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@ARTICLE{Jung:143228,
      author       = {A. Y. Jung$^*$ and X. Cai$^*$ and K. Thoene and N. Obi and
                      S. Jaskulski$^*$ and S. Behrens$^*$ and D. Flesch-Janys and
                      J. Chang-Claude$^*$},
      title        = {{A}ntioxidant supplementation and breast cancer prognosis
                      in postmenopausal women undergoing chemotherapy and
                      radiation therapy.},
      journal      = {The American journal of clinical nutrition},
      volume       = {109},
      number       = {1},
      issn         = {1938-3207},
      address      = {Oxford},
      publisher    = {Oxford University Press},
      reportid     = {DKFZ-2019-00827},
      pages        = {69 - 78},
      year         = {2019},
      abstract     = {There is a paucity of information on the prevalence of
                      dietary supplement use in breast cancer survivors. Only a
                      few studies have examined the impact of dietary supplements,
                      particularly antioxidants, on breast cancer prognosis and
                      the results are inconclusive.We examined pre- and
                      postdiagnosis use of supplements in postmenopausal breast
                      cancer survivors in Germany and investigated associations
                      between postdiagnosis use of antioxidants and other
                      supplements, and prognosis (total and breast cancer
                      mortality, and recurrence-free survival) both overall and in
                      women who received chemotherapy and radiation therapy.Data
                      from 2223 postmenopausal women diagnosed with nonmetastatic
                      breast cancer from the population-based Mamma Carcinoma Risk
                      Factor Investigation (MARIE) study were used. Women were
                      interviewed at recruitment in 2002-2005 and again in 2009
                      and followed-up until 30 June 2015. Multivariate Cox
                      regression analysis was used to estimate HRs and
                      corresponding $95\%$ CIs.Pre- and postdiagnosis supplement
                      use was reported by $36\%$ and $45\%$ of the women,
                      respectively. There were 240 deaths (134 from breast cancer)
                      and 200 breast cancer recurrences after a median follow-up
                      time of 6.0 y after the 2009 re-interview. After adjusting
                      for relevant confounders, concurrent antioxidant use with
                      chemotherapy or radiation therapy among 1940 women was
                      associated with increased risk of total mortality (HR: 1.64;
                      $95\%$ CI: 1.01, 2.66) and worsened recurrence-free survival
                      (HR: 1.84; $95\%$ CI: 1.26, 2.68). Overall postdiagnosis
                      supplement use was not associated with breast cancer
                      prognosis.Antioxidant use during chemotherapy or radiation
                      therapy was associated with worsened breast cancer prognosis
                      in postmenopausal women. There was no overall association
                      between postdiagnosis supplement use and breast cancer
                      prognosis. Results from our study align with the current
                      recommendation to possibly avoid the use of antioxidants
                      during chemotherapy or radiation therapy.},
      cin          = {C020},
      ddc          = {570},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30668630},
      doi          = {10.1093/ajcn/nqy223},
      url          = {https://inrepo02.dkfz.de/record/143228},
}