Breast Cancer Supplement Recommendations

Multiple nutritional supplements have been associated with reduced cancer occurrence and/or cancer progression. The list below contains those with the greatest evidence-base and benefit, though it is not necessary that they all be included.

Vitamin D

  • Vitamin D levels are associated with both the risk of breast cancer as well as the risk of dying from it.
  • Suggested dose is that sufficient to raise vitamin D blood levels to >40 ng/mL, which may require 5000 IU per day or more.[1]

Omega-3 fatty acids

  • Omega-3 fatty acids, DHA and EPA, have been shown to exert numerous anti-proliferative effects on breast cancer cells, as well as reduced inflammation and fatigue among breast cancer survivors.[2] DHA/EPA have also demonstrated protective effects when combined with several chemotherapeutic agents.[3] Additionally, GLA, another omega-3, helps to maintain balance in the fatty acids and enhances the anti-inflammatory effect.[4],[5]
  • Suggested dose: 2-3 grams combined EPA & DHA per day, with at least 1-2 grams of a GLA source.

DIM & Isothiocyanates

  • Isothiocyanates, which are abundant in cruciferous vegetables, like broccoli, cauliflower and cabbage, have shown anti-tumor activity and DIM (3,3′-Diindolylmethane), also found in these same vegetables, inhibits cancer cell proliferation in estrogen receptor positive and negative cells, and has shifted urinary estrogen metabolites to those with lower cancer risk among cancer survivors.[6],[7],[8]
  • Suggested dose: DIM 250mg & Isothiocyanates 600mcg per day.

Scutellaria barbata

  • Scutellaria barbata is an herb that grows in Korea and southern China. An extract of this plant has been shown to be safe in a clinical trial of women with advanced breast cancer, and to inhibit cell proliferation and induce cancer cell death.[9],[10]
  • Suggested dose: 1-2g per day.

Curcumin

  • The active extract from the spice turmeric, curcumin displays an ability to inhibit many tumor cell types, and also may sensitize cancer cells to other therapies.[11] Recently it was combined with docetaxel, a commonly used chemotherapy medication, in patients with advanced and metastatic breast cancer with encouraging results.[12]
  • Suggested dose: 1-2g per day of Meriva® or Longvida® curcumin.[13],[14]

Green tea extract

  • Catechins, antioxidants found in green tea, particularly EGCG (epigallocatechin-3-gallate), are known to have numerous anti-metastatic and anti-proliferative properties. Also, clinical trials suggest EGCG may enhance other therapies.[15][16]
  • Suggested dose: 1g EGCG and mixed catechins.

Resveratrol

  • Found in red wine and grapes, this antioxidant has been shown to influence the methylation of genes in women at high breast cancer risk, and to reduce the toxicity of radiation therapy.[17],[18]
  • Suggested dose: 100-200mg per day.

Milk thistle

  • Silymarin and silibinin from milk thistle have anti-proliferative and anti-metastatic properties, and may enhance the effectiveness of other therapies.[19],[20]
  • Suggested dose: At least 500mg silymarin per day.

Quercetin

  • This antioxidant has multiple mechanisms by which it inhibits breast cancer proliferation and induces apoptosis (programmed cell death), and alters the metabolism of estrogen to less toxic compounds.[21],[22] It may be particularly beneficial for Her2/neu positive cancer.[23]
  • Suggested dose: 200-400mg, three times per day.

Grape seed extract and/or pycnogenol

  • Grape seed extract has been shown to inhibit breast cell carcinogenesis in response to several common toxins, and to inhibit the enzyme aromatase, a factor in hormone-sensitive cancers.[24],[25]
  • Suggested dose: 100-200mg per day.

Melatonin

  • A hormone, supplemental melatonin intake has improved survival in a number of cancers, and may enhance conventional therapy effectiveness.[26]
  • Suggested dose: at least 3mg at night, preferably time-released.

