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Acupuncture for hot flashes in hormone receptor-positive breast cancer, a coordinated multinational study: Rationale and design of the study protocol. Contemp Clin Trials 2022; 121:106885. [PMID: 35998768 DOI: 10.1016/j.cct.2022.106885] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 07/30/2022] [Accepted: 08/12/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Acupuncture has been reported to reduce hot flashes in patients with breast cancer undergoing adjuvant hormonal therapy. Although hot flashes are common, the prevalence varies among cultures, races, and ethnicities; the efficacy of acupuncture across cultures has not been investigated. METHODS This is a coordinated multinational study, including three parallel randomized trials with a planned analysis of individual patient data, to test the effectiveness of acupuncture on hot flash-related symptoms in hormone receptor-positive breast cancer patients on adjuvant endocrine therapy. Using a standardized acupuncture protocol (total across all three studies of n = 80) versus usual care (total n = 80), symptoms are assessed using changes in the Endocrine Symptom Subscale of Functional Assessment of Cancer Therapy-Endocrine Symptoms. Secondary outcomes include hot flash severity, quality of life, and sleep quality. Differences in response to acupuncture between participants in the three countries will also be explored. DISCUSSION Here we describe the design of a protocol for a coordinated multinational study, with attention to the complex considerations in developing a multinational research effort testing a non-pharmacologic intervention. This protocol and approach provide guidance for future efforts to evaluate and test non-pharmacologic interventions across multinational populations. TRIAL REGISTRATION clinicaltrials.gov (Identifier: NCT00797732, registered on December 21, 2018), Chinese Clinical Trial Registry (ChiCTR2100045888), and The Clinical Research Information Service (CRIS) of Korea (Registration number: KCT0003618).
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Lei Y, Ho SC, Kwok C, Cheng A, Cheung KL, Lee R, Mo FKF, Yeo W. Menopausal symptoms inversely associated with quality of life: findings from a 5-year longitudinal cohort in Chinese breast cancer survivors. Menopause 2021; 28:928-934. [PMID: 33878090 DOI: 10.1097/gme.0000000000001784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study assessed menopausal symptoms (MPS) after breast cancer in relation to quality of life (QoL) during the first 5 years of survival. METHODS An ongoing prospective study enrolled 1,462 Chinese women with early-stage breast cancer. They were longitudinally followed up at four time-points, namely baseline, 18-, 36-, and 60-month after diagnosis. At each follow-up, Menopause Rating Scale (MRS) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 were used to assess MPS and QoL, respectively. RESULTS In total, 1,462, 1,289, 1,125, and 1,116 patients were included into the analyses at baseline, 18-, 36-, and 60-months, respectively. The percentages of patients with no or little, mild, moderate, and severe MPS at baseline were 31.8%, 30.0%, 30.4%, and 7.7%, respectively; the corresponding figures at 18-, 36-, and 60-month follow-up were similar. Using data from four follow-ups, Generalized Estimating Equations analyses showed that MPS was inversely associated with QoL. Higher MRS scores were related to lower QoL scores. For instance, every 1 point increase in MRS score was associated with a 1.5 point decrease in global health status/QoL score (P < 0.01). In terms of symptoms, higher MRS scores were related to more severe symptoms. CONCLUSIONS This study highlighted patients with more severe MPS tend to have worse QoL. Future investigation should be conducted to assess different means of alleviating MPS to improve patient's QoL.
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Affiliation(s)
- Yuanyuan Lei
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Suzanne C Ho
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Carol Kwok
- Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong SAR, China
| | - Ashley Cheng
- Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong SAR, China
| | - Ka Li Cheung
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Roselle Lee
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Frankie K F Mo
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
- Hong Kong Cancer Institute, State Key Laboratory in Oncology in South China, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Winnie Yeo
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
- Hong Kong Cancer Institute, State Key Laboratory in Oncology in South China, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
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Changes in hot flash experiences and related factors in women with breast cancer. ACTA ACUST UNITED AC 2020; 27:535-542. [PMID: 32068690 DOI: 10.1097/gme.0000000000001507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Taiwanese women are younger than women in western countries when diagnosed with breast cancer, and many of them are still menstruating. One of many distressing side effects reported by premenopausal women treated for breast cancer are hot flashes (HFs). The purposes of this study were to identify: (1) the trajectories of hot flash (HF) occurrence, frequency, and interference and (2) potential factors associated with HF changes. METHODS Peri- or premenopausal women newly diagnosed with breast cancer scheduled to receive chemotherapy and hormonal therapy were enrolled. HF frequency, HF interference, and other symptoms were measured six times from prechemotherapy to 24 months after chemotherapy. Data were analyzed using hierarchical linear modeling. RESULTS A total of 90 women were eligible for the study. The prechemotherapy occurrence rate of HFs was 7.9%, but rapidly increased to 42.5% immediately after chemotherapy. The change curve of HF frequency and interference appeared quadratic, increasing first and slightly decreasing later. At any time point, increased body mass index (BMI) was associated with both higher HF frequency (P = 0.020) and HF interference (P = 0.002), whereas anxiety (P < 0.001) and loss of sexual desire (P = 0.038) were associated with higher HF interference. Six months after completing chemotherapy, premenopausal women reported significantly higher HF frequency than perimenopausal women (P = 0.041). CONCLUSION A significant proportion of pre- and perimenopausal women experienced HFs after receiving breast cancer treatment. Our findings on HF trajectories can educate patients newly diagnosed with breast cancer. Special attention should be paid to those with increased body mass index changes and those still regularly menstruating.
