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Vitamin A and Breast Cancer Survival: A Systematic Review and Meta-analysis

Published:August 03, 2018DOI:https://doi.org/10.1016/j.clbc.2018.07.025

      Abstract

      Background

      The association between vitamin A intake and breast cancer survival has been inconsistent. We conducted a systemic review and meta-analysis to summarize the results on the association between dietary or supplement vitamin A and its derivatives and breast cancer-specific survival and overall survival (OS).

      Materials and Methods

      A comprehensive search of PubMed and EMBASE was performed from inception to January 31, 2018. The summary hazard ratios and 95% confidence intervals were estimated using a random effects model.

      Results

      Ten studies (8 cohort, 1 clinical trial, and 1 of pooled studies), with 19,450 breast cancer cases, were included in the meta-analysis. The dietary intake of β-carotene was significantly associated with improved breast cancer OS, with a summary hazard ratio of 0.70 (95% confidence interval, 0.50-0.99; I2 = 37.5%) for the highest versus lowest intake and 0.93 (95% confidence interval, 0.88-0.99; I2 = 38.7%) per 1200 μg/day increment of intake when assessing diet before diagnosis. Meta-regression analysis showed that adjustment for body mass index was a modified factor for the association between the intake of β-carotene and breast cancer OS (P = .013). However, the intake of other vitamin A derivatives (eg, α-carotene, β-cryptoxanthin, lycopene, retinol, lutein) had no effect on breast cancer prognosis when assessing diet before and after the diagnosis.

      Conclusion

      Our findings suggest limited evidence for the significantly inverse association between the prediagnosis dietary intake of β-carotene and OS among women with breast cancer. However, the intake of other vitamin A derivatives was not significantly associated with survival.