Vitamin E

  • Various components of vitamin E have shown anti-cancer properties. Although alpha-tocopherol is often used in clinical trials, when given alone it may deplete other important components of vitamin E.[27],[28]
  • Suggested dose: 200-400 IU per day of mixed tocopherols and tocotrienols.

Vitamin K2

  • Vitamin K-2 (MK-7) has the longest half-life, meaning it is the most stable, of all forms of vitamin K. Shown to improve bone and cardiovascular health, higher intakes of this form have also been associated with reduced cancer incidence & fatality, and may improve effectiveness of other therapies.[29],[30],[31]
  • Suggested dose: 100 mcg vitamin K-2 (MK-7).

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[1] Garland CF, French CB, Baggerly LL, et al. Vitamin D supplement doses and serum 25-hydroxyvitamin D in the range associated with cancer prevention. Anticancer Res. 2011 Feb;31(2):607-11.

[2] Alfano CM, Imayama I, Neuhouser ML, et al. Fatigue, inflammation, and ω-3 and ω-6 fatty acid intake among breast cancer survivors. J Clin Oncol. 2012 Apr 20;30(12):1280-7.

[3] Ghoreishi Z, Esfahani A, Djazayeri A, et al. Omega-3 fatty acids are protective against paclitaxel-induced peripheral neuropathy: a randomized double-blind placebo controlled trial. BMC Cancer. 2012 Aug 15;12:355.

[4] Xu Y, Qian SY1. Anti-cancer activities of ω-6 polyunsaturated fatty acids. Biomed J. 2014 May-Jun;37(3):112-9.

[5] Biomed J. 2014 May-Jun;37(3):112-9. Gamma linolenic acid with tamoxifen as primary therapy in breast cancer. Int J Cancer. 2000 Mar 1;85(5):643-8.

[6] Gupta P, Srivastava SK. Antitumor activity of phenethyl isothiocyanate in HER2-positive breast cancer models. BMC Med. 2012 Jul 24;10:80.

[7] Jin Y. 3,3′-Diindolylmethane inhibits breast cancer cell growth via miR-21-mediated Cdc25A degradation. Mol Cell Biochem. 2011 Dec;358(1-2):345-54.

[8] Dalessandri KM, Firestone GL, et al. Pilot study: effect of 3,3′-diindolylmethane supplements on urinary hormone metabolites in postmenopausal women with a history of early-stage breast cancer. Nutr Cancer. 2004;50(2):161-7.

[9] Perez AT, Arun B, Tripathy D, et al. A phase 1B dose escalation trial of Scutellaria barbata (BZL101) for patients with metastatic breast cancer. Breast Cancer Res Treat. 2010 Feb;120(1):111-8.

[10] Klawitter J, Klawitter J, Gurshtein J, et al. Bezielle (BZL101)-induced oxidative stress damage followed by redistribution of metabolic fluxes in breast cancer cells: a combined proteomic and metabolomic study. Int J Cancer. 2011 Dec 15;129(12):2945-57.

[11] Royt M, Mukherjee S, Sarkar R, et al. Curcumin sensitizes chemotherapeutic drugs via modulation of PKC, telomerase, NF-kappaB and HDAC in breast cancer. Ther Deliv. 2011 Oct;2(10):1275-93.

[12] Bayet-Robert M, Kwiatkowski F, Leheurteur M, et al. Phase I dose escalation trial of docetaxel plus curcumin in patients with advanced and metastatic breast cancer. Cancer Biol Ther. 2010 Jan;9(1):8-14. Epub 2010 Jan 21.

[13] Marczylo TH, Verschoyle RD, Cooke DN, et al. Comparison of systemic availability of curcumin with that of curcumin formulated with phosphatidylcholine. Cancer Chemother Pharmacol. 2007 Jul;60(2):171-7.

[14] DiSilvestro RA1, Joseph E, Zhao S, Bomser J. Diverse effects of a low dose supplement of lipidated curcumin in healthy middle aged people. Nutr J. 2012 Sep 26;11:79. doi: 10.1186/1475-2891-11-79.

