Abstract
Intake of flavonoids is associated with the incidence of breast cancer, but the association between the intake of flavonoids and cancer recurrence is unclear. This study aimed to investigate the hypothesis that intake of flavonoids and flavonoid-rich foods is negatively associated with cancer recurrence. Among 572 women who underwent breast cancer surgery, 66 patients had a cancer recurrence. Dietary data were collected using a structured 24-h dietary recall, and intake of flavonoids was calculated based on the Korea Rural Development Administration flavonoid database. Among overweight and obese patients, disease-free survival was associated with intake of flavonoids (p = 0.004) and flavonoid-rich foods (p = 0.003). Intake of flavonoids (hazard ratio (HR) = 0.249, 95% confidence interval (CI): 0.09–0.64) and flavonoid-rich foods (HR = 0.244, 95% CI: 0.09–0.66) was negatively associated with cancer recurrence after adjusting for confounding factors in overweight and obese patients. Consumption of flavonoids and flavonoid-rich foods was lower in overweight and obese patients with cancer recurrence than those without recurrence and in normal-weight patients. This study suggests that intake of flavonoids and flavonoid-rich foods could have beneficial effects on cancer recurrence in overweight and obese breast cancer survivors.
Highlights
Breast cancer is the most common cancer and the leading cause of cancer-related deaths among women worldwide [1]
This study suggests that intake of flavonoids and flavonoid-rich foods could have beneficial effects on cancer recurrence in overweight and obese breast cancer survivors
There were no significant differences in family history of breast cancer, smoking status, American Joint Committee on Cancer (AJCC) stage, type of treatment, histological grade, estrogen receptor (ER) status, hormone receptor status, human epidermal growth factor receptor 2 (HER2) amplification status, and subtype between the groups (Table 1)
Summary
Breast cancer is the most common cancer and the leading cause of cancer-related deaths among women worldwide [1]. Breast cancer recurrence leads to an increased risk of metastases and decreased survival [1]. Diet is a major modifiable risk factor for breast cancer incidence, recurrence, and mortality [2]. Our previous study showed that anti-inflammatory diets were related with cancer recurrence and overall mortality in breast cancer patients [3]. A meta-analysis of epidemiological studies reported that vegetable intake was negatively associated with cancer-related mortality [4] and breast cancer incidence [5]. Vegetables are the main source of flavonoids, including flavonols and flavones, which are natural antioxidants that reduce oxidative DNA damage [6]
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