Background
Methods
Study population
Data collection
Statistical analysis
No. non-EBS users (%) | No. EBS users (%) |
P valuea
| |
---|---|---|---|
N = 464 | N = 303 | ||
Study site |
0.12
| ||
Western Washington | 90 (19.4) | 70 (23.1) | |
New Mexico | 259 (55.8) | 146 (48.2) | |
Los Angeles County | 115 (24.8) | 87 (28.7) | |
Race |
0.63
| ||
Non-Hispanic white | 281 (60.6) | 173 (57.1) | |
African-American | 115 (24.8) | 88 (29.0) | |
Hispanic | 53 (11.4) | 33 (10.9) | |
Others | 15 (3.2) | 9 (3.0) | |
Education |
< 0.0001
| ||
≤ High school | 143 (30.8) | 51 (16.8) | |
Technical school or some college | 154 (33.2) | 126 (41.6) | |
College graduate | 167 (36.0) | 126 (41.6) | |
Mean age at diagnosis (SDb), years | 56.0 (10.6) | 52.5 (8.7) |
< 0.0001
c
|
Stage at diagnosis |
0.41
| ||
In situ | 110 (23.7) | 60 (19.8) | |
Localized | 257 (55.4) | 173 (57.1) | |
Regional | 97 (20.9) | 70 (23.1) | |
Breast cancer treatment |
0.43
| ||
No radiation and no chemotherapy | 155 (33.4) | 86 (28.4) | |
Radiation only | 171 (36.9) | 116 (38.3) | |
Chemotherapy only | 45 (9.7) | 29 (9.6) | |
Radiation and chemotherapy | 93 (20.0) | 72 (23.8) | |
Tamoxifen use |
0.24
| ||
No | 248 (53.5) | 175 (57.8) | |
Yes | 216 (46.6) | 128 (42.2) | |
Medical comorbidity |
0.007
| ||
None | 332 (71.6) | 243 (80.2) | |
1 or more condition(s) | 132 (28.5) | 60 (19.8) | |
Activity level within the past year of 30-month interview from sports/recreation (MET hours/week) |
< 0.0001
| ||
0 | 93 (20.0) | 33 (10.9) | |
0.1-8.9 | 201 (43.3) | 115 (38.0) | |
≥ 9 | 170 (36.6) | 155 (51.2) | |
Menopausal status at 30-month interview |
0.01
| ||
Premenopausal | 74 (16.0) | 68 (22.4) | |
Postmenopausal | |||
Never HTd after diagnosis | 193 (41.6) | 135 (44.6) | |
Ever HTd after diagnosis | 172 (37.1) | 80 (26.4) | |
Unknown | 25 (5.4) | 20 (6.6) | |
Body mass index at 30-month interview (kg/m2) |
0.13
| ||
< 25 | 180 (38.8) | 128 (42.2) | |
25-29 | 133 (28.7) | 97 (32.0) | |
≥ 30 | 151 (32.5) | 78 (25.7) | |
Mean isoflavones from soy-containing foods (SDb), mg/day | 1.9 (9.4) | 4.0 (9.9) |
0.002
c
|
Results
Characteristics of EBS users and non-users
EBS use and HRQOL
Association with continuous HRQOL score | Association with better HRQOL (≥ 50) | |||||
---|---|---|---|---|---|---|
No. | Adjusted regression coefficient (standard error) |
P value | No. with low score < 50 | No. with high score ≥ 50 | Adjusted OR (95% CI) | |
Association with physical component summary (PCS) | ||||||
Ever used EBS after diagnosis
a
| ||||||
No | 464 | 228 | 236 | 1.00 | ||
Yes | 303 | -1.27 (0.67) |
0.06
| 142 | 161 | 0.84 (0.60-1.18) |
By number of EBS used
a
| ||||||
1 | 141 | -1.56 (0.86) |
0.07
| 66 | 75 | 0.83 (0.54-1.28) |
≥ 2 | 162 | -0.99 (0.84) |
0.24
| 76 | 86 | 0.85 (0.56-1.28) |
By type of EBS used
a, b
| ||||||
Soy supplements | 127 | 1.63 (0.93) |
0.08
| 52 | 75 | 1.66 (1.02-2.70) |
Ginseng | 103 | -2.77 (1.04) |
0.008
| 55 | 48 | 0.68 (0.40-1.15) |
