) Phytoestrogen concentrations in serum and spot urine as biomarkers for dietary phytoestrogen intake and their relation to breast cancer risk in European prospective investigation of cancer and nutrition-norfolk. Cancer Epidemiol Biomarkers Prev 13(5):698–708PubMed Grace PB, Taylor JI, Low YL et al (2004) Phytoestrogen concentrations in serum and spot urine as biomarkers for dietary phytoestrogen intake and their relation to breast cancer risk in European prospective investigation of cancer and nutrition-norfolk. Cancer Epidemiol Biomarkers Prev 13(5):698–708PubMed
22.
go back to reference Keinan-Boker L, van Der Schouw YT, Grobbee DE, Peeters PH (2004) Dietary phytoestrogens and breast cancer risk. Am J Clin Nutr 79(2):282–288PubMed Keinan-Boker L, van Der Schouw YT, Grobbee DE, Peeters PH (2004) Dietary phytoestrogens and breast cancer risk. Am J Clin Nutr 79(2):282–288PubMed
23.
go back to reference Touillaud MS, Thiebaut AC, Niravong M, Boutron-Ruault MC, Clavel-Chapelon F (2006) No association between dietary phytoestrogens and risk of premenopausal breast cancer in a French cohort study. Cancer Epidemiol Biomarkers Prev 15(12):2574–2576CrossRefPubMed Touillaud MS, Thiebaut AC, Niravong M, Boutron-Ruault MC, Clavel-Chapelon F (2006) No association between dietary phytoestrogens and risk of premenopausal breast cancer in a French cohort study. Cancer Epidemiol Biomarkers Prev 15(12):2574–2576CrossRefPubMed
24.
go back to reference Verheus M, van Gils CH, Keinan-Boker L, Grace PB, Bingham SA, Peeters PH (2007) Plasma phytoestrogens and subsequent breast cancer risk. J Clin Oncol 25(6):648–655CrossRefPubMed Verheus M, van Gils CH, Keinan-Boker L, Grace PB, Bingham SA, Peeters PH (2007) Plasma phytoestrogens and subsequent breast cancer risk. J Clin Oncol 25(6):648–655CrossRefPubMed
25.
go back to reference Hedelin M, Lof M, Olsson M, Adlercreutz H, Sandin S, Weiderpass E (2008) Dietary phytoestrogens are not associated with risk of overall breast cancer but diets rich in coumestrol are inversely associated with risk of estrogen receptor and progesterone receptor negative breast tumors in Swedish women. J Nutr 138(5):938–945PubMed Hedelin M, Lof M, Olsson M, Adlercreutz H, Sandin S, Weiderpass E (2008) Dietary phytoestrogens are not associated with risk of overall breast cancer but diets rich in coumestrol are inversely associated with risk of estrogen receptor and progesterone receptor negative breast tumors in Swedish women. J Nutr 138(5):938–945PubMed
26.
go back to reference Iwasaki M, Inoue M, Otani T, Sasazuki S, Kurahashi N, Miura T, Yamamoto S, Tsugane S (2008) Plasma isoflavone level and subsequent risk of breast cancer among Japanese women: a nested case–control study from the Japan Public Health Center-based prospective study group. J Clin Oncol 26(10):1677–1683CrossRefPubMed Iwasaki M, Inoue M, Otani T, Sasazuki S, Kurahashi N, Miura T, Yamamoto S, Tsugane S (2008) Plasma isoflavone level and subsequent risk of breast cancer among Japanese women: a nested case–control study from the Japan Public Health Center-based prospective study group. J Clin Oncol 26(10):1677–1683CrossRefPubMed
27.
go back to reference Travis RC, Allen NE, Appleby PN, Spencer EA, Roddam AW, Key TJ (2008) A prospective study of vegetarianism and isoflavone intake in relation to breast cancer risk in British women. Int J Cancer 122(3):705–710CrossRefPubMed Travis RC, Allen NE, Appleby PN, Spencer EA, Roddam AW, Key TJ (2008) A prospective study of vegetarianism and isoflavone intake in relation to breast cancer risk in British women. Int J Cancer 122(3):705–710CrossRefPubMed
28.
