Division of Cancer Prevention and Genetics, European Institute of Oncology, Milan, Italy.
Breast. 2011 Oct;20 Suppl 3:S36-41. doi: 10.1016/S0960-9776(11)70292-2.
This review highlights the role of vitamins and natural compounds in breast cancer prevention, with a particular focus on Vitamin D. In the last decades, both encouraging and discouraging results about the association between antioxidant supplementation and cancer have been reported to public and scientific community. Their safe and favorable toxicity profile makes them suitable to be investigated in a preventive setting. However, a recent large meta-analysis showed that treatment with beta carotene, vitamin A, and vitamin E may increase mortality, whereas the potential roles of vitamin C and selenium on mortality need further study. Likewise, folate levels were not associated with reduced breast cancer risk in a recent meta-analysis. Several studies have shown that a high proportion of women at-risk for breast cancer or affected by the disease have deficient vitamin D levels, i.e., 250 H-D <20 ng/ml or 50 nmol/L. While the association between Vitamin D levels and breast cancer risk/prognosis is still controversial, the U-shaped relationship between 250 H-D levels observed in different studies suggests the need to avoid both deficient and too high levels. Further trials using an optimal dose range are needed to assess the preventive and therapeutic effect of vitamin D. Finally, Fenretinide, a pro-apoptotic and pro-oxidant vitamin A derivative, has shown promise in several trials and its preventive potential is being assessed in young women at very high risk for breast cancer.
这篇综述强调了维生素和天然化合物在乳腺癌预防中的作用，特别关注维生素 D。在过去几十年中，关于抗氧化剂补充剂与癌症之间的关联，向公众和科学界报告了既有令人鼓舞的结果，也有令人沮丧的结果。它们安全且有利的毒性特征使它们适合在预防环境中进行研究。然而，最近一项大型荟萃分析表明，β-胡萝卜素、维生素 A 和维生素 E 的治疗可能会增加死亡率，而维生素 C 和硒对死亡率的潜在作用需要进一步研究。同样，在最近的一项荟萃分析中，叶酸水平与降低乳腺癌风险无关。一些研究表明，很大一部分有乳腺癌风险或患有这种疾病的女性维生素 D 水平不足，即 250 H-D<20ng/ml 或 50nmol/L。虽然维生素 D 水平与乳腺癌风险/预后之间的关系仍存在争议，但不同研究中观察到的 250 H-D 水平呈 U 形关系表明需要避免水平过低和过高。需要进一步使用最佳剂量范围的试验来评估维生素 D 的预防和治疗效果。最后，芬维 A 胺，一种促凋亡和促氧化的维生素 A 衍生物，在几项试验中显示出希望，其预防潜力正在对处于极高乳腺癌风险的年轻女性进行评估。
