Phytotherapy and Nutritional Supplements on Breast Cancer

Table 1

The main clinical effects of the most common phytotherapeutic products used in breast cancer.

Nutritional supplements	Disease phases	Trials versus nontrial	Main effects from clinical studies	Type of clinical study	Ref.
Echinacea spp.	Risk	0/1	(i) Consumption not associated with increased risk for breast cancer	Prospective cohort	[30]
	Treatment	0/1	(i) Consumption not induced pharmacokinetic parameters alterations of docetaxel	Case control	[40]
	Prognostic	0/2	(i) Consumption associated with breast cancer survivors	Prospective cohort	[33, 34]
Tabebuia impetiginosa		0/0
Salvia spp.	Prognostic	1/1	(i) Administration of Salvia extract (20 mg/Kg) and Coriolus versicolor (polysaccharopeptide 50 mg/Kg) promoted the immune function in posttreatment of breast cancer patients	Nonrandom clinical trial	[54]
	Side effects	1/1	(i) Administration of Salvia extract (IV) reduced skin ischemia and necrosis after mastectomy with less side effects when compared to anisodamine drug	Random clinical trial	[55]
Uncaria spp.	Side effects	1/1	(i) Uncaria extract (300 mg/day) reduced the neutropenia caused by chemotherapy and restored cell DNA damage in patients with Invasive Ductal Carcinoma Stage II	Random clinical trial	[56]
Allium sativum L.	Risk	0/1	(i) High consumption of Allium may reduce the risk of breast cancer	Case control	[57]
	Treatment	1/1	(i) Consumption does not affect the distribution of docetaxel. However, it can decrease docetaxel clearance in patients carrying a CYP3A51A allele	Nonrandom pilot clinical trial	[58]
Linum usitatissimum	Risk	0/1	(i) Dietary consumption associated with a reduction in breast cancer risk	Case control	[59]
	Treatment	3/3	(i) Dietary consumption had the potential to reduce tumour growth in patients with breast cancer	Random double-blind placebo-controlled clinical trial	[60]
			(ii) Dietary consumption of flaxseed (25 g) to healthy volunteers during one menstrual cycle does not affect the angiogenin and VEGF levels in normal breast tissue but increase the endostatin levels similar to tamoxifen	Random clinical trial	[61]
			(iii) Flaxseed consumption does not affect the aromatase inhibitors activity	Random pilot clinical trial	[62]
	Prognostic	0/1	(i) High consumption of enterolignans (sunflower, pumpkinseeds, sesame, and flaxseeds origin) may have a better impact in postmenopausal breast cancer patient survival	Cohort	[63]
Curcuma longa		1/1	(i) Dose of 6 g/day of curcumin in combination with docetaxel (standard dose) demonstrated safe profile has a superior antitumour activity compared to docetaxel monotherapy	Nonrandom open-label clinical trial phase I	[64]
Camellia sinensis	Risk	1/6	(i) High tea consumption had no significant effect on the risk of several cancers, including breast cancer	Meta-analysis of prospective observational studies	[65]
			(ii) Green tea consumption was not associated with breast cancer risk in Japanese women	Cohort	[66]
			(iii) Regular green tea consumption can protect against breast cancer	Case control	[67]
			(iv) No association between plasma tea polyphenols and the risk of breast cancer in Japanese women	Nested case control	[68]
			(v) High epicatechin may be related to a reduced risk of breast cancer	Nested case control	[69]
			(vi) ECGC can prevent breast cancer by influencing the growth factor signalling, angiogenesis, and lipid metabolism mechanisms	Random placebo-controlled clinical trial phase IB	[70]
	Polymorphism	0/3	(i) Genetic polymorphism can influence polyphenols green tea metabolism and excretion	Nested case control	[71]
			(ii) Men carrying low-activity associated COMT genotype may retain more tea polyphenols	Cross sectional	[72]
			(iii) Green tea appeared to reduce breast cancer risk in Asian-American women with low-activity COMT alleles	Cross sectional	[73]
	Treatment	3/3	(i) EGCG potentiated efficacy of radiotherapy in breast cancer patients	Random pilot clinical trial	[74]
			(ii) Daily consumption of green tea (843 mg EGCG) is well tolerated by Caucasian postmenopausal women	Random double-blind placebo-controlled clinical trial	[75]
			(iii) Green tea extract phytosomes increased EGCG bioavailability and decreased tumour circulating biomarker revealing antiproliferative effects on breast cancer tissue	Nonrandom pilot clinical trial	[76]
	Prognostic	0/1	(i) Consumption of 5 or more cups of green tea a day may prevent breast cancer recurrence in early-stage (I and II) cancers	Meta-analysis of observational studies	[77]
Ginseng	Treatment	1/1	(i) Chinese herb formula including ginseng showed immunological improvement in breast cancer patients	Random clinical trial	[78]
	Prognostic	0/2	(i) Consumption of ginseng among breast cancer survivors was not associated with quality of life improvement	Cohort	[79]
			(ii) Regular consumption of ginseng 1.3 g/day may improve both overall and disease-free survival and enhance the quality life of Chinese women breast cancer survivors	Cohort	[80]
Cimicifuga racemosa	Risk	0/1	(i) No relationship was found between black cohosh consumption and increased risk of breast cancer	Meta-analysis of interventional and observational studies	[81]
	Prognostic	0/1	(i) Consumption can reduce risk of recurrence in patients taking tamoxifen	Retrospective cohort study	[82]
Viscum album	Treatment	1/1	(i) Mistletoe extract was highly effective in the tumour regression of breast cancer	Nonrandom pilot clinical trial	[83]
	Side effects	2/5	(i) Mistletoe therapy associated with CAF (Cyclophosphamide, Doxorubicin, and 5-Fluorouracil) chemotherapy resulted in clinical improvements of life quality in breast cancer patients	Random open-label pilot clinical trial	[84]
			(ii) Viscum album therapy during chemotherapy in the early-stage breast cancer patients increased the life quality, may prevent neutropenia, and did not influence the frequency of relapse or metastasis within 5 years	Prospective noninterventional follow-up study of a clinical trial	[85]
			(iii) Standardized aqueous mistletoe extracts therapy was well tolerated and reduced the side effects of chemotherapy, resulting in a significant stabilization of Health Related Quality of Life	Prospective cohort	[86]
			(iv) Mistletoe intravenous administration (1 and 5 mg) during chemotherapy had no significant effect on granulocyte function but reduced chemotherapy-related side effects	Random clinical trial phase II	[87]
			(v) Standardized mistletoe extract therapy improved quality of life and significantly reduced side effects of the disease/treatment	Prospective cohort	[88]

COMT: catechol-O-methyltransferase; VEGF: vascular endothelial growth factor.