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Flaxseeds & Breast Cancer Survival: Epidemiological Evidence

Lignan intake is associated with improved breast cancer survival in three recent population studies following a total of thousands of women after diagnosis.

April 8, 2013 |
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Supplementary Info

Sources Cited

L. U. Thompson, J. M. Chen, T. Li, K. Strasser-Weippl, P. E. Goss. Dietary flaxseed alters tumor biological markers in postmenopausal breast cancer. Clin. Cancer Res. 2005 11(10):3828 - 3835

L. S. Velentzis, J. V. Woodside, M. M. Cantwell, A. J. Leathem, M. R. Keshtgar. Do phytoestrogens reduce the risk of breast cancer and breast cancer recurrence? What clinicians need to know. Eur. J. Cancer 2008 44(13):1799 - 1806

S. E. McCann, L. U. Thompson, J. Nie, J. Dorn, M. Trevisan, P. G. Shields, C. B. Ambrosone, S. B. Edge, H.-F. Li, C. Kasprzak, J. L. Freudenheim. Dietary lignan intakes in relation to survival among women with breast cancer: The Western New York Exposures and Breast Cancer (WEB) Study. Breast Cancer Res. Treat. 2010 122(1):229 - 235

P. Guglielmini, A. Rubagotti, F. Boccardo. Serum enterolactone levels and mortality outcome in women with early breast cancer: A retrospective cohort study. Breast Cancer Res. Treat. 2012 132(2):661 - 668

K. Buck, A. K. Zaineddin, A. Vrieling, J. Linseisen, J. Chang-Claude. Meta-analyses of lignans and enterolignans in relation to breast cancer risk. Am. J. Clin. Nutr. 2010 92(1):141 - 153

S. Abarzua, T. Serikawa, M. Szewczyk, D.-U. Richter, B. Piechulla, V. Briese. Antiproliferative activity of lignans against the breast carcinoma cell lines MCF 7 and BT 20. Arch. Gynecol. Obstet. 2012 285(4):1145 - 1151

K. Buck, A. Vrieling, A. K. Zaineddin, S. Becker, A. Hüsing, R. Kaaks, J. Linseisen, D. Flesch-Janys, J. Chang-Claude. Serum enterolactone and prognosis of postmenopausal breast cancer. J. Clin. Oncol. 2011 29(28):3730 - 3738

U. W. N. AAberg, N. Saarinen, A. Abrahamsson, T. Nurmi, S. Engblom, C. Dabrosin. Tamoxifen and flaxseed alter angiogenesis regulators in normal human breast tissue in vivo. PLoS ONE 2011 6(9):e25720

C. J. Fabian, B. F. Kimler, C. M. Zalles, J. R. Klemp, B. K. Petroff, Q. J. Khan, P. Sharma, K. D. R. Setchell, X. Zhao, T. A. Phillips, T. Metheny, J. R. Hughes, H.-W. Yeh, K. A. Johnson. Reduction in Ki-67 in benign breast tissue of high-risk women with the lignan secoisolariciresinol diglycoside. Cancer Prev Res (Phila) 2010 3(10):1342 - 1350

R. E. Patterson. Flaxseed and breast cancer: What should we tell our patients? J. Clin. Oncol. 2011 29(28):3723 - 3724

Acknowledgements

Images thanks to calvinfleming

Transcript

The class of phytonutrients known as lignans can be thought of as the Western equivalent of the isoflavone phytoestrogens found in soy foods popular in traditional Asian diets, as they share many purported anti-cancer mechanisms. Since soy food consumption is associated with both preventing breast cancer and prolonging breast cancer survival, one might expect the same to be found for lignans. There covered the population-based, in-vitro, and clinical evidence supporting prevention, but what about for women already diagnosed with the dreaded disease? Three studies following a total of thousands of women diagnosed with breast cancer were recently published. The first was from New York, reporting substantially reduced risks of overall mortality, and especially breast cancer mortality, associated with higher lignan intakes in postmenopausal women. Although higher lignan intakes may just be a marker of a diet high in plant foods, specific combinations of foods particularly high in lignans may be necessary to produce effects on mortality-related risk factors to subsequently impact survival." The next was out of Italy. At surgery, when the women were getting their primary breast tumors removed, they had some blood drawn and within 5 years those who had lower circulating levels of lignans were significantly more likely to die from their cancer coming back than those with more lignans in their bloodstream. They concluded, "Lignans might play an important role in reducing all-cause and cancer-specific mortality of the patients operated on for breast cancer." And same thing out of Germany, in the latest and largest study to date, Postmenopausal patients with breast cancer who have high serum enterolactone levels may have better survival." Here's the survival curve, the higher the better. Those who had the most lignans in their blood lived the longest and tended to live the longest disease free. So what should oncologists tell their patients?  "Given this objective evidence that a biomarker of lignan intake improves breast cancer outcomes, should we declare success and recommend that our patients with breast cancer supplement their diet with flaxseed?" Not based on population evidence alone, the editorial concluded, robust experimental evidence is needed, which I'll cover in the next video…

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by Jonathan Hodgson.

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger

Doctor's Note

For more on breast cancer survival, see:

What about the role of flaxseeds in preventing breast cancer in the first place? See the previous video Flaxseeds & Breast Cancer Prevention. In the next video Flaxseeds & Breast Cancer Survival: Clinical Evidence, I'll detail a randomized double-blind placebo-controlled clinical trial in breast cancer patients where flaxseeds are actually put to the test.

For some context, please also check out my associated blog posts: Treating Sensitive Skin From the Inside OutFlax and Breast Cancer Prevention , and  Flax and Breast Cancer Survival 

If you haven't yet, you can subscribe to my videos for free by clicking here.

  • slim_langer

    If you happen to follow Caldwell Esselstyn’s version of a whole-food plant-based diet, you’re already supplementing daily with 1TB ground flaxseed for omega 3′s. Since the series on fenugreek as an anti-cancer agent, I added a Tsp of ground fg seed (very bitter to start but maybe I’ve begun to like it) same with the hybiscus and green teas. My question is after you’ve been living like this for several years (20+years vegan, fit/slender pushing 60 no health issues), what should you specifically look for (and look out for) in your blood and other tests — living long-term as a WFPB vegan? Maybe this could be worth a series. Thanks.

  • http://www.facebook.com/darryl.roy.752 Darryl Roy

    Off topic – just calling attention to a fascinating story in today’s NYT:
    http://www.nytimes.com/2013/04/08/health/study-points-to-new-culprit-in-heart-disease.html?_r=0

    The gut bacteria of omnivores convert the amino acid carnitine in meats into trimethylamine n-oxide, and high TMAO serum levels were predictive of a 3-fold higher risk of heart attack/stroke/death (2.5 fold adjusted) in this paper
    http://content.onlinejacc.org/article.aspx?articleid=1665659

    The diet of vegans evidently doesn’t support the same gut microbiota, so they didn’t produce TMAO, even when given carnitine supplements.

    • Thea

      Darryl: I wanted to thank you for your posts in general. You have supplied some great information to this site. While I have not responded to your posts before, I wanted you to know that I have read your posts and really appreciated them!

  • tduke

    Dr. Greger I’m hoping with Angelina Jolie’s recent disclosure that she had a preventative double mastectomy you could highlight all of your wonderful videos and articles on breast cancer prevention through diet (and perhaps speak to this in a new article?). Women really need this information. Thank you!