Flaxseed oil | 100 | 0.41 (1.07) |
0.70
| 41 | 59 | 1.20 (0.68-2.09) |
Black cohosh | 68 | -0.70 (1.31) |
0.59
| 35 | 33 | 0.66 (0.35-1.27) |
Yam | 47 | 1.13 (1.51) |
0.45
| 19 | 28 | 1.52 (0.70-3.27) |
Dong quai | 39 | -1.17 (1.65) |
0.48
| 21 | 18 | 0.70 (0.31-1.61) |
Red clover | 38 | -1.40 (1.70) |
0.41
| 22 | 16 | 0.61 (0.26-1.41) |
Licorice | 37 | 1.37 (1.62) |
0.40
| 17 | 20 | 1.50 (0.64-3.47) |
Alfalfa | 31 | -0.86 (1.76) |
0.62
| 19 | 12 | 0.65 (0.26-1.60) |
Cat's claw | 24 | -2.38 (2.00) |
0.23
| 13 | 11 | 0.80 (0.28-2.28) |
DHEA | 24 | -1.65 (1.85) |
0.37
| 16 | 8 | 0.40 (0.15-1.07) |
Other EBS | 34 | 1.26 (1.67) |
0.45
| 16 | 18 | 1.17 (0.50-2.76) |
Association with mental component summary (MCS) | ||||||
Ever used EBS after diagnosis
a
| ||||||
No | 464 | 200 | 264 | 1.00 | ||
Yes | 303 | 0.57 (0.80) |
0.48
| 122 | 181 | 1.16 (0.85-1.57) |
By number of EBS used
a
| ||||||
1 | 141 | 0.80 (1.02) |
0.43
| 58 | 83 | 1.09 (0.74-1.61) |
≥ 2 | 162 | 0.35 (1.00) |
0.73
| 64 | 98 | 1.23 (0.84-1.79) |
By type of EBS used
a, b
| ||||||
Soy supplements | 127 | 1.06 (1.11) |
0.34
| 44 | 83 | 1.42 (0.92-2.20) |
Ginseng | 103 | -0.80 (1.24) |
0.52
| 44 | 59 | 0.88 (0.55-1.42) |
Flaxseed oil | 100 | 2.39 (1.28) |
0.06
| 33 | 67 | 1.76 (1.05-2.94) |
Black cohosh | 68 | -0.50 (1.57) |
0.75
| 28 | 40 | 0.94 (0.52-1.73) |
Yam | 47 | -0.36 (1.81) |
0.84
| 18 | 29 | 1.14 (0.56-2.31) |
Dong quai | 39 | 1.28 (1.97) |
0.52
| 16 | 23 | 0.98 (0.46-2.11) |
Red clover | 38 | 0.75 (2.04) |
0.71
| 14 | 24 | 1.15 (0.51-2.57) |
Licorice | 37 | -1.09 (1.95) |
0.57
| 16 | 21 | 0.79 (0.37-1.67) |
Alfalfa | 31 | -0.11 (2.10) |
0.96
| 13 | 18 | 0.89 (0.40-2.00) |
Cat's claw | 24 | -3.07 (2.40) |
0.20
| 12 | 12 | 0.52 (0.21-1.30) |
DHEA | 24 | 1.49 (2.22) |
0.50
| 10 | 14 | 0.93 (0.40-2.21) |
Other EBS | 34 | 0.19 (2.00) |
0.93
| 12 | 22 | 1.25 (0.57-2.75) |
EBS use and total fatigue score
Association with continuous total fatigue score | Association with severe fatigue (≥ 4) | |||||
---|---|---|---|---|---|---|
No. | Adjusted regression coefficient (standard error) |
P value | No. with PFS < 4 | No. with PFS ≥ 4 | Adjusted OR (95% CI) | |
Ever used EBS after diagnosis
a
| ||||||
No | 464 | 280 | 184 | 1.00 | ||
Yes | 303 | 0.13 (0.17) |
0.44
| 179 | 124 | 1.06 (0.78-1.45) |
By number of EBS used
a
| ||||||
1 | 141 | 0.11 (0.21) |
0.59
| 86 | 55 | 0.98 (0.66-1.46) |
≥ 2 | 162 | 0.14 (0.21) |
0.50
| 93 | 69 | 1.14 (0.78-1.69) |
By type of EBS used
a, b
| ||||||
Soy supplements | 127 | 0.07 (0.23) |
0.75
| 75 | 52 | 1.16 (0.74-1.80) |
Ginseng | 103 | 0.81 (0.26) |
0.002
| 54 | 49 | 1.70 (1.04-2.76) |
Flaxseed oil | 100 | -0.22 (0.26) |
0.40
| 66 | 34 | 0.66 (0.39-1.12) |
Black cohosh | 68 | -0.17 (0.32) |
0.60
| 43 | 25 | 0.78 (0.41-1.46) |
Yam | 47 | -0.003 (0.37) |
0.99
| 30 | 17 | 0.94 (0.45-1.96) |
Dong quai | 39 | -0.25 (0.40) |
0.53
| 24 | 15 | 0.83 (0.38-1.81) |
Red clover | 38 | -0.60 (0.42) |
0.15
| 26 | 12 | 0.52 (0.22-1.21) |