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Lavdaniti M, Owens DA, Liamopoulou P, Marmara K, Zioga E, Mantzanas MS, Evangelidou E, Vlachou E. Factors Influencing Quality of Life in Breast Cancer Patients Six Months after the Completion of Chemotherapy. Diseases 2019; 7:diseases7010026. [PMID: 30813488 PMCID: PMC6473656 DOI: 10.3390/diseases7010026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 02/17/2019] [Accepted: 02/22/2019] [Indexed: 12/13/2022] Open
Abstract
Purpose: To assess breast cancer patients’ quality of life six months after the completion of adjuvant chemotherapy, and to investigate factors affecting this. Methods: The study was conducted in one large hospital located in a major Greek city. A convenience sample of 61 breast cancer outpatients was recruited. A questionnaire, including the SF-36 scale and questions regarding demographic and clinical information, was used to collect data. Results: The mean age of the patients was 51.52 ± 12.10. The effect of age on the physical role was significant (p = 0.003). Τhe effect of menopausal status on physical role was also found to be significant (p = 0.003); this might be explained by age. Regarding the treatment type, patients who received hormone therapy in addition to surgery and chemotherapy reported a significantly higher quality of life in terms of bodily pain (p = 0.04) and vitality (p = 0.04) than patients who underwent only surgery and chemotherapy. Conclusions: Quality of life is affected by factors such as age, menopausal status, and previous therapy. Health care professionals should be more aware of the factors that influence the quality of life domains (physical role, bodily pain, vitality) within this group of cancer patients in order to meet their needs following acute treatment.
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Affiliation(s)
- Maria Lavdaniti
- Nursing Department, Alexander Technological Educational Institute, 57400 Thessaloniki, Greece.
| | | | - Polixeni Liamopoulou
- Nursing Department, Alexander Technological Educational Institute, 57400 Thessaloniki, Greece.
| | - Kalliopi Marmara
- Faculty of Physical Education, Aristotele University of Thessaloniki, 54124 Thermi Thessaloniki, Greece.
| | | | - Michael S Mantzanas
- Department of University Orthopedic, MSc, MHSc, PhD, General Hospital of Nea Ionia "Konstantopouleio-Patision", 14233 Athens, Greece.
| | - Eftychia Evangelidou
- Department of Infection Control, MSc, MHSc, PhD(c), General Hospital of Nea Ionia "Konstantopouleio-Patision", 14233 Athens, Greece.
| | - Eugenia Vlachou
- Nursing Department, University of West Attica, 12243 Athens, Greece.
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How Menopause Symptoms and Attitude Impact Korean Women's Quality of Life After Adjuvant Treatment for Breast Cancer. Cancer Nurs 2016; 40:E60-E66. [PMID: 27922913 DOI: 10.1097/ncc.0000000000000448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Attitudes toward menopause vary across cultures and influence women's experiences of menopausal symptoms, possibly leading to reduced posttreatment quality of life in breast cancer survivors. OBJECTIVE The aim of this study is to examine the effects of menopausal symptoms and attitudes on health-related quality of life in breast cancer survivors who were premenopausal at the time of diagnosis. METHODS A total of 139 women receiving chemotherapy with/without endocrine therapy were assessed with self-report questionnaires of established reliability and validity. Hierarchical regression was conducted to assess the impact of menopausal symptoms and attitudes on quality of life, while controlling for demographic characteristics. RESULTS Overall, participants endorsed more than half of 46 symptoms, most at the level of mild symptoms, and most reported a less positive attitude toward menopause. Lower quality of life was significantly predicted by more menopausal symptoms endorsed and more negative attitudes when controlling for demographic factors associated with quality of life (R = 26.1%). Most participants experienced change from premenopause to postmenopause after the completion of adjuvant chemotherapy with or without tamoxifen. CONCLUSIONS The results suggest that more menopausal symptoms and negative attitudes toward menopause may affect health-related quality of life considerably in chemotherapy-treated Asian breast cancer survivors. IMPLICATIONS FOR PRACTICE Healthcare professionals should develop a better understanding of the effects of menopausal symptoms and attitudes on quality of life by using a culturally relevant perspective based on patients' sociocultural backgrounds. Furthermore, these findings help healthcare professionals communicate with their Asian clients in a more informed way and provide culturally appropriate and individualized care.
