Dietary Supplement Use in Women Diagnosed with Breast Cancer

Abstract

Background: Vitamins, minerals, and natural product (NP)-derived dietary supplements are commonly used among women with breast cancer, where interactions with treatments and the disease are possible, emphasizing the importance for health care providers to be aware of supplement use.

Objectives: The study aimed to investigate current vitamin/mineral (VM) and NP supplement use among those diagnosed with breast cancer, including usage based on tumor type or concurrent breast cancer treatments and primary information sources for specific supplements.

Methods: Social media recruiting to complete an online questionnaire self-reporting current VM and NP use and breast cancer diagnosis and treatment information primarily attracted US participants. Analyses, including multivariate logistic regression, were performed on 1271 women who self-reported breast cancer diagnosis and completed the survey.

Results: Most participants reported current VM (89.5%) and NP (67.7%) use, with 46.5% (VM) and 26.7% (NP) using at least 3 products concurrently. Top-reported (>15% prevalence) products were vitamin D, calcium, multivitamin, and vitamin C for VM and probiotics, turmeric, fish oil/omega-3 fatty acids, melatonin, and cannabis for NP. Overall, VM or NP use was higher among those with hormone receptor-positive tumors. Although overall NP use did not differ according to current breast cancer treatments, VM use was significantly less common among those currently undergoing chemotherapy or radiation, but higher with current endocrine therapy. Among current chemotherapy users, specific VM and NP supplements with possible adverse effects were still used by 23% of respondents. Medical providers were the primary information source for VM, whereas NP information sources were more varied.

Conclusions: Because women diagnosed with breast cancer commonly reported concurrent use of multiple VM and NP supplements, including those with known or underexplored risks (or benefits) in breast cancer, it is important for health care providers to inquire about and facilitate discussions regarding supplement use in this population.

Keywords: botanical; breast cancer; chemotherapy; dietary supplement; endocrine therapy; hormone receptor; mineral; natural product; vitamin.

FIGURE 1

Study Consolidated Standards of Reporting Trials (CONSORT) diagram. The chart indicates the disposition of all participants who advanced beyond implied consent to initiate the survey (n = 2141). Of those self-reporting a breast cancer diagnosis (n = 1481), 210 (14%) were eliminated because of incomplete demographic (demo), clinical breast cancer, and/or dietary supplement (DS) information, yielding 1271 participants for analysis.

FIGURE 2

Dietary supplement use by breast cancer survivors by product type (n = 1271 participants). (A) Total number of vitamin/mineral (VM) supplements used and (B) prevalence of product-specific VM use, including products itemized in survey or write-in products with >5% prevalent use (product-specific missing data ranged from 0.6% to 2.6%). (C) Total number of non-VM, natural product (NP) supplements used and (B) prevalence of product-specific NP use, including products itemized in survey or write-in products with >5% prevalent use (product-specific missing data ranged from 0.1% to 1.8%).

FIGURE 3

Primary information source when choosing to take a dietary supplement. Product-specific distribution of the reported primary information source for supplement use, including health care providers (e.g., doctor, nurse, and dietitian) (white box); alternative medicine practitioners (e.g., naturopath and acupuncturist) (white box with checkers); family/friends (grey box); internet/social media (grey box with checkers); or other (black box). Note: “other” category frequently included reference to “self” and included other information sources, such as health food stores or books.