      Keywords

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      References

        • Siegel R.L.
        • Miller K.D.
        • Jemal A.
        Cancer Statistics, 2017.
        CA Cancer J Clin. 2017; 67: 7-30
        • American Cancer Society
        Breast Cancer Facts & Figures, 2013–2014.
        American Cancer Society Inc, Atlanta2013
      1. Horner M.J. Ries L.A.G. Krapcho M. SEER Cancer Statistics Review, 1975-2006. National Cancer Institute, Bethesda2009 (Available at:) (Accessed June 30, 2009)
      2. World Cancer Research Fund International/American Institute for Cancer Research Continuous Update Project Report: Diet, Nutrition, Physical Activity, and Breast Cancer Survivors.
        (Available at:) (Accessed August 31, 2014)
        • Krinsky N.I.
        • Johnson E.J.
        Carotenoid actions and their relation to health and disease.
        Mol Aspects Med. 2005; 26: 459-516
        • Li C.
        • Imai M.
        • Matsuura T.
        • et al.
        Inhibitory effects of retinol are greater than retinoic acid on the growth and adhesion of human refractory cancer cells.
        Biol Pharm Bull. 2016; 39: 636-640
        • Doldo E.
        • Costanza G.
        • Agostinelli S.
        • et al.
        Vitamin A, cancer treatment and prevention: the new role of cellular retinol binding proteins.
        Biomed Res Int. 2015; 2015: 624627
        • Rohan T.E.
        • Hiller J.E.
        • McMichael A.J.
        Dietary factors and survival from breast cancer.
        Nutr Cancer. 1993; 20: 167-177
        • Jain M.
        • Miller A.B.
        • To T.
        Premorbid diet and the prognosis of women with breast cancer.
        J Natl Cancer Inst. 1994; 86: 1390-1397
        • Holmes M.D.
        • Stampfer M.J.
        • Colditz G.A.
        • et al.
        Dietary factors and the survival of women with breast carcinoma.
        Cancer. 1999; 86: 826-835
        • Saxe G.A.
        • Rock C.L.
        • Wicha M.S.
        • et al.
        Diet and risk for breast cancer recurrence and survival.
        Breast Cancer Res Treat. 1999; 53: 241-253
        • Fink B.N.
        • Gaudet M.M.
        • Britton J.A.
        • et al.
        Fruits, vegetables, and micronutrient intake in relation to breast cancer survival.
        Breast Cancer Res Treat. 2006; 98: 199-208
        • McEligot A.J.
        • Largent J.
        • Ziogas A.
        • et al.
        Dietary fat, fiber, vegetable, and micronutrients are associated with overall survival in postmenopausal women diagnosed with breast cancer.
        Nutr Cancer. 2006; 55: 132-140
        • Beasley J.M.
        • Newcomb P.A.
        • Trentham-Dietz A.
        • et al.
        Post-diagnosis dietary factors and survival after invasive breast cancer.
        Breast Cancer Res Treat. 2011; 128: 229-236
        • Saquib J.
        • Rock C.L.
        • Natarajan L.
        • et al.
        Dietary intake, supplement use, and survival among women diagnosed with early-stage breast cancer.
        Nutr Cancer. 2011; 63: 327-333
        • Greenlee H.
        • Kwan M.L.
        • Kushi L.H.
        • et al.
        Antioxidant supplement use after breast cancer diagnosis and mortality in the Life After Cancer Epidemiology (LACE) cohort.
        Cancer. 2012; 118: 2048-2058
        • Poole E.M.
        • Shu X.
        • Caan B.J.
        • et al.
        Postdiagnosis supplement use and breast cancer prognosis in the After Breast Cancer Pooling Project.
        Breast Cancer Res Treat. 2013; 139: 529-537
        • Stroup D.F.
        • Berlin J.A.
        • Morton S.C.
        • et al.
        Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group.
        JAMA. 2000; 283: 2008-2012
        • Hayden J.A.
        • van der Windt D.A.
        • Cartwright J.L.
        • et al.
        Assessing bias in studies of prognostic factors.
        Ann Intern Med. 2013; 158: 280-286
        • DerSimonian R.
        • Laird N.
        Meta-analysis in clinical trials.
        Control Clin Trials. 1986; 7: 177-188
        • Greenland S.
        • Longnecker M.P.
        Methods for trend estimation from summarized dose-response data, with applications to meta-analysis.
        Am J Epidemiol. 1992; 135: 1301-1309
        • Orsini N.
        • Bellocco R.
        • Greenland S.
        Generalized least squares for trend estimation of summarized dose-response data.
        Stata J. 2006; 6: 40-57
        • Higgins J.P.
        • Thompson S.G.
        • Deeks J.J.
        • et al.
        Measuring inconsistency in meta-analyses.
        BMJ. 2003; 327: 557-560
        • Jain M.
        • Miller A.B.
        Tumor characteristics and survival of breast cancer patients in relation to premorbid diet and body size.
        Breast Cancer Res Treat. 1997; 42: 43-55
        • Ingram D.
        Diet and subsequent survival in women with breast cancer.
        Br J Cancer. 1994; 69: 592-595
        • Sporn M.B.
        • Roberts A.B.
        Role of retinoids in differentiation and carcinogenesis.
        Cancer Res. 1983; 43: 3034-3040
        • Johnson I.T.
        IARC handbooks of cancer prevention volume 2: carotenoids and volume 3: vitamin A.
        Eur J Clin Nutr. 1999; 53: 830-834
        • Fulan H.
        • Changxing J.
        • Baina W.Y.
        • et al.
        Retinol, vitamins A, C, and E and breast cancer risk: a meta-analysis and meta-regression.
        Cancer Causes Control. 2011; 22: 1383-1396
        • Wu Y.
        • Ye Y.
        • Shi Y.
        • et al.
        Association between vitamin A, retinol intake and blood retinol level and gastric cancer risk: a meta-analysis.
        Clin Nutr. 2015; 34: 620-626
        • Yu N.
        • Su X.
        • Wang Z.
        • et al.
        Association of dietary vitamin A and beta-carotene intake with the risk of lung cancer: a meta-analysis of 19 publications.
        Nutrients. 2015; 7: 9309-9324
        • Chen Q.
        • Ross A.C.
        All-trans-retinoic acid and the glycolipid alpha-galactosylceramide combined reduce breast tumor growth and lung metastasis in a 4T1 murine breast tumor model.
        Nutr Cancer. 2012; 64: 1219-1227
        • George S.M.
        • Park Y.
        • Leitzmann M.F.
        • et al.
        Fruit and vegetable intake and risk of cancer: a prospective cohort study.
        Am J Clin Nutr. 2009; 89: 347-353
        • van Duijnhoven F.J.
        • Bueno-De-Mesquita H.B.
        • Ferrari P.
        • et al.
        Fruit, vegetables, and colorectal cancer risk: the European Prospective Investigation into Cancer and Nutrition.
        Am J Clin Nutr. 2009; 89: 1441-1452
        • Hauner D.
        • Janni W.
        • Rack B.
        • et al.
        The effect of overweight and nutrition on prognosis in breast cancer.
        Dtsch Arztebl Int. 2011; 108: 795-801
        • Ibrahim E.M.
        • Al-Homaidh A.
        Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies.
        Med Oncol. 2011; 28: 753-765
        • Berube S.
        • Lemieux J.
        • Moore L.
        • et al.
        Smoking at time of diagnosis and breast cancer-specific survival: new findings and systematic review with meta-analysis.
        Breast Cancer Res. 2014; 16: R42
        • Zhao Z.
        • Zhang Z.P.
        • Soprano D.R.
        • et al.
        Effect of 9-cis-retinoic acid on growth and RXR expression in human breast cancer cells.
        Exp Cell Res. 1995; 219: 555-561
        • Ribeiro M.P.
        • Santos A.E.
        • Custodio J.B.
        Interplay between estrogen and retinoid signaling in breast cancer—current and future perspectives.
        Cancer Lett. 2014; 353: 17-24
        • Koga M.
        • Ogasawara H.
        Induction of hepatocyte mitosis in intact adult rat by interleukin-1 alpha and interleukin-6.
        Life Sci. 1991; 49: 1263-1270
        • Sheikh M.S.
        • Shao Z.M.
        • Chen J.C.
        • et al.
        Estrogen receptor-negative breast cancer cells transfected with the estrogen receptor exhibit increased RAR alpha gene expression and sensitivity to growth inhibition by retinoic acid.
        J Cell Biochem. 1993; 53: 394-404