While it is refreshing to see more and more published medical research on prevention of cancer, much of the information is quite generic. There is no mention of the most beneficial forms of the nutrients mentioned. Everyone has unique needs with some people requiring activated forms of certain vitamins, others have problems absorbing or metabolising fat-soluble vitamins A and D.
Chemoprevention of breast cancer with vitamins & micronutrients
Breast cancer is a common disease, with an annual global incidence of more than 2 million cases per year. Limitations of current treatments include significant side-effects, resistance to drug treatment, and significant costs.1
A number of dietary compounds and vitamins have been found to inhibit the molecular events and signalling pathways associated with various stages of breast cancer development, and therefore show promise as strategies for breast cancer prevention.
A recent literature review, investigated the effects of vitamins and micronutrients that exert protective effects against breast cancer. The authors found sufficient evidence that certain vitamins, such as folate, vitamin D3, vitamin B6, and beta carotene as well as dietary micronutrients, including sulforaphane from cruciferous vegetables, curcumin, piperine, quercetin, epigallocatechin gallate (EGCG) and omega-3 polyunsaturated fatty acids (PUFAs), show an antitumoral activity against breast cancer and may offer natural strategies for breast cancer chemoprevention as well as reduce the risk of breast cancer recurrence.
Folate (Vitamin B9) is an essential nutrient that is involved as a cofactor in numerous intracellular reactions. Due to its role in one-carbon metabolism, folate metabolism has been extensively studied for its potential to reduce cancer development.2 A pooled analysis showed that folate intake was associated with an 18% decrease in the risk of developing hormone receptor negative breast cancer.1
Vitamin D3 is well known for its role in bone and mineral metabolism however recent literature also demonstrates that vitamin D has anti-proliferative and pro-apoptotic effects.3 A 2019 meta-analysis demonstrated that vitamin D deficiency was directly related to breast cancer risk while supplemental vitamin D and total blood vitamin D levels had a protective effect.4
Vitamin B6 is involved in many biochemical reactions, including 1-carbon metabolism. It is a crucial coenzyme in the conversion of tetrahydrofolate to 5,10-methylenetetrahydrofolate,2 which is needed for DNA synthesis, repair, and methylation.5 Therefore, inadequate vitamin B6 intake may lead to imbalances in DNA precursors, disruption in DNA repair, and aberrations in DNA methylation, any of which may enhance carcinogenesis. A 2017 analysis showed that high intake of dietary vitamin B6 via food only, was significantly associated with a 22% lower risk of all cancers.1
Beta Carotene is a precursor for vitamin A and is one of more than 600 carotenoids, micronutrients which are potentially anticarcinogenic. The possible biologic activities of carotenoids include antioxidation, immune enhancement, increased gap-junction intercellular communication, inhibition of tumorigenesis and malignant transformation, and metabolism to retinoids, which in turn contribute to cellular differentiation.6 Studies suggest carotenoids inhibit tumour progression and reduce proliferation in both oestrogen receptor positive and oestrogen receptor negative breast cancer cells. In a large prospective analysis with 20 years of follow-up, women with high plasma carotenoids had a reduced breast cancer risk, particularly for more aggressive cancers.1
Curcumin is a polyphenolic compound that is thought to influence breast cancer development through its effect on the cell cycle and proliferation, natural cell death, and inhibition of tumour progression.1 While there is a lack of evidence from human studies, extensive evidence from laboratory and animal studies demonstrate a diverse activity against breast cancer cells and tumours, although exact mechanisms are yet to be elucidated.1
