Plasma Carotenoids and Recurrence-Free Survival inWomen With a History of Breast Cancer

plasma-falls

This was a study done for the purpose of identifying a relationship between antioxidant therapy via fruits and vegetables and the reduction of breast cancer recurrence.

Plasma Carotenoids and Recurrence-Free Survival
in Women With a History of Breast Cancer
Cheryl L. Rock, Shirley W. Flatt, Loki Natarajan, Cynthia A. Thomson, Wayne A. Bardwell, Vicky A. Newman, Kathy A. Hollenbach, Lovell Jones, Bette J. Caan, and John P. Pierce

A B S T R A C T
Purpose
Previous studies suggest that diet may affect recurrence or survival rates in women who have been diagnosed with breast cancer. The purpose of this study was to examine the relationship between plasma carotenoid concentration, as a biomarker of vegetable and fruit intake, and risk for a new breast cancer event in a cohort of women with a history of early-stage breast cancer.

Methods
Participants were 1,551 women previously treated for breast cancer who were randomly
assigned to the control arm of a diet intervention trial between March 1995 and November
2000. Outcome events were probed during semiannual interviews and verified by medical
record review. During the period under study, 205 women had a recurrence or new primary breast cancer. Plasma carotenoid concentrations were measured in baseline blood samples.

Hazard ratios (HR) and 95% CIs by quartiles of plasma carotenoids were computed, controlling for tumor stage, grade, and hormone receptor status; chemotherapy and tamoxifen therapy; clinical site; age at diagnosis; body mass index; and plasma cholesterol concentration.

Results
Women in the highest quartile of plasma total carotenoid concentration had significantly
reduced risk for a new breast cancer event (HR, 0.57; 95% CI, 0.37 to 0.89), controlled for
covariates influencing breast cancer prognosis.

Conclusion
Plasma carotenoids are a biologic marker of intake of vegetables and fruit, so this observation supports findings from previous studies that have linked increased vegetable and fruit intake with greater likelihood of recurrence-free survival in women who have been diagnosed with early-stage breast cancer.

J Clin Oncol 23:6631-6638. © 2005 by American Society of Clinical Oncology

INTRODUCTION
Carotenoids are biologically active compounds
that are pigments in plants, microorganisms,
fish, and birds, but they cannot be
synthesized in animals. The absorption of
carotenoids is not regulated when consumed
by humans, so carotenoids in the blood and
peripheral tissue reflect dietary intake.1 Vegetables
and fruit contribute the overwhelming
majority of carotenoids in the diet, so the
amount of carotenoids in the circulation reflects
vegetable and fruit intake, although a few
influencing factors need to be considered in
the interpretation of these concentrations as
dietary biomarkers. Plasma carotenoids have
been consistently associated with dietary intake
of vegetables and fruit in observational
studies,2,3 and tissue concentrations increase
in response to feeding or prescribing these
foods4-8 and in diet intervention studies that
successfully promote increased vegetable and
fruit intake.9-13
Breast cancer currently accounts for
32% of the incident cancers and 15% of the
cancer deaths among women in the United
From the Departments of Family and
Preventive Medicine and Psychiatry,
and Cancer Prevention and Control
Program, University of California, San
Diego, San Diego; and Division of
Research, Kaiser Permanente Northern
California, Oakland, CA; Arizona Cancer
Center, University of Arizona, Tucson,
AZ; M.D. Anderson Cancer Center, The
University of Texas, Houston, TX; and
the Women’s Healthy Eating and Living
Study Group.
Submitted March 10, 2005; accepted
May 18, 2005.
Supported by NCI Grant No. CA69375;
University of California, San Diego,
General Clinical Research Center NIH
Grant No. M01-RR00827; University of
California, San Francisco, General Clinical
Research Center NIH Grant No.
M01-RR00079; Stanford University
General Clinical Research Center NIH
Grant No. M01-RR00070; and the
Walton Family Foundation.
Authors’ disclosures of potential conflicts
of interest are found at the end of
this article.
Address reprint requests to Cheryl L.
Rock, PhD, RD, University of California,
San Diego, 9500 Gilman Dr, La Jolla, CA
92093-0901; e-mail: clrock@ucsd.edu.
© 2005 by American Society of Clinical
Oncology
0732-183X/05/2327-6631/$20.00
DOI: 10.1200/JCO.2005.19.505
JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T

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