title: Dietary isoflavone intake and all-cause mortality in breast cancer survivors: The Breast Cancer Family Registry.
abstract: Soy foods possess both antiestrogenic and estrogen-like properties. It remains controversial whether women diagnosed with breast cancer should be advised to eat more or less soy foods, especially for those who receive hormone therapies as part of cancer treatment.
  
  
  
  The association of dietary intake of isoflavone, the major phytoestrogen in soy, with all-cause mortality was examined in 6235 women with breast cancer enrolled in the Breast Cancer Family Registry. Dietary intake was assessed using a Food Frequency Questionnaire developed for the Hawaii-Los Angeles Multiethnic Cohort among 5178 women who reported prediagnosis diet and 1664 women who reported postdiagnosis diet. Cox proportional-hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
  
  
  
  During a median follow-up of 113 months (approximately 9.4 years), 1224 deaths were documented. A 21% decrease was observed in all-cause mortality for women who had the highest versus lowest quartile of dietary isoflavone intake (≥1.5 vs < 0.3 mg daily: HR, 0.79; 95% confidence interval CI, 0.64-0.97; Ptrend= .01). Lower mortality associated with higher intake was limited to women who had tumors that were negative for hormone receptors (HR, 0.49; 95% CI, 0.29-0.83; Ptrend= .005) and those who did not receive hormone therapy for their breast cancer (HR, 0.68; 95% CI, 0.51-0.91; Ptrend= .02). Interactions, however, did not reach statistical significance.
  
  
  
  In this large, ethnically diverse cohort of women with breast cancer living in North America, a higher dietary intake of isoflavone was associated with reduced all-cause mortality. Cancer 2017;123:2070-2079. © 2017 American Cancer Society.
authors.affiliation: Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
authors.forename: Fang Fang
authors.initials: FF
authors.lastname: Zhang
authors.affiliation: Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
authors.forename: Danielle E
authors.initials: DE
authors.lastname: Haslam
authors.affiliation: Mailman School of Public Health, Columbia University, New York, New York.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Terry
authors.affiliation: Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Julia A
authors.initials: JA
authors.lastname: Knight
authors.affiliation: Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Irene L
authors.initials: IL
authors.lastname: Andrulis
authors.affiliation: Clinical Genetics, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
authors.forename: Mary B
authors.initials: MB
authors.lastname: Daly
authors.affiliation: Huntsman Cancer Institute at the University of Utah Health Sciences Center, Salt Lake City, Utah.
authors.forename: Saundra S
authors.initials: SS
authors.lastname: Buys
authors.affiliation: Cancer Prevention Institute of California, Fremont, California.|Department of Health Research and Policy (Epidemiology) and Stanford Cancer Institute, Stanford University of School of Medicine, Stanford, California.
authors.forename: Esther M
authors.initials: EM
authors.lastname: John
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D004032:Diet / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007529:Isoflavones; D008875:Middle Aged; D009026:Mortality; D016016:Proportional Hazards Models; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012042:Registries; D017741:Survivors
chemical_list: D007529:Isoflavones; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone
keywords: breast cancer; breast cancer survivors; isoflavone; mortality; soy; survival