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Yamamoto S, Masutani E, Arao H. Effect of persistent menopausal symptoms on the wellbeing of Japanese breast cancer survivors. Nurs Health Sci 2016; 18:379-86. [PMID: 27101769 DOI: 10.1111/nhs.12283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 02/08/2016] [Accepted: 03/09/2016] [Indexed: 11/28/2022]
Abstract
While more women with breast cancer survive because of advances in cancer treatment including hormonal therapy, they are at a risk of menopausal symptoms, which can threaten their psychological wellbeing. We examined the effect of menopausal symptoms on women's psychological wellbeing during three different phases of breast cancer: short-term (0-1 years since diagnosis), medium-term (2-5 years), and long-term (more than 5 years). In this cross-sectional study, 425 survivors treated with hormonal therapy were recruited from a convenience sample in Japan and completed an anonymous self-administered questionnaire. Multiple regression analysis revealed that menopausal symptoms significantly contributed to psychological wellbeing in all phases. In long-term survivors, menopausal symptoms were significantly milder; however, the negative effect was prolonged. One in three to four survivors was suspected to have poor psychological wellbeing, irrespective of time. Although the effect of menopausal symptoms on psychological wellbeing has been described in short-term survivors, little is known about the long-term effect. This study examines the effect of menopausal symptoms on psychological wellbeing, thereby providing useful information regarding long-term quality of life.
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Affiliation(s)
- Sena Yamamoto
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eiko Masutani
- Cancer Education and Research Center, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Harue Arao
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
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Ramadas A, Qureshi AM, Dominic NA, Botross NP, Riad A, Arasoo VJT, Elangovan S. Socio-Demography and Medical History as Predictors of Health-Related Quality of Life of Breast Cancer Survivors. Asian Pac J Cancer Prev 2015; 16:1479-85. [DOI: 10.7314/apjcp.2015.16.4.1479] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Chen Y, Dorjgochoo T, Bao PP, Zheng Y, Cai H, Lu W, Shu XO. Menopausal symptoms among breast cancer patients: a potential indicator of favorable prognosis. PLoS One 2013; 8:e75926. [PMID: 24098745 PMCID: PMC3786948 DOI: 10.1371/journal.pone.0075926] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 08/22/2013] [Indexed: 01/15/2023] Open
Abstract
Menopausal symptoms have been suggested to be an indicator of better prognosis among patients treated for breast cancer, because women who experience these symptoms usually have a lower level of estrogen. We tested this hypothesis in a population-based, prospective cohort study involving 4,842 women with stage 0 to III primary breast cancer who were enrolled in the Shanghai Breast Cancer Survival Study between March 2002 and April 2006, were aged 20 to 75 years, and were recruited 6 months post-diagnosis. They were followed-up by in-person surveys and record linkages with the vital statistics registry. Cox regression analysis was used to evaluate the association of menopausal symptoms at baseline with breast cancer recurrence. Approximately 56% of patients experienced at least one menopausal symptom, including hot flashes, night sweats, and/or vaginal dryness at baseline. During a median follow-up period of 5.3 years, 720 women had a recurrence. Experiencing hot flashes or having ≥2 menopausal symptoms was associated with lower risk of recurrence among premenopausal women (hazard ratio [HR]=0.77, 95% confidence interval [CI]: 0.62-0.96 for hot flashes; 0.73, 0.56-0.96 for ≥2 menopausal symptoms). Lower recurrence risk in relation to hot flashes was also observed among women who were not overweight/obese (HR=0.78, 95% CI: 0.64-0.99), those with relatively low waist-to-hip ratio (WHR) (HR=0.77, 95% CI: 0.61-0.97), and those who used tamoxifen (HR=0.75, 95% CI: 0.58-0.98). Consistently experiencing multiple menopausal symptoms was associated with lower recurrence risk among women with low WHR or who used tamoxifen. This large, population-based cohort study of women with breast cancer confirms that experiencing menopausal symptoms is an indicator of favorable breast cancer prognosis.
