title: Vitamin supplement consumption and breast cancer risk: a review.
abstract: BACKGROUND
  Breast cancer is the most frequently diagnosed cancer globally, and studies provide contradictory results about the possible effects of vitamin supplementation to reduce cancer risk. Our aim was to conduct a review to better investigate whether vitamin supplements given orally modify breast cancer risk.
  
  
  METHODS
  We conducted a comprehensive, systematic bibliographic search of the medical literature to identify relevant studies. Case-control, cohort studies, and randomised controlled trials (RCTs) published up to August 2013 that reported cancer risk estimates for vitamin supplementation were included. For each study, we retrieved study characteristics, study population, exposure evaluation, and risk estimates.
  
  
  RESULTS
  We identified 26 studies (14 cohort, 11 case-control, and one RCT) and overall, we found 104 estimates. We grouped all the estimates into six supplementation categories: vitamin A and beta-carotene, B-group vitamins and folic acid, vitamin C, vitamin D, vitamin E, and multivitamins. Only a few studies showed a statistically significant association between the consumption of supplemental vitamins and the occurrence of breast cancer, and most of the significant estimates were found in case-control studies. The results found in prospective studies seem to be in the opposite direction.
  
  
  CONCLUSIONS
  The role of vitamin supplements in preventing breast cancer still remains unclear, considering our review. Although biologic mechanisms exist to support the anticancer effects of vitamins, there is no clear evidence for an effect in cancer prevention for vitamin supplements. Further investigations are warranted to elucidate the mechanisms by which vitamin supplementation can modify breast cancer development.
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan 20141, Italy.
authors.forename: Alessandro M
authors.initials: AM
authors.lastname: Misotti
authors.forename: Patrizia
authors.initials: P
authors.lastname: Gnagnarella
keywords: antioxidants; breast cancer; dietary supplements; vitamin supplementation; vitamins