Dietary Intake of Isoflavone and All‐Cause Mortality in Women with Breast Cancer: the Breast Cancer Family Registry
Bibliographic record
Abstract
Background Soy foods possess both anti‐estrogenic and estrogen‐like properties. Epidemiologic data on soy intake and breast cancer survival are sparse, especially from women living in North America who typically have a low intake. Methods We examined dietary intake of isoflavones, the major bioactive component of soy, in association with all‐cause mortality among 6,842 women diagnosed with a first primary invasive breast cancer that were enrolled in the Breast Cancer Family Registry and followed for a median length of 9.5 years. Dietary intake was assessed using a Food Frequency Questionnaire developed for the Multiethnic Cohort, with 5,178 women who reported pre‐diagnosis diet and 1,664 women who reported post‐diagnosis diet. Cox proportional hazard models were performed to estimate the hazard ratios (HR's) and 95% confidence intervals (CI's). Results We observed an overall 25% decrease in all‐cause mortality among women in the highest quartile of dietary isoflavone intake (≥1.4 mg/d) compared to those in the lowest quartile (<0.3 mg/d) (Q4 vs. Q1: HR = 0.75, 95% CI: 0.62 – 0.91, p trend =0.002). Reduced risk was observed only among post‐menopausal women (HR = 0.70, 95% CI: 0.52 – 0.93, p trend =0.01), women with a body mass index <25 kg/m 2 (HR = 0.68, 95% CI: 0.51 – 0.90, p trend =0.01), women with negative tumor hormone receptors (HR=0.42, 95% CI: 0.22–0.80, p trend =0.006), and women who did not receive hormonal therapy (HR=0.68, 95% CI: 0.52–0.88, p trend =0.01). The inverse association was stronger for post‐diagnosis dietary intake of isoflavone (HR = 0.59, 95% CI: 0.39 – 0.90, p trend =0.01) than pre‐diagnosis intake (HR = 0.82, 95% CI: 0.66 – 1.02, p trend =0.06). Conclusion In this large ethnically‐diverse cohort of women with breast cancer, a higher dietary intake of isoflavones was associated with a reduced total mortality. Characteristics of Women in the Breast Cancer Family Registry (BCFR) (N=6,842) N (%) or Mean (SD) Age at enrollment, y, mean (SD) 52.5 (22.5) Race/ethnicity, N (%) Non‐Hispanic White 4,068 (69.4) Hispanic 1,112 (16.2) Black 809 (11.8) Asian/Pacific Islander 738 (10.8) Other 118 (1.72) Education , N(%) High school or less 2,520 (36.8) Some college or bachelor's degree 3,244 (47.4) Graduate degree 1,045 (15.3) Menopausal status at enrollemnt, N (%) Pre‐menopausal 3,943 (57.6) Post‐menopausal 2,902 (42.4) Body Mass Index (BMI) at enrollment, kg/m 2 , mean (SD) 26.5 (5.90) BMI status , N (%) Underweight 156 (2.28) Normal Weight 3,139 (45.9) Overweight 1,868 (27.3) Obese 1,479 (21.6) Recreational Physical Activity , N (%) Active 2,954 (43.2) Inactive 3,609 (52.7) Cigarette Smoking, N (%) Never 3,967 (58.0) Ever 2,864 (41.8) Pack‐years (among smokers), mean (SD)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".