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Multivitamin use and breast cancer outcomes in women with early-stage breast cancer: the Life After Cancer Epidemiology study

  • Epidemiology
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Abstract

Little is known about the relation of multivitamin use to breast cancer outcomes. 2,236 women diagnosed from 1997 to 2000 with early-stage breast cancer (Stage I ≥ 1 cm, II, or IIIA) were enrolled about 2 years post-diagnosis, primarily from the Kaiser Permanente Northern California Cancer Registry (83%). Multivitamin use pre-diagnosis and post-diagnosis was assessed via mailed questionnaire. Outcomes were ascertained yearly by self-report and verified by medical record review. Delayed-entry Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI), adjusting for sociodemographic, tumor, and lifestyle factors. Overall, 54 and 72% of the cohort reported using multivitamins pre- and post-diagnosis, respectively. A total of 380 recurrences, 212 breast cancer deaths, and 396 total deaths were confirmed. Compared to never use, multivitamin use after diagnosis was not associated with any outcome (recurrence HR = 0.92; 95% CI: 0.71, 1.20; total mortality HR = 0.92; 95% CI: 0.71, 1.19). Compared to never use, persistent use of multivitamins from pre- to post-diagnosis was associated with a non-significant decreased risk of recurrence (HR = 0.76; 95% CI: 0.54, 1.06) and total mortality (HR = 0.79; 95% CI: 0.56, 1.12). The protective associations were limited to women who had been treated by radiation only (P for trend = 0.048 and 0.083 for recurrence and total mortality, respectively) and both radiation and chemotherapy (P for trend = 0.015 and 0.095 for recurrence and total mortality, respectively). In stratified analyses, women who consistently used multivitamins before and after diagnosis and ate more fruits/vegetables (P for trend = 0.008) and were more physically active (P for trend = 0.034) had better overall survival. Multivitamin use along with practice of other health-promoting behaviors may be beneficial in improving breast cancer outcomes in select groups of survivors.

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Acknowledgments

We thank Erin Weltzien for programming support, and all LACE study staff and participants. This study was funded by the National Cancer Institute (R01 CA129059). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute.

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Authors and Affiliations

  1. Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA, 94612, USA

    Marilyn L. Kwan, Valerie S. Lee, Adrienne Castillo, Erica P. Gunderson, Laurel A. Habel, Lawrence H. Kushi, Emily K. Tam & Bette J. Caan

  2. Department of Epidemiology, Mailman School of Public Health, Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA

    Heather Greenlee

  3. Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA

    Carol Sweeney

Authors
  1. Marilyn L. Kwan
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  2. Heather Greenlee
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  3. Valerie S. Lee
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  4. Adrienne Castillo
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  5. Erica P. Gunderson
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  6. Laurel A. Habel
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  7. Lawrence H. Kushi
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  9. Emily K. Tam
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  10. Bette J. Caan
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Correspondence to Marilyn L. Kwan.

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Kwan, M.L., Greenlee, H., Lee, V.S. et al. Multivitamin use and breast cancer outcomes in women with early-stage breast cancer: the Life After Cancer Epidemiology study. Breast Cancer Res Treat 130, 195–205 (2011). https://doi.org/10.1007/s10549-011-1557-4

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  • DOI: https://doi.org/10.1007/s10549-011-1557-4

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