Quercetin is a flavonoid pigment which has antioxidant and anti-tumour properties. Studies suggest the cancer-protecting effects of quercetin results from triggering cancer cell death and inhibiting oncogene expression. Quercetin can also reverse multidrug resistance and restore chemo sensitivity in chemo-resistant breast cancer cells.1
Epigallocatechin-3-gallate (EGCG) is the principle polyphenol in green tea, and is thought to be responsible for the cancer-protective effects of green tea. Evidence suggests that green polyphenols can modulate multiple signalling pathways, regulating growth, survival and metastasis of cancer cells at multiple levels. A meta-analysis showed that green tea consumption was inversely associated with breast cancer recurrence.1
Omega-3 fatty acids (PUFAs) – studies suggest that higher incidence of breast cancer in developed countries such as Western Europe & North America, when compared to the Inuit and Japan, may be due to varying dietary patterns, specifically the intake of fatty fish.1 The cancer-protective effects of PUFAs, specifically omega-3 and omega-6, has been supported by a number of studies. Research suggests that PUFAs can reduce the amount of pro-inflammatory lipid derivatives, growth factor receptor signalling, cytokine production, and breast cancer cell growth, by competing for cyclooxygenase and lipoxygenase pathways. In studied populations, higher dietary intake ratios of omega-3 to omega-6 PUFAs resulted in significantly reduced risk of breast cancer.1
Sulforaphane and indol-3-carbinol are two phytochemicals found in cruciferous vegetables that have been researched for their positive effect in breast cancer.1 Broccoli, broccoli sprouts, Brussel sprouts, kale and cabbage are particularly rich food sources of these phytochemicals. Sulforaphane has been reported to have several chemo-prevention benefits due to its antioxidant, anti-inflammatory and anti-cancer properties. Sulforaphane influences the development and progression of cancer through the regulation of the cell cycle, including tumour growth reduction, induction of cell cycle arrest, disruption of signalling within the tumour microenvironment, and activation of apoptosis.1
Indole-3-carbonol has the ability to selectively induce apoptosis and modify oestrogen metabolism, which makes it particularly effective in hormone-dependent breast cancer.1 A meta-analysis indicated that high consumption of cruciferous vegetables was associated with a 15% reduction of breast cancer risk.1
The results of these studies suggest that supplementation with key evidenced-based nutrients and dietary manipulation may be a beneficial part of standard breast cancer treatment regimes.
- Mokbel, K., & Mokbel, K. (2019). Chemoprevention of Breast Cancer With Vitamins and Micronutrients: A Concise Review. In vivo (Athens, Greece), 33(4), 983–997. doi:10.21873/invivo.11568
- Pieroth, R., Paver, S., Day, S., & Lammersfeld, C. (2018). Folate and Its Impact on Cancer Risk. Current nutrition reports, 7(3), 70–84. doi:10.1007/s13668-018-0237-y
- Simboli-Campbell, M., Narvaez, C.J., Tenniswood, M., Welsh, J. (1996). 1,25-Dihydroxyvitamin D3 induces morphological and biochemical markers of apoptosis in MCF-7 breast cancer cells. J Steroid Biochem Mol Biol.;58(4):367–376. PMID: 8903420. DOI: 10.1016/0960-0760(96)00055-6
- Hossain, S., Beydoun, M. A., Beydoun, H. A., Chen, X., Zonderman, A. B., & Wood, R. J. (2019). Vitamin D and breast cancer: A systematic review and meta-analysis of observational studies. Clinical nutrition ESPEN, 30, 170–184. doi:10.1016/j.clnesp.2018.12.085
- Chou, Y. C., Chu, C. H., Wu, M. H., Hsu, G. C., Yang, T., Chou, W. Y., … Sun, C. A. (2011). Dietary intake of vitamin B(6) and risk of breast cancer in Taiwanese women. Journal of epidemiology, 21(5), 329–336. doi:10.2188/jea.JE20100188
- Eliassen, A. H., Hendrickson, S. J., Brinton, L. A., Buring, J. E., Campos, H., Dai, Q., … Hankinson, S. E. (2012). Circulating carotenoids and risk of breast cancer: pooled analysis of eight prospective studies. Journal of the National Cancer Institute, 104(24), 1905–1916. doi:10.1093/jnci/djs461
Article and research courtesy: BioMedica Nutraceuticals