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Dietary Flavonoid Intake and Breast Cancer Survival among Women on Long Island

Departments of ¹ Epidemiology and ² Nutrition, School of Public Health, University of North Carolina, Chapel Hill, North Carolina; ³ Department of Public Health & Homeland Security, University of Toledo, Toledo, Ohio; ⁴ Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; ⁵ Department of Community and Preventive Medicine, Mt. Sinai School of Medicine; ⁶ Department of Epidemiology, Joseph L. Mailman School of Public Health and ⁷ Department of Medicine, College of Physicians & Surgeons, Columbia University, New York, New York; ⁸ Department of Epidemiology and Population Health, Albert Einstein School of Medicine, Bronx, New York; and ⁹ Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland

Requests for reprints: Brian N. Fink, Department of Public Health & Homeland Security, University of Toledo, Health Science Campus, Mailstop 1027, 3015 Arlington Avenue, Toledo, OH 43614-5803. Phone: 419-383-4817; Fax: 419-383-5880. E-mail: brian.fink2{at}utoledo.edu

Background: Laboratory research and a growing number of epidemiologic studies have provided evidence for a reduced risk of breast cancer associated with dietary intake of certain classes of flavonoids. However, the effects of flavonoids on survival are not known. In a population-based cohort of breast cancer patients, we investigated whether dietary flavonoid intake before diagnosis is associated with subsequent survival.

Methods: Women ages 25 to 98 years who were newly diagnosed with a first primary invasive breast cancer between August 1, 1996, and July 31, 1997, and participated in a population-based, case-control study (n = 1,210) were followed for vital status through December 31, 2002. At the case-control interview conducted shortly after diagnosis, respondents completed a FFQ that assessed dietary intake in the previous 12 months. All-cause mortality (n = 173 deaths) and breast cancer–specific mortality (n = 113 deaths) were determined through the National Death Index.

Results: Reduced hazard ratios [age- and energy-adjusted hazard ratio (95% confidence interval)] for all-cause mortality were observed among premenopausal and postmenopausal women for the highest quintile of intake, compared with the lowest, for flavones [0.63 (0.41-0.96)], isoflavones [0.52 (0.33-0.82)], and anthocyanidins [0.64 (0.42-0.98)]. No significant trends in risk were observed. Results were similar for breast cancer–specific mortality only.

Conclusion: Mortality may be reduced in association with high levels of dietary flavones and isoflavones among postmenopausal U.S. breast cancer patients. Larger studies are needed to confirm our findings. (Cancer Epidemiol Biomarkers Prev 2007;16(11):2285–92)