Soy isoflavone supplementation for breast cancer risk reduction: a randomized phase II trial.
Soy isoflavone consumption may protect against breast cancer development. We conducted a phase IIB trial of soy isoflavone supplementation to examine its effect on breast epithelial proliferation and other biomarkers in the healthy high-risk breast. One hundred and twenty-six consented women underwent a random fine-needle aspiration (rFNA); those with 4,000 or more epithelial cells were randomized to a double-blind 6-month intervention of mixed soy isoflavones (PTIG-2535) or placebo, followed by repeat rFNA. Cells were examined for Ki-67 labeling index and atypia. Expression of 28 genes related to proliferation, apoptosis, and estrogenic effect was measured using quantitative reverse transcriptase PCR. Hormone and protein levels were measured in nipple aspirate fluid (NAF). All statistical tests were two-sided. Ninety-eight women were evaluable for Ki-67 labeling index. In 49 treated women, the median Ki-67 labeling index was 1.18 at entry and 1.12 post intervention, whereas in 49 placebo subjects, it was 0.97 and 0.92 (P for between-group change: 0.32). Menopausal stratification yielded similar results between groups, but within premenopausal soy-treated women, Ki-67 labeling index increased from 1.71 to 2.18 (P = 0.04). We saw no treatment effect on cytologic atypia or NAF parameters. There were significant increases in the expression of 14 of 28 genes within the soy, but not the control group, without significant between-group differences. Plasma genistein values showed excellent compliance. A 6-month intervention of mixed soy isoflavones in healthy, high-risk adult Western women did not reduce breast epithelial proliferation, suggesting a lack of efficacy for breast cancer prevention and a possible adverse effect in premenopausal women.
Department of Surgery, Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago IL 60611, USA. skhan@nmh.org
Seema A
SA
Khan
Robert T
RT
Chatterton
Nancy
N
Michel
Michelle
M
Bryk
Oukseub
O
Lee
David
D
Ivancic
Richard
R
Heinz
Carola M
CM
Zalles
Irene B
IB
Helenowski
Borko D
BD
Jovanovic
Adrian A
AA
Franke
Maarten C
MC
Bosland
Jun
J
Wang
Nora M
NM
Hansen
Kevin P
KP
Bethke
Alexander
A
Dew
Margerie
M
Coomes
Raymond C
RC
Bergan
D000328:Adult; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000178:diet therapy* / Q000517:prevention & control*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007529:Isoflavones / Q000008:administration & dosage*; D008875:Middle Aged; D011379:Prognosis; D040242:Risk Reduction Behavior; D013025:Glycine max / Q000737:chemistry*
D007529:Isoflavones