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Dietary Flaxseed Alters Tumor Biological Markers in Postmenopausal Breast Cancer

Authors' Affiliations: ¹ Department of Nutritional Sciences, ² Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada, and ³ Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts

Requests for reprints: Paul E. Goss, Massachusetts General Hospital Cancer Center, Cancer Center Administration, 55 Fruit Street, Cox Building, Room 640, Boston, MA 02114. Phone: 617-724-3118; Fax: 617-724-3166; E-mail: pgoss{at}partners.org.

Purpose: Flaxseed, the richest source of mammalian lignan precursors, has previously been shown to reduce the growth of tumors in rats. This study examined, in a randomized double-blind placebo-controlled clinical trial, the effects of dietary flaxseed on tumor biological markers and urinary lignan excretion in postmenopausal patients with newly diagnosed breast cancer.

Experimental Design: Patients were randomized to daily intake of either a 25 g flaxseed-containing muffin (n = 19) or a control (placebo) muffin (n = 13). At the time of diagnosis and again at definitive surgery, tumor tissue was analyzed for the rate of tumor cell proliferation (Ki-67 labeling index, primary end point), apoptosis, c-erbB2 expression, and estrogen and progesterone receptor levels. Twenty-four–hour urine samples were analyzed for lignans, and 3-day diet records were evaluated for macronutrient and caloric intake. Mean treatment times were 39 and 32 days in the placebo and flaxseed groups, respectively.

Results: Reductions in Ki-67 labeling index (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) were observed in the flaxseed, but not in the placebo group. No significant differences in caloric and macronutrient intake were seen between groups and between pre- and posttreatment periods. A significant increase in mean urinary lignan excretion was observed in the flaxseed group (1,300%; P < 0.01) compared with placebo controls. The total intake of flaxseed was correlated with changes in c-erbB2 score (r = –0.373; P = 0.036) and apoptotic index (r = 0.495; P < 0.004).

Conclusion: Dietary flaxseed has the potential to reduce tumor growth in patients with breast cancer.

Key Words: flaxseed • lignans • tumor cell proliferation • apoptosis • c-erbB2

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