[15] Zhang G, Wang Y, Zhang Y, et al. Anti-cancer activities of tea epigallocatechin-3-gallate in breast cancer patients under radiotherapy. Curr Mol Med. 2012 Feb;12(2):163-76.

[16] Eddy SF, Kane SE, Sonenshein GE. Trastuzumab-resistant HER2-driven breast cancer cells are sensitive to epigallocatechin-3 gallate. Cancer Res. 2007 Oct 1;67(19):9018-23.

[17] Zhu W, Qin W, Zhang K, et al. Trans-resveratrol alters mammary promoter hypermethylation in women at increased risk for breast cancer. Nutr Cancer. 2012 Apr;64(3):393-400.

[18] Di Franco R, Calvanese M, Murino P, et al. Skin toxicity from external beam radiation therapy in breast cancer patients: protective effects of Resveratrol, Lycopene, Vitamin C and anthocianin (Ixor®). Radiat Oncol. 2012 Jan 30;7:12.

[19] Kim S, Kim SH, Hur SM, et al. Silibinin prevents TPA-induced MMP-9 expression by down-regulation of COX-2 in human breast cancer cells. J Ethnopharmacol. 2009 Nov 12;126(2):252-7.

[20] Tyagi AK, Agarwal C, Chan DC, et al. Synergistic anti-cancer effects of silibinin with conventional cytotoxic agents doxorubicin, cisplatin and carboplatin against human breast carcinoma MCF-7 and MDA-MB468 cells. Oncol Rep. 2004 Feb;11(2):493-9.

[21] Duo J, Ying GG, Wang GW, et al. Quercetin inhibits human breast cancer cell proliferation and induces apoptosis via Bcl-2 and Bax regulation. Mol Med Rep. 2012 Jun;5(6):1453-6.

[22] Mense SM, Chhabra J, Bhat HK. Preferential induction of cytochrome P450 1A1 over cytochrome P450 1B1 in human breast epithelial cells following exposure to quercetin. J Steroid Biochem Mol Biol. 2008 May;110(1-2):157-62.

[23] Seo HS, Choi HS, Choi HS, et al. Phytoestrogens induce apoptosis via extrinsic pathway, inhibiting nuclear factor-kappaB signaling in HER2-overexpressing breast cancer cells. Anticancer Res. 2011 Oct;31(10):3301-13.

[24] Song X, Siriwardhana N, et al. Grape seed proanthocyanidin suppression of breast cell carcinogenesis induced by chronic exposure to combined 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone and benzo[a]pyrene. Mol Carcinog. 2010 May;49(5):450-63.

[25] Kijima I, Phung S, Hur G, et al. Grape seed extract is an aromatase inhibitor and a suppressor of aromatase expression. Cancer Res. 2006 Jun 1;66(11):5960-7.

[26] Cutando A, López-Valverde A, et al. Role of melatonin in cancer treatment. Anticancer Res. 2012 Jul;32(7):2747-53.

[27] Ju J, Picinich SC, Yang Z, et al. Cancer-preventive activities of tocopherols and tocotrienols. Carcinogenesis. 2010 Apr;31(4):533-42.

[28] Yang CS, Suh N, Kong AN. Does vitamin E prevent or promote cancer? Cancer Prev Res (Phila). 2012 May;5(5):701-5.

[29] Nimptsch K, Rohrmann S, Kaaks R, et al. Dietary vitamin K intake in relation to cancer incidence and mortality: results from the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg). Am J Clin Nutr. 2010 May;91(5):1348-58.

[30] Nimptsch K, Rohrmann S, Linseisen J. Dietary intake of vitamin K and risk of prostate cancer in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg). Am J Clin Nutr. 2008 Apr;87(4):985-92.

[31] Zhang H, Ozaki I, Hamajima H, et al. Vitamin K2 augments 5-fluorouracil-induced growth inhibition of human hepatocellular carcinoma cells by inhibiting NF-κB activation. Oncol Rep. 2011 Jan;25(1):159-66.

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