go back to reference Ward H, Chapelais G, Kuhnle GG, Luben R, Khaw KT, Bingham S (2008) Breast cancer risk in relation to urinary and serum biomarkers of phytoestrogen exposure in the European Prospective into Cancer-Norfolk cohort study. Breast Cancer Res 10(2):R32CrossRefPubMed Ward H, Chapelais G, Kuhnle GG, Luben R, Khaw KT, Bingham S (2008) Breast cancer risk in relation to urinary and serum biomarkers of phytoestrogen exposure in the European Prospective into Cancer-Norfolk cohort study. Breast Cancer Res 10(2):R32CrossRefPubMed
29.
go back to reference Wu AH, Koh WP, Wang R, Lee HP, Yu MC (2008) Soy intake and breast cancer risk in Singapore Chinese Health Study. Br J Cancer 99(1):196–200CrossRefPubMed Wu AH, Koh WP, Wang R, Lee HP, Yu MC (2008) Soy intake and breast cancer risk in Singapore Chinese Health Study. Br J Cancer 99(1):196–200CrossRefPubMed
30.
go back to reference Goodman MT, Shvetsov YB, Wilkens LR, Franke AA, Le Marchand L, Kakazu KK, Nomura AM, Henderson BE, Kolonel LN (2009) Urinary phytoestrogen excretion and postmenopausal breast cancer risk: the Multiethnic Cohort Study. Cancer Prev Res 2(10):887–894CrossRef Goodman MT, Shvetsov YB, Wilkens LR, Franke AA, Le Marchand L, Kakazu KK, Nomura AM, Henderson BE, Kolonel LN (2009) Urinary phytoestrogen excretion and postmenopausal breast cancer risk: the Multiethnic Cohort Study. Cancer Prev Res 2(10):887–894CrossRef
31.
go back to reference Key TJ, Sharp GB, Appleby PN, Beral V, Goodman MT, Soda M, Mabuchi K (1999) Soya foods and breast cancer risk: a prospective study in Hiroshima and Nagasaki, Japan. Br J Cancer 81(7):1248–1256CrossRefPubMed Key TJ, Sharp GB, Appleby PN, Beral V, Goodman MT, Soda M, Mabuchi K (1999) Soya foods and breast cancer risk: a prospective study in Hiroshima and Nagasaki, Japan. Br J Cancer 81(7):1248–1256CrossRefPubMed
32.
go back to reference Nishio K, Niwa Y, Toyoshima H et al (2007) Consumption of soy foods and the risk of breast cancer: findings from the Japan Collaborative Cohort (JACC) Study. Cancer Causes Control 18(8):801–808CrossRefPubMed Nishio K, Niwa Y, Toyoshima H et al (2007) Consumption of soy foods and the risk of breast cancer: findings from the Japan Collaborative Cohort (JACC) Study. Cancer Causes Control 18(8):801–808CrossRefPubMed
33.
go back to reference Shu XO, Jin F, Dai Q, Wen W, Potter JD, Kushi LH, Ruan Z, Gao YT, Zheng W (2001) Soyfood intake during adolescence and subsequent risk of breast cancer among Chinese women. Cancer Epidemiol Biomarkers Prev 10(5):483–488PubMed Shu XO, Jin F, Dai Q, Wen W, Potter JD, Kushi LH, Ruan Z, Gao YT, Zheng W (2001) Soyfood intake during adolescence and subsequent risk of breast cancer among Chinese women. Cancer Epidemiol Biomarkers Prev 10(5):483–488PubMed
34.