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Affiliation(s)
- Yong Chen
- Department of Science & Education, Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China
| | - Tsogzolmaa Dorjgochoo
- Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Ping-Ping Bao
- Department of Cancer Prevention & Control, Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China
| | - Ying Zheng
- Department of Cancer Prevention & Control, Shanghai Institute of Preventive Medicine, Shanghai, China
| | - Hui Cai
- Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Wei Lu
- Department of Cancer Prevention & Control, Shanghai Institute of Preventive Medicine, Shanghai, China
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee, United States of America
- * E-mail:
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Bao PP, Lu W, Cui Y, Zheng Y, Gu K, Chen Z, Zheng W, Shu XO. Ginseng and Ganoderma lucidum use after breast cancer diagnosis and quality of life: a report from the Shanghai Breast Cancer Survival Study. PLoS One 2012; 7:e39343. [PMID: 22745737 PMCID: PMC3379976 DOI: 10.1371/journal.pone.0039343] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 05/18/2012] [Indexed: 11/18/2022] Open
Abstract
Objective To evaluate associations between quality of life (QOL) and use of ginseng and Ganoderma lucidum (G. lucidum) among breast cancer survivors. Methods Included in this study were 4,149 women with breast cancer who participated in the Shanghai Breast Cancer Survival Study. Ginseng use was assessed at 6-, 18-, and 36-month post-diagnosis surveys; G. lucidum use was assessed at the 6- and 36-month surveys. QOL was evaluated at the 6- and 36-month surveys. Multiple linear regression models were used to examine associations between ginseng and G.lucidum use and QOL assessed at the 36-month survey, with adjustment for potential confounders and baseline QOL. Results At 6 months post-diagnosis, 14.2% of participants reported regular use of ginseng and 58.8% reported use of G. lucidum. We found no significant associations between ginseng use at 6, 18, and 36 months post-diagnosis and participants’ total QOL score or individual scores for psychological, physical, or social well-being. Post-diagnosis G. lucidum use was positively associated with social well-being (adjusted mean difference: 1.26; 95% CI: 0.66, 1.86), but was inversely associated with physical well-being (adjusted mean difference: −1.16; 95% CI: −1.86, −0.47) with a dose-response pattern observed for cumulative number of times of use (P for trend <0.001 for both). Conclusion We found no evidence that post-diagnosis ginseng use improved the QOL of breast cancer survivors. Post-diagnosis G. lucidum use was associated with better social well-being scores, but poorer physical well-being scores.
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Affiliation(s)
- Ping-Ping Bao
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Wei Lu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Yong Cui
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Ying Zheng
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Kai Gu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People’s Republic of China
| | - Zhi Chen
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Xiao Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
- * E-mail:
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Dorjgochoo T, Gu K, Zheng Y, Kallianpur A, Chen Z, Zheng W, Lu W, Shu XO. Soy intake in association with menopausal symptoms during the first 6 and 36 months after breast cancer diagnosis. Breast Cancer Res Treat 2010; 130:879-89. [PMID: 20703939 DOI: 10.1007/s10549-010-1096-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 07/24/2010] [Indexed: 10/19/2022]
Abstract
It has been suggested that soy food and its components may relieve menopausal symptoms (MPS) including hot flashes, night sweats, and vaginal dryness in healthy women. However, little is known about the effect of soy food intake on MPS in women with breast cancer. We examined associations of occurrence of MPS with soy food intake in 4,842 Chinese women aged 20-75 years who had non-metastatic breast cancer and had not used hormone replacement therapy. MPS were assessed at 6 and 36 months after cancer diagnosis using a standardized questionnaire, and associations with soy food intake were evaluated in multivariate regression analyses. Daily soy food intake was assessed at 6 months postdiagnosis and over the first 36 months postdiagnosis using a validated food frequency questionnaire. The prevalence of MPS was 56% at 6 months and 63% at 36 months postdiagnosis with the hotflash being the most common MPS (~44-55%). Hot flashes occurred mainly in premenopausal breast cancer patients who were in the highest quartile of isoflavone intake at 6 months postdiagnosis (OR = 1.20, 95% CI: 0.98-1.59) compared with the lowest quartile. This association was stronger at 36 months postdiagnosis (OR = 1.59, 95% CI: 1.02-2.48). We found no significant associations for any MPS, night sweats, or vaginal dryness. Neither tamoxifen use nor BMI modified the association between MPS and isoflavone intake. There was no evidence that soy food consumption reduced MPS among breast cancer patients. High soy intake may increase the prevalence of hotflashes among premenopausal patients. Our study suggests that soy acts as an estrogen antagonist in breast cancer patients.
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Affiliation(s)
- Tsogzolmaa Dorjgochoo
- Vanderbilt Epidemiology Center, Department of Medicine, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 600, Nashville, TN 37203-1738, USA
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