Skip to main content

Advertisement

Log in

The association between soy isoflavone intake and menopausal symptoms after breast cancer diagnosis: a prospective longitudinal cohort study on Chinese breast cancer patients

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

This study investigated the association between soy isoflavone intake and menopausal symptoms (MPS) among Chinese women with early stage breast cancer in a prospective cohort study.

Methods

In an on-going prospective cohort study that involved 1462 Chinese women with early stage breast cancer, MPS were assessed at 18, 36 and 60 months after cancer diagnosis using the validated menopausal rating scale (MRS) questionnaire. Daily soy food intake for the previous 12 months was assessed at the same time using a validated food frequency questionnaire. The associations between MPS and soy isoflavone intake were evaluated in multivariable logistic regression analyses.

Results

The prevalence of MPS was almost the same during the first 60 months after cancer diagnosis, which were 64.5%, 65.2%, and 63.9% at 18, 36, and 60 months, respectively. Patients with MPS tended to be younger than those without MPS. The intake of soy isoflavones was not associated with the total score of MRS at 18-month follow-up [highest vs lowest tertile, odds ratio (OR) = 1.00, 95% CI 0.75–1.34]. Similarly, no significant association was noted at 36-month (OR = 1.25, 95% CI 0.92–1.69) and 60-month (OR = 1.21, 95% CI 0.84–1.74) follow-up. With regards to specific domain within MRS, the risk of symptoms presenting in somatic domain was higher among breast cancer patients who were in the highest tertile of soy isoflavone intake at 36 months post-diagnosis (OR = 1.44, 95% CI 1.07–1.94, P-trend = 0.02), compared with the lowest tertile, where a stronger significant association was noted among patients who were younger than 60 years (OR = 1.52, 95% CI 1.05–2.20, P-trend = 0.03) and pre-menopausal (OR = 3.81, 95% CI 1.85–8.11, P-trend < 0.01).

Conclusion

The present study provided further evidence that soy isoflavone consumption was not associated with MPS among Chinese breast cancer patients. In fact, patients with higher intake of soy isoflavone have increased risk of experiencing somatic symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Loibl S, Lintermans A, Dieudonne AS, Neven P (2011) Management of menopausal symptoms in breast cancer patients. Maturitas 68(2):148–154. https://doi.org/10.1016/j.maturitas.2010.11.013

    Article  CAS  PubMed  Google Scholar 

  2. Lammerink EA, de Bock GH, Schroder CP, Mourits MJ (2012) The management of menopausal symptoms in breast cancer survivors: case-based approach. Maturitas 73(3):265–268. https://doi.org/10.1016/j.maturitas.2012.07.010

    Article  PubMed  Google Scholar 

  3. Cohen PA, Brennan A, Marino JL, Saunders CM, Hickey M (2017) Managing menopausal symptoms after breast cancer: a multidisciplinary approach. Maturitas 105:4–7. https://doi.org/10.1016/j.maturitas.2017.04.013

    Article  PubMed  Google Scholar 

  4. Santen RJ, Stuenkel CA, Davis SR, Pinkerton JV, Gompel A, Lumsden MA (2017) Managing menopausal symptoms and associated clinical issues in breast cancer survivors. J Clin Endocrinol Metab 102(10):3647–3661. https://doi.org/10.1210/jc.2017-01138

    Article  PubMed  Google Scholar 

  5. Dorjgochoo T, Gu K, Kallianpur A, Zheng Y, Zheng W, Chen Z, Lu W, Shu XO (2009) Menopausal symptoms among breast cancer patients 6 months after diagnosis: a report from the Shanghai Breast Cancer Survival Study. Menopause 16(6):1205–1212. https://doi.org/10.1097/gme.0b013e3181aac32b

    Article  PubMed  PubMed Central  Google Scholar 

  6. Kurzer MS, Xu X (1997) Dietary phytoestrogens. Annu Rev Nutr 17:353–381. https://doi.org/10.1146/annurev.nutr.17.1.353

    Article  CAS  PubMed  Google Scholar 

  7. Dixon RA (2004) Phytoestrogens. Annu Rev Plant Biol 55:225–261. https://doi.org/10.1146/annurev.arplant.55.031903.141729

    Article  CAS  PubMed  Google Scholar 

  8. Eden JA (2012) Phytoestrogens for menopausal symptoms: a review. Maturitas 72(2):157–159. https://doi.org/10.1016/j.maturitas.2012.03.006

    Article  CAS  PubMed  Google Scholar 

  9. He F-J, Chen J-Q (2013) Consumption of soybean, soy foods, soy isoflavones and breast cancer incidence: differences between Chinese women and women in Western countries and possible mechanisms. Food Sci Hum Well 2(3–4):146–161. https://doi.org/10.1016/j.fshw.2013.08.002

