Impact of Dietary Supplements on Clinical Outcomes and Quality of Life in Patients with Breast Cancer: A Systematic Review.

2025-03-11
Nutrients 17(6)
- Luca Scafuri
- Carlo Buonerba
- Oriana Strianese
- Evandro de Azambuja
- Michela Palleschi
- Vittorio Riccio
- Vincenzo Marotta
- Concetta Scocca
- Giovanni Riccio
- Carla Errico
- Grazia Arpino
- Giuseppe Di Lorenzo

PubMed: 40290044
DOI: 10.3390/nu17060981

Study Design

Type: Systematic Review
Sample size: n = 45
Population: adult breast cancer patients
Methods: Only RCTs investigating the effects of various orally administered supplements in adult breast cancer patients were included.

Rigorous Journal

Background: This systematic review aimed to evaluate the efficacy and safety of dietary supplements in breast cancer patients, focusing on their impact on clinical outcomes, treatment-related side effects, and therapy adherence. Methods: Only RCTs investigating the effects of various orally administered supplements in adult breast cancer patients were included. Well-defined substances like vitamins, minerals, antioxidants, and specific herbal extracts were explored. The review excluded studies solely based on dietary interventions or non-supplemental approaches. The primary outcome assessed was quality of life. Secondary outcomes included disease-free survival, overall survival, tumor response, and biomarkers indicative of disease progression. Results: A total of 45 randomized controlled trials (RCTs) were included in this systematic review. Overall, supplementation was not associated with serious adverse events in the included trials. Vitamin D supplementation showed promise in some studies, with potential immunomodulatory and antioxidant effects, particularly when combined with other interventions. Omega-3 fatty acids and beta-glucan demonstrated potential in alleviating certain symptoms and improving quality of life. Studies on amino acids like acetyl-L-carnitine and L-arginine also yielded mixed results. Beta-glucan exhibited potential for immune-enhancing effects, while melatonin and creatine showed limited or no benefit for fatigue or muscle strength. Herbal extracts, including silymarin, curcumin, and EGCG, had varied effects. Curcumin studies presented mixed results. Silymarin showed potential for hepatoprotective effects. Conclusions: These findings highlight the potential of specific dietary supplements to improve various aspects of breast cancer care. However, the evidence is mixed across supplement types, and further research is needed to determine the most effective and safe approaches.

Research Insights

Acetyl-Carnitine→Improved Quality of Life
Studies on amino acids like acetyl-L-carnitine and L-arginine also yielded mixed results.
Effect
Neutral
Effect size
Small
L-Arginine→Improved Quality of Life
Studies on amino acids like acetyl-L-carnitine and L-arginine also yielded mixed results.
Effect
Neutral
Effect size
Small
Thistle→Improved Liver Function
Silymarin showed potential for hepatoprotective effects.
Effect
Beneficial
Effect size
Small
Thistle→Reduced Hepatotoxicity
Silymarin showed potential for hepatoprotective effects.
Effect
Beneficial
Effect size
Small
Turmeric→Improved Disease-Free Survival
Curcumin studies presented mixed results.
Effect
Neutral
Effect size
Small
Turmeric→Improved Overall Survival
Curcumin studies presented mixed results.
Effect
Neutral
Effect size
Small
Turmeric→Improved Quality of Life
Studies on amino acids like acetyl-L-carnitine and L-arginine also yielded mixed results.
Effect
Neutral
Effect size
Small
Turmeric→Improved Tumor Response
Curcumin studies presented mixed results.
Effect
Neutral
Effect size
Small
Turmeric→Reduced Disease Progression Biomarker
Curcumin studies presented mixed results.
Effect
Neutral
Effect size
Small
Vitamin D→Improved Quality of Life
Studies on amino acids like acetyl-L-carnitine and L-arginine also yielded mixed results.
Effect
Neutral
Effect size
Small

Adverse Events Reported

L-Arginine→Overall tolerability
Overall, supplementation was not associated with serious adverse events in the included trials.
Finding
Reported
Acetyl-Carnitine→Overall tolerability
Overall, supplementation was not associated with serious adverse events in the included trials.
Finding
Reported
Turmeric→Overall tolerability
Overall, supplementation was not associated with serious adverse events in the included trials.
Finding
Reported
Thistle→Overall tolerability
Overall, supplementation was not associated with serious adverse events in the included trials.
Finding
Reported
Vitamin D→Overall tolerability
Overall, supplementation was not associated with serious adverse events in the included trials.
Finding
Reported