Association of Fermented Products with Risk of Cancer Recurrence and Mortality among Breast Cancer Survivors: A Prospective Cohort Study

Abstract

We hypothesized that the intake of fermented soy and dairy products, but not fermented vegetable products, was associated with reduced cancer recurrence and mortality in breast cancer survivors. Women (n = 606) who underwent dietary survey using a 24-h recall within 3 years of breast cancer surgery were recruited, and were followed up for a mean of 89 mo,. Cox proportional hazards regression analysis showed that the risk of cancer recurrence was inversely associated with the intake of fermented soy products (Hazard ratios (HRs):0.976, 95% confidence intervals (CI):0.95–0.99) and fermented dairy products (HRs:0.992, 95% CI:0.98–0.99). Furthermore, the risk of cancer recurrence was inversely associated with the intake of fermented soy products in hormone receptor-positive (HRs:0.296, 95% CI:0.11–0.79), estrogen receptor-positive (HRs:0.971, 95% CI:0.94–0.99), and progesterone receptor-positive (HRs:0.972, 95% CI:0.94–0.99) patients. Mortality was inversely associated with the intake of fermented soy products (HRs:0.967, 95% CI:0.93–0.99). Disease-free survival (P = 0.001) and overall survival (P = 0.004) were positively associated with intake of fermented soy products. Intake of fermented vegetable products had no significant effect on cancer recurrence or mortality. This study suggests that the intake of fermented soy and dairy could be beneficial in preventing cancer recurrence.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Ethics Approval Statement and Consent to Participate

All patients were given a written description of the study, and informed consent was obtained. Full anonymity of the 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).

Author Contributions

J.Y. conducted the study, analyzed the clinical data, and prepared the original draft of the manuscript. Y.P. designed and supervised the study. M.C. revised the manuscript. All authors have read and approved the manuscript.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (NRF-2021R1A2B02002208).