    Article  Google Scholar 

  10. Magee PJ, Rowland I (2012) Soy products in the management of breast cancer. Curr Opin Clin Nutr Metab Care 15(6):586–591. https://doi.org/10.1097/MCO.0b013e328359156f

    Article  CAS  PubMed  Google Scholar 

  11. Roberts H, Lethaby A (2014) Phytoestrogens for menopausal vasomotor symptoms: a Cochrane review summary. Maturitas 78(2):79–81. https://doi.org/10.1016/j.maturitas.2014.04.004

    Article  CAS  PubMed  Google Scholar 

  12. Taku K, Melby MK, Kronenberg F, Kurzer MS, Messina M (2012) Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity: systematic review and meta-analysis of randomized controlled trials. Menopause 19(7):776–790. https://doi.org/10.1097/gme.0b013e3182410159

    Article  PubMed  Google Scholar 

  13. Thomas AJ, Ismail R, Taylor-Swanson L, Cray L, Schnall JG, Mitchell ES, Woods NF (2014) Effects of isoflavones and amino acid therapies for hot flashes and co-occurring symptoms during the menopausal transition and early postmenopause: a systematic review. Maturitas 78(4):263–276. https://doi.org/10.1016/j.maturitas.2014.05.007

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Gold EB, Flatt SW, Pierce JP, Bardwell WA, Hajek RA, Newman VA, Rock CL, Stefanick ML (2006) Dietary factors and vasomotor symptoms in breast cancer survivors: the WHEL Study. Menopause 13(3):423–433. https://doi.org/10.1097/01.gme.0000185754.85328.44

    Article  PubMed  Google Scholar 

  15. Dorjgochoo T, Gu K, Zheng Y, Kallianpur A, Chen Z, Zheng W, Lu W, Shu XO (2011) Soy intake in association with menopausal symptoms during the first 6 and 36 months after breast cancer diagnosis. Breast Cancer Res Treat 130(3):879–889. https://doi.org/10.1007/s10549-010-1096-4

    Article  CAS  PubMed  Google Scholar 

  16. Quella SK, Loprinzi CL, Barton DL, Knost JA, Sloan JA, LaVasseur BI, Swan D, Krupp KR, Miller KD, Novotny PJ (2000) Evaluation of soy phytoestrogens for the treatment of hot flashes in breast cancer survivors: a North Central Cancer Treatment Group Trial. J Clin Oncol 18(5):1068–1074. https://doi.org/10.1200/jco.2000.18.5.1068

    Article  CAS  PubMed  Google Scholar 

  17. Van Patten CL, Olivotto IA, Chambers GK, Gelmon KA, Hislop TG, Templeton E, Wattie A, Prior JC (2002) Effect of soy phytoestrogens on hot flashes in postmenopausal women with breast cancer: a randomized, controlled clinical trial. J Clin Oncol 20(6):1449–1455. https://doi.org/10.1200/jco.2002.20.6.1449

    Article  PubMed  Google Scholar 

  18. Nikander E, Kilkkinen A, Metsa-Heikkila M, Adlercreutz H, Pietinen P, Tiitinen A, Ylikorkala O (2003) A randomized placebo-controlled crossover trial with phytoestrogens in treatment of menopause in breast cancer patients. Obstet Gynecol 101(6):1213–1220

    CAS  PubMed  Google Scholar 

  19. MacGregor CA, Canney PA, Patterson G, McDonald R, Paul J (2005) A randomised double-blind controlled trial of oral soy supplements versus placebo for treatment of menopausal symptoms in patients with early breast cancer. Eur J Cancer 41(5):708–714. https://doi.org/10.1016/j.ejca.2005.01.005

    Article  CAS  PubMed  Google Scholar 

  20. Nomura SJO, Hwang YT, Gomez SL, Fung TT, Yeh SL, Dash C, Allen L, Philips S, Hilakivi-Clarke L, Zheng YL, Wang JH (2018) Dietary intake of soy and cruciferous vegetables and treatment-related symptoms in Chinese-American and non-Hispanic White breast cancer survivors. Breast Cancer Res Treat 168(2):467–479. https://doi.org/10.1007/s10549-017-4578-9

    Article  CAS  PubMed  Google Scholar 

  21. Edge SB, Compton CC, Fritz AG, Greene FL, Trotti A (eds) (2010) AJCC cancer staging manual, 7th edn. Springer, New York, NY

    Google Scholar 

  22. Zhang CX, Ho SC (2009) Validity and reproducibility of a food frequency Questionnaire among Chinese women in Guangdong province. Asia Pac J Clin Nutr 18(2):240–250