go back to reference Wu AH, Wan P, Hankin J, Tseng CC, Yu MC, Pike MC (2002) Adolescent and adult soy intake and risk of breast cancer in Asian-Americans. Carcinogenesis 23(9):1491–1496CrossRefPubMed Wu AH, Wan P, Hankin J, Tseng CC, Yu MC, Pike MC (2002) Adolescent and adult soy intake and risk of breast cancer in Asian-Americans. Carcinogenesis 23(9):1491–1496CrossRefPubMed
35.
go back to reference Thanos J, Cotterchio M, Boucher BA, Kreiger N, Thompson LU (2006) Adolescent dietary phytoestrogen intake and breast cancer risk (Canada). Cancer Causes Control 17(10):1253–1261CrossRefPubMed Thanos J, Cotterchio M, Boucher BA, Kreiger N, Thompson LU (2006) Adolescent dietary phytoestrogen intake and breast cancer risk (Canada). Cancer Causes Control 17(10):1253–1261CrossRefPubMed
36.
go back to reference Korde LA, Wu AH, Fears T, Nomura AM, West DW, Kolonel LN, Pike MC, Hoover RN, Ziegler RG (2009) Childhood soy intake and breast cancer risk in Asian American women. Cancer Epidemiol Biomarkers Prev 18(4):1050–1059CrossRefPubMed Korde LA, Wu AH, Fears T, Nomura AM, West DW, Kolonel LN, Pike MC, Hoover RN, Ziegler RG (2009) Childhood soy intake and breast cancer risk in Asian American women. Cancer Epidemiol Biomarkers Prev 18(4):1050–1059CrossRefPubMed
37.
go back to reference Mitchell JH, Gardner PT, McPhail DB, Morrice PC, Collins AR, Duthie GG (1998) Antioxidant efficacy of phytoestrogens in chemical and biological model systems. Arch Biochem Biophys 360(1):142–148CrossRefPubMed Mitchell JH, Gardner PT, McPhail DB, Morrice PC, Collins AR, Duthie GG (1998) Antioxidant efficacy of phytoestrogens in chemical and biological model systems. Arch Biochem Biophys 360(1):142–148CrossRefPubMed
38.
go back to reference Cassidy A, Bingham S, Setchell KD (1994) Biological effects of a diet of soy protein rich in isoflavones on the menstrual cycle of premenopausal women. Am J Clin Nutr 60(3):333–340PubMed Cassidy A, Bingham S, Setchell KD (1994) Biological effects of a diet of soy protein rich in isoflavones on the menstrual cycle of premenopausal women. Am J Clin Nutr 60(3):333–340PubMed
39.
go back to reference Lu LJ, Anderson KE, Grady JJ, Nagamani M (1996) Effects of soya consumption for one month on steroid hormones in premenopausal women: implications for breast cancer risk reduction. Cancer Epidemiol Biomarkers Prev 5(1):63–70PubMed Lu LJ, Anderson KE, Grady JJ, Nagamani M (1996) Effects of soya consumption for one month on steroid hormones in premenopausal women: implications for breast cancer risk reduction. Cancer Epidemiol Biomarkers Prev 5(1):63–70PubMed
40.
go back to reference Hooper L, Madhavan G, Tice JA, Leinster SJ, Cassidy A (2010) Effects of isoflavones on breast density in pre- and post-menopausal women: a systematic review and meta-analysis of randomized controlled trials. Hum Reprod Update 16(6):745–760 [Epub ahead of print]CrossRefPubMed Hooper L, Madhavan G, Tice JA, Leinster SJ, Cassidy A (2010) Effects of isoflavones on breast density in pre- and post-menopausal women: a systematic review and meta-analysis of randomized controlled trials. Hum Reprod Update 16(6):745–760 [Epub ahead of print]CrossRefPubMed
Metadata
Title
Soy isoflavones consumption and risk of breast cancer incidence or recurrence: a meta-analysis of prospective studies
Authors
Jia-Yi Dong
Li-Qiang Qin
Publication date
01-01-2011
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 2/2011
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-010-1270-8

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