Licorice | 37 | 0.07 (0.40) |
0.85
| 21 | 16 | 1.41 (0.65-3.06) |
Alfalfa | 31 | -0.39 (0.43) |
0.36
| 21 | 10 | 0.72 (0.30-1.71) |
Cat's claw | 24 | 0.79 (0.49) |
0.11
| 12 | 12 | 2.03 (0.76-5.42) |
DHEA | 24 | 0.27 (0.45) |
0.55
| 11 | 13 | 1.96 (0.82-4.70) |
Other EBS | 34 | -0.57 (0.41) |
0.16
| 22 | 12 | 0.79 (0.35-1.77) |
EBS use and hormone-related symptoms
Ginseng | Red Clover | Alfalfa | DHEA | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
No | Yes | Adjusteda OR (95% CI) | No | Yes | Adjusteda OR (95% CI) | No | Yes | Adjusteda OR (95% CI) | No | Yes | Adjusteda OR (95% CI) | |
Hot flashes | ||||||||||||
No | 179 | 19 | 1.00 | 191 | 7 | 1.00 | 187 | 11 | 1.00 | 187 | 11 | 1.00 |
Yes | 485 | 84 | 1.41 (0.76-2.63) | 538 | 31 | 0.99 (0.34-2.85) | 549 | 20 | 0.43 (0.17-1.08) | 556 | 13 | 0.33 (0.14-0.82) |
Vaginal discharge | ||||||||||||
No | 427 | 53 | 1.00 | 457 | 23 | 1.00 | 460 | 20 | 1.00 | 466 | 14 | 1.00 |
Yes | 237 | 50 | 1.81 (1.12-2.93) | 272 | 15 | 0.92 (0.42-2.05) | 276 | 11 | 0.94 (0.41-2.20) | 277 | 10 | 1.15 (0.48-2.73) |
Weight gain | ||||||||||||
No | 234 | 37 | 1.00 | 253 | 18 | 1.00 | 257 | 14 | 1.00 | 262 | 9 | 1.00 |
Yes | 430 | 66 | 0.94 (0.57-1.55) | 476 | 20 | 0.41 (0.19-0.91) | 479 | 17 | 0.76 (0.33-1.76) | 481 | 15 | 0.88 (0.36-2.11) |
Unhappy with bodily appearance | ||||||||||||
No | 221 | 17 | 1.00 | 225 | 13 | 1.00 | 226 | 12 | 1.00 | 230 | 8 | 1.00 |
Yes | 443 | 86 | 2.58 (1.38-4.81) | 504 | 25 | 0.49 (0.21-1.17) | 510 | 19 | 0.67 (0.28-1.60) | 513 | 16 | 0.76 (0.30-1.93) |
Forgetfulness | ||||||||||||
No | 147 | 13 | 1.00 | 153 | 7 | 1.00 | 154 | 6 | 1.00 | 156 | 4 | 1.00 |
Yes | 517 | 90 | 2.19 (1.11-4.33) | 576 | 31 | 1.09 (0.40-2.98) | 582 | 25 | 1.09 (0.39-3.02) | 587 | 20 | 1.38 (0.43-4.42) |
Tendency to take naps, stay in bed | ||||||||||||
No | 326 | 39 | 1.00 | 346 | 19 | 1.00 | 352 | 13 | 1.00 | 357 | 8 | 1.00 |
Yes | 338 | 64 | 2.24 (1.35-3.72) | 383 | 19 | 1.20 (0.54-2.70) | 384 | 18 | 1.37 (0.59-3.18) | 386 | 16 | 1.96 (0.79-4.87) |
Night sweats | ||||||||||||
No | 272 | 31 | 1.00 | 285 | 18 | 1.00 | 288 | 15 | 1.00 | 293 | 10 | 1.00 |
Yes | 392 | 72 | 1.42 (0.84-2.39) | 444 | 20 | 0.40 (0.18-0.90) | 448 | 16 | 0.66 (0.29-1.53) | 450 | 14 | 0.82 (0.34-1.97) |
Difficulty concentrating | ||||||||||||
No | 268 | 34 | 1.00 | 282 | 20 | 1.00 | 292 | 10 | 1.00 | 293 | 9 | 1.00 |
Yes | 396 | 69 | 1.51 (0.91-2.50) | 447 | 18 | 0.41 (0.18-0.90) | 444 | 21 | 1.84 (0.77-4.41) | 450 | 15 | 1.17 (0.48-2.84) |
Interrupted sleeping | ||||||||||||
No | 146 | 18 | 1.00 | 154 | 10 | 1.00 | 151 | 13 | 1.00 | 157 | 7 | 1.00 |
Yes | 518 | 85 | 1.49 (0.80-2.80) | 575 | 28 | 0.67 (0.26-1.77) | 585 | 18 | 0.28 (0.12-0.68) | 586 | 17 | 0.54 (0.21-1.39) |
Irritability or mood swingsb
| ||||||||||||
No | 270 | 24 | 1.00 | 283 | 11 | 1.00 | 281 | 13 | 1.00 | 282 | 12 | 1.00 |
Yes | 393 | 79 | 2.19 (1.26-3.82) | 445 | 27 | 1.20 (0.51-2.87) | 454 | 18 | 0.79 (0.34-1.86) | 460 | 12 | 0.59 (0.24-1.45) |