The impact of Soy Isoflavone Intake on Mammographic Density: a systematic review and meta-analysis
Abstract
Background: The hypothesis suggests that the comparatively elevated consumption of soy in Asian countries may contribute to the decreased incidence of breast cancer observed in these regions when compared to the Western world. The objective of this meta-analysis study was to investigate the impact of daily soy supplementation on mammographic density, which is recognized as one of the most influential risk factors for breast cancer.
Method: PubMed, Scopus, and Web of Science were queried up until May 2024. We extracted publications that met our specific eligibility criteria to obtain data on fractional anisotropy and brain connectivity. The digital data was extracted using the Web Plot Digitizer. We utilized the most recent iteration of STATA (version 18) to perform a meta-analysis on the data. The evaluation of the studies' quality was conducted utilizing a critical appraisal instrument.
Result: Results of analysis revealed that the Soy receiving group had 80 % lower percent mammographic densities compared to placebo receiving group which was statistically significant. groups had a statistically different BMI values compared to one another. soy receiving group had 19% higher BMI values than control group.
Conclusion: Our results suggest that the effect of soy intake on percent mammographic density is moderate but possibly of clinical relevance.
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References
Łukasiewicz S, Czeczelewski M, Forma A, Baj J, Sitarz R, Stanisławek A. Breast Cancer-Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies-An Updated Review. Cancers. 2021;13(17), 10.3390/cancers13174287.
Lu L-JW, Chen N-W, Brunder DG, Nayeem F, Nagamani M, Nishino TK, et al. Soy isoflavones decrease fibroglandular breast tissue measured by magnetic resonance imaging in premenopausal women: A 2-year randomized double-blind placebo controlled clinical trial. Clinical Nutrition ESPEN. 2022;52:158-68, 10.1016/j.clnesp.2022.10.007.
• 3. McCormack VA, dos Santos Silva I. Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiology Biomarkers & Prevention. 2006;15(6):1159-69, 10.1158/1055-9965.EPI-06-0034
Spicer DV, Ursin G, Parisky YR, Pearce JG, Shoupe D, Pike A, et al. Changes in mammographic densities induced by a hormonal contraceptive designed to reduce breast cancer risk. JNCI: Journal of the National Cancer Institute. 1994;86(6):431-6, 10.1093/jnci/86.6.431
Atkinson C, Bingham SA. Mammographic breast density as a biomarker of effects of isoflavones on the female breast. Breast Cancer Research. 2001;4:1-4, 10.1186/bcr410.
Rajaram N, Yap B, Eriksson M, Mariapun S, Tan LM, Sa’at H, et al. A randomized controlled trial of soy isoflavone intake on mammographic density among Malaysian women. Nutrients. 2023;15(2):299, 10.3390/nu15020299.
Maskarinec G, Verheus M, Tice JA. Epidemiologic studies of isoflavones & mammographic density. Nutrients. 2010;2(1):35-48, 10.3390/nu2010035.
Balk E, Chung M, Chew P, Ip S, Raman G, Kupelnick B, et al. Effects of Soy on Health Outcomes: Evidence Report/Technology Assessment, Number 126. PsycEXTRA Dataset. 2005, 10.1037/e439502005-001.
Messina M, McCaskill-Stevens W, Lampe JW. Addressing the soy and breast cancer relationship: review, commentary, and workshop proceedings. Journal of the National Cancer Institute. 2006;98(18):1275-84, 10.1093/jnci/djj356.
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group* t. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of internal medicine. 2009;151(4):264-9, 10.1371/journal.pmed.1000097.
Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2000, 25:603-605.
Rohatgi A. Webplotdigitizer: Version 4.5, 2021. URL https://automeris io/WebPlotDigitizer. 2022;4(2).
Duval S, Tweedie R. Trim and fill: a simple funnel-plot–based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56(2):455-63, 10.1111/j.0006-341x.2000.00455.x..
Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. Bmj. 1997;315(7109):629-34, 10.1136/bmj.315.7109.629.
Sutton AJ, Abrams KR, Jones DR, Sheldon TA, Song F. Methods for meta-analysis in medical research: Wiley Chichester; 2000, 10.1002/sim.1565.
HP L. Dietary effects on breast-cancer risk in Singapore. Lancet. 1991;338(8760):186-7, 10.1016/0140-6736(91)92867-2.
Hirose K, Takezaki T, Hamajima N, Miura S, Tajima K. Dietary factors protective against breast cancer in Japanese premenopausal and postmenopausal women. International journal of cancer. 2003;107(2):276-82, 10.1002/ijc.11373.
