Abstract P1-09-04: Flaxseed & breast cancer: A systematic review
Bibliographic record
Abstract
Abstract Background: Flaxseed has been extensively studied in in vitro and in vivo models for possible association with reducing the risk of breast cancer. Clinical trials have been limited. There has been confusion regarding whether it is safe and beneficial for breast cancer survivors to take flaxseed. Therefore, we conducted a systematic review to evaluate the existing randomized controlled trial to understand the safety and efficacy of using flaxseed for symptom control and reducing the risk of recurrence among breast cancer survivors. Patients and Methods: We conducted a literature search of English language publications in MEDLINE, EMBASE, and Cochrane from the databases’ inception to May 2021 using the keywords flaxseed, breast cancer, randomized clinical trial, and human studies. Results: We identified three randomized controlled trials (RCT) that include patients with a history of breast cancer. Sample size ranged from 24 to 178 patients and treatment duration ranged from 13 to 42 days. The primary end points were hot flash severity (one study) and tumor biomarkers (two studies). There was no statistically significant reduction in mean hot flash score in the flaxseed group compared to the placebo group. One study showed a statistically significant reduction in Ki-67 (34.2%; P=0.001) and in c-erbB2 expression (71.0%; P=0.003), and an increase in apoptosis (30.7%; P=0.007) in the group that received flaxseed, but not in the placebo group. On the contrary, another study showed no difference in Ki-67, caspase, the Ki-67/caspase ratio, and Estrogen-receptor β. Two studies reported mild adverse events as shown in Table 1. None of the studies assessed the change in estrogen level. Risk of bias assessment showed that the overall risk of bias associated with the included studies is moderate to high. The high risk of bias originates from lack of blinding of participants and personnel. Conclusion: Current clinical research in breast cancer survivors is too limited to recommend flaxseed for cancer prevention. Flaxseed appears to be safe with mild side effects, however, the effect of flaxseed on estrogen concentration has not been established. Table 1.Characteristics of included studies and risk of bias assessmentIDBreast cancer participantsSample sizeExperimentalControlOutcomesAdverse eventsRisk of biasPruthi 2012(U.S.)With breast cancer: (Yes/No)Flaxseed: 44/88Placebo: 47/90Flaxseed: 88Placebo: 90Flaxseed bar: 7.5g of flaxseed, 200 calories, one bar daily, 6 weeksPlacebo bar: 2g protein, 20% fiber, 200 calories, one bar daily, 6 weeksFrequency and severity of hot flash; hot flash interference; the Profile of Mood States; the Menopause Quality of Life Scale; the Global Impression of BenefitAbdominal distension and pain, diarrhea, flatulence, nausea, pruritus, maculopapular rash, vomitingLowThompson 2005(Canada)Flaxseed: (ER+ & PR+) 17/19; (ER- OR PR-) 2/19Placebo: (ER+ & PR+) 11/13; (ER- OR PR-) 2/13Flaxseed: 19Placebo: 13Flaxseed muffin: 25g flaxseed + 20.7g white wheat flour, one daily, 32 daysPlacebo muffin: 20.7g whole wheat flour+10g canola oil, one daily, 39 daysBreast cancer biomarkers including Ki-67, apoptosis, C-erbB2, ER and PR scoresAbdominal fullness and increased bowel movementsSome concernMcCann 2014(Canada)Clinical stage: Flaxseed: I 4/6; IIA 1/6; IIB 1/6;Anastrozole: I 6/7; IIA 1/7;Flaxseed/Anastrozole: I 5/6; IIA 1/6;Placebo: I 3/5; IIA 2/5Flaxseed: 6;Anastrozole: 7;Flaxseed/Anastrozole: 6;Placebo: I5;Flaxseed: 25 g/d ground flaxseed + 1/d placebo pill, 13-16 daysAnastrozole: 1 mg/d;Flaxseed/Anastrazole: 25 g/d ground flaxseed + 1 mg/d Anastrozole;Placebo: 1/d; 13-16 daysBreast cancer biomarkers including Ki-67, caspase, the Ki-67/caspase ratio, and Estrogen-receptor βNot reportedHigh Citation Format: Rui Wang, Mingxiao Yang, Iris Zhi, Ting Bao. Flaxseed & breast cancer: A systematic review [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-09-04.
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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 | 0.004 | 0.021 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.006 |
| Bibliometrics | 0.009 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
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".