Association of Dietary Total Antioxidant Capacity with Cancer Recurrence and Mortality among Breast Cancer Survivors: A Prospective Cohort Study

Abstract

Antioxidants decrease the risk of breast cancer by reducing oxidative stress, but the association between dietary total antioxidant capacity (DTAC) and cancer recurrence has not yet been investigated. The present study aimed to test the hypothesis that DTAC is inversely associated with cancer recurrence and mortality in breast cancer patients. Breast cancer patients (n = 603) who underwent breast cancer surgery and a dietary survey within 5 years after surgery were recruited. This study observed disease-free survival (DFS) and mortality in breast cancer patients according to DTAC calculated based on 24-hr dietary recall. Total DTAC was significantly lower in patients with cancer recurrence than in those without. DFS was positively associated with the total DTAC (p = 0.005) and DTAC of vegetables and legumes (p = 0.001 and p = 0.010), respectively. However, total DTAC was not associated with mortality. Cox proportional hazards regression analysis showed that total DTAC (HR: 0.44, 95% CI 0.26-0.94) and DTAC of vegetables (HR: 0.30, 95% CI 0.14-0.65) and legumes (HR: 0.38, 95% CI 0.18-0.73) were inversely associated with cancer recurrence after adjusting for confounding factors. This study was the first to indicate that total DTAC and DTAC of vegetables and legumes could be beneficial in decreasing breast cancer recurrence.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Author Contributions

D.H. conducted the study and prepared the original draft. Y.P. designed and supervised the study. MS.C. analyzed the clinical data and revised the manuscript. All authors read and approved the manuscript.

Ethics Approval and Consent to Participate

Ethics approval and consent to participate all patients were given a written description of the study and completed an informed consent. Full anonymity of questionnaire information was guaranteed, as per the consent letter. The project was approved by the Institutional Review Board of Hanyang University Hospital (HYU 2010-02-001-031) and Hanyang University (HYI-15-070).

Additional information

Funding

This study was supported by the BK21 FOUR (Fostering Outstanding Universities for Research) project of the National Research Foundation of Korea Grant, and a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (NRF-2021R1A2B5B02002208).