    CAS  PubMed  Google Scholar 

  23. Yang Y-X, Wang G-Y, Pan X-C (2002) China Food Composition 2002. Peking University Medical Press, Beijing, China

    Google Scholar 

  24. Chan SG, Murphy PA, Ho SC, Kreiger N, Darlington G, So EK, Chong PY (2009) Isoflavonoid content of Hong Kong soy foods. J Agric Food Chem 57(12):5386–5390. https://doi.org/10.1021/jf803870k

    Article  CAS  PubMed  Google Scholar 

  25. Wu HC, Wen SH, Hwang JS, Huang SC (2015) Validation of the traditional Chinese version of the Menopausal Rating Scale with WHOQOL-BREF. Climacteric 18(5):750–756. https://doi.org/10.3109/13697137.2015.1044513

    Article  PubMed  Google Scholar 

  26. Heinemann LA, Potthoff P, Schneider HP (2003) International versions of the Menopause Rating Scale (MRS). Health Qual Life Outcomes 1:28. https://doi.org/10.1186/1477-7525-1-28

    Article  PubMed  PubMed Central  Google Scholar 

  27. Heinemann K, Ruebig A, Potthoff P, Schneider HP, Strelow F, Heinemann LA, Do MT (2004) The Menopause Rating Scale (MRS) scale: a methodological review. Health and quality of life outcomes 2:45. https://doi.org/10.1186/1477-7525-2-45

    Article  PubMed  PubMed Central  Google Scholar 

  28. Menopause Rating Scale. https://www.menopause-rating-scaleinfo/documents/Ref_Values_CountrGr.pdf

  29. Invasive Breast Cancer Version 3.2020, NCCN Clinical Practice Guidelines in Oncology

  30. Chan SG, Ho SC, Kreiger N, Darlington G, So KF, Chong PY (2007) Dietary sources and determinants of soy isoflavone intake among midlife Chinese Women in Hong Kong. J Nutr 137(11):2451–2455

    Article  CAS  Google Scholar 

  31. Hickey M, Saunders CM, Stuckey BG (2005) Management of menopausal symptoms in patients with breast cancer: an evidence-based approach. Lancet Oncol 6(9):687–695. https://doi.org/10.1016/s1470-2045(05)70316-8

    Article  PubMed  Google Scholar 

  32. Kaunitz AM, Manson JE (2015) Management of Menopausal Symptoms. Obstet Gynecol 126(4):859–876. https://doi.org/10.1097/aog.0000000000001058

    Article  PubMed  PubMed Central  Google Scholar 

  33. Bachmann G (1995) Urogenital ageing: an old problem newly recognized. Maturitas 22(Suppl):S1–s5

    Article  Google Scholar 

  34. Wu AH, Pike MC, Williams LD, Spicer D, Tseng CC, Churchwell MI, Doerge DR (2007) Tamoxifen, soy, and lifestyle factors in Asian American women with breast cancer. J Clin Oncol 25(21):3024–3030. https://doi.org/10.1200/jco.2006.10.5023

    Article  CAS  PubMed  Google Scholar 

  35. Anderson JJ, Anthony M, Messina M, Garne SC (1999) Effects of phyto-oestrogens on tissues. Nutr Res Rev 12(1):75–116. https://doi.org/10.1079/095442299108728875

    Article  CAS  PubMed  Google Scholar 

  36. Santell RC, Chang YC, Nair MG, Helferich WG (1997) Dietary genistein exerts estrogenic effects upon the uterus, mammary gland and the hypothalamic/pituitary axis in rats. J Nutr 127(2):263–269

    Article  CAS  Google Scholar 

  37. Wang TT, Sathyamoorthy N, Phang JM (1996) Molecular effects of genistein on estrogen receptor mediated pathways. Carcinogenesis 17(2):271–275

    Article  Google Scholar 

  38. Alipour S, Jafari-Adli S, Eskandari A (2015) Benefits and harms of phytoestrogen consumption in breast cancer survivors. Asian Pac J Cancer Prev 16(8):3091–3396

    Article  Google Scholar 

  39. Sonestedt E, Wirfalt E (2010) Enterolactone and breast cancer: methodological issues may contribute to conflicting results in observational studies. Nutr Res 30(10):667–677. https://doi.org/10.1016/j.nutres.2010.09.010

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The study was approved by the Joint CUHK-NTEC Clinical Research Ethics Committee and the KWC Research Ethics Committee of the Chinese University of Hong Kong and the Hong Kong Hospital Authority.

Funding

This study was funded by World Cancer Research Fund International (Grant Number WCRF 2010/249 and WCRF 2014/1197).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Winnie Yeo.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 25 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lei, YY., Ho, S.C., Cheng, A. et al. The association between soy isoflavone intake and menopausal symptoms after breast cancer diagnosis: a prospective longitudinal cohort study on Chinese breast cancer patients. Breast Cancer Res Treat 181, 167–180 (2020). https://doi.org/10.1007/s10549-020-05616-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-020-05616-3

Keywords

Navigation