Yamamoto S, Sobue T, Kobayashi M, Sasaki S, Tsugane S. Soy, isoflavones, and breast cancer risk in Japan. Journal of the national cancer institute. 2003;95(12):906-13, 10.1093/jnci/95.12.906.
Shu XO, Jin F, Dai Q, Wen W, Potter JD, Kushi LH, et al. Soyfood intake during adolescence and subsequent risk of breast cancer among Chinese women. Cancer Epidemiology Biomarkers & Prevention. 2001;10(5):483-8, 11352858.
Wu AH, Wan P, Hankin J, Tseng C-C, Yu MC, Pike MC. Adolescent and adult soy intake and risk of breast cancer in Asian-Americans. Carcinogenesis. 2002;23(9):1491-6, 10.1093/carcin/23.9.1491.
Peeters P, Keinan-Boker L, Van Der Schouw Y, Grobbee D. Phytoestrogens and breast cancer risk. Breast cancer research and treatment. 2003;77:171-83, 10.1023/a:1021381101632.
Key T, Sharp G, Appleby P, Beral V, Goodman M, Soda M, et al. Soya foods and breast cancer risk: a prospective study in Hiroshima and Nagasaki, Japan. British journal of cancer. 1999;81(7):1248-56, 10.1038/sj.bjc.6690837.
Van Gils CH, Peeters PH, Bueno-de-Mesquita HB, Boshuizen HC, Lahmann PH, Clavel-Chapelon F, et al. Consumption of vegetables and fruits and risk of breast cancer. Jama. 2005;293(2):183-93, 10.1001/jama.293.2.183.
Pike AC, Brzozowski AM, Hubbard RE, Bonn T, Thorsell AG, Engström O, et al. Structure of the ligand‐binding domain of oestrogen receptor beta in the presence of a partial agonist and a full antagonist. The EMBO journal. 1999, 10.1093/emboj/18.17.4608.
Slattery ML, Boucher KM, Caan BJ, Potter JD, Ma K-N. Eating patterns and risk of colon cancer. American journal of epidemiology. 1998;148(1):4-16, 10.1093/aje/148.1.4-a.
Jakes R, Duffy S, Ng F, Gao F, Ng E. Mammographic parenchymal patterns and risk of breast cancer at and after a prevalence screen in Singaporean women. International journal of epidemiology. 2000;29(1):11-9, 10.1093/ije/29.1.11.
Boyd NF, Lockwood GA, Byng JW, Tritchler DL, Yaffe MJ. Mammographic densities and breast cancer risk. Cancer epidemiology, biomarkers & prevention: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 1998;7(12):1133-44.
Yuan J, Wang Q, Ross R, Henderson B, Yu M. Diet and breast cancer in Shanghai and Tianjin, China. British Journal of Cancer. 1995;71(6):1353-8, 10.1038/bjc.1995.263.
Hankin JH, Stram DO, Arakawa K, Park S, Low S-H, Lee H-P, et al. Singapore Chinese Health Study: development, validation, and calibration of the quantitative food frequency questionnaire. Nutrition and cancer. 2001;39(2):187-95, 10.1207/S15327914nc392_5.
Ng EH, Ng FC, Tan PH, Low SC, Chiang G, Tan KP, et al. Results of intermediate measures from a population‐based, randomized trial of mammographic screening prevalence and detection of breast carcinoma among Asian women: the Singapore Breast Screening Project. Cancer: Interdisciplinary International Journal of the American Cancer Society. 1998;82(8):1521-8.
Potter J. World cancer research fund, food, nutrition and the prevention of cancer: a global perspective. Washington. American Institute for Cancer Research. 1997, 10.1016/s0899-9007(99)00021-0.
Smith-Warner SA, Spiegelman D, Yaun S-S, Adami H-O, Beeson WL, Van Den Brandt PA, et al. Intake of fruits and vegetables and risk of breast cancer: a pooled analysis of cohort studies. Jama. 2001;285(6):769-76, 10.1001/jama.285.6.769.
Marashi A, Hasany S, Moghimi S, Kiani R, Mehran Asl S, Dareghlou YA, Lorestani P, Varmazyar S, Jafari F, Ataeian S, Naghavi K. Targeting gut-microbiota for gastric cancer treatment: a systematic review. Frontiers in Medicine. 2024 Aug 2;11:1412709.
Rashtchian A, Etemadi MH, Asadi E, Binaei S, Abbasi M, Bayani M, Izadi E, Sadat-Madani SF, Naziri M, Khoshravesh S, Shirani M. Diabetes mellitus and risk of incident dementia in APOE ɛ4 carriers: an updated meta-analysis. BMC neuroscience. 2024 Jun 25;25(1):28.
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