Background
Methods
Participants
Measures
Assessment of change in vitamin/mineral supplement intake
Baseline assessment of diet and physical activity
Statistical analyses
Results
Participant characteristics
All (n = 2,596) % | Non-Hispanic White (n = 1,857) % | African American (n = 155) % | Asian (n = 309) % | Hispanic (n = 275) % | P-valueb
| |
---|---|---|---|---|---|---|
Demographic characteristics
| ||||||
Age | <.0001 | |||||
<50 | 18.5 | 13.0 | 19.4 | 39.5 | 31.3 | |
50-59 | 26.7 | 24.8 | 35.5 | 30.4 | 29.8 | |
60-69 | 31.9 | 35.2 | 27.7 | 22.7 | 22.9 | |
70+ | 23.0 | 27.0 | 17.4 | 7.4 | 16.0 | |
Education | <.0001 | |||||
High school or less | 13.6 | 11.8 | 19.4 | 8.1 | 28.4 | |
Some college | 33.4 | 35.1 | 42.6 | 14.9 | 37.8 | |
College graduate | 28.4 | 26.7 | 22.6 | 49.5 | 19.6 | |
Post graduate | 24.5 | 26.3 | 15.5 | 27.5 | 14.2 | |
Clinical characteristics
| ||||||
Stage at diagnosis | 0.13 | |||||
I | 56.2 | 57.3 | 50.3 | 54.7 | 54.2 | |
II | 33.0 | 32.2 | 37.4 | 35.0 | 34.2 | |
III | 9.6 | 9.4 | 9.0 | 10.0 | 11.3 | |
IV | 1.1 | 1.2 | 3.2 | 0.32 | 0.36 | |
Hormone-receptor positivity | <.0001 | |||||
ER-/PR- | 15.7 | 13.9 | 29.0 | 17.2 | 18.2 | |
ER-/PR+ | 0.12 | 0.05 | 0.0 | 0.0 | 0.73 | |
ER+/PR- | 20.0 | 21.1 | 22.6 | 15.5 | 16.0 | |
ER+/PR+ | 64.1 | 64.8 | 47.7 | 67.3 | 65.1 | |
Unknown | 0.15 | 0.16 | 0.65 | 0.0 | 0.0 | |
Use of vitamin/mineral supplements prior to diagnosis
| ||||||
Any vitamin/mineral | 83.6 | 85.9 | 82.6 | 78.3 | 73.8 | <.0001 |
Multivitamins | 70.0 | 73.0 | 66.5 | 64.7 | 58.2 | <.0001 |
Vitamin C | 32.3 | 34.7 | 27.7 | 26.5 | 24.7 | 0.0003 |
Calcium, tums, or antacids with calcium | 23.6 | 25.1 | 20.6 | 21.4 | 17.8 | 0.03 |
Vitamin E | 21.9 | 23.4 | 22.6 | 17.2 | 16.7 | 0.01 |
Vitamin D | 15.4 | 16.0 | 20.0 | 10.4 | 14.5 | 0.02 |
Iron | 12.2 | 11.5 | 24.5 | 10.4 | 12.4 | <.0001 |
Vitamin B12 | 9.6 | 9.4 | 16.1 | 6.5 | 11.3 | 0.007 |
Folic acid (folate) | 8.4 | 8.9 | 9.7 | 6.5 | 6.9 | 0.36 |
Magnesium | 5.2 | 5.7 | 5.8 | 1.6 | 5.5 | 0.03 |
Zinc | 4.7 | 5.2 | 3.2 | 2.9 | 4.0 | 0.24 |
Vitamin A | 3.2 | 3.1 | 4.5 | 1.6 | 4.7 | 0.13 |
Chromium | 2.7 | 2.7 | 2.6 | 1.9 | 4.0 | 0.49 |
Niacin (B3) | 2.0 | 2.2 | 1.9 | 1.0 | 1.8 | 0.58 |
Beta carotene | 1.7 | 2.0 | 0.6 | 0.6 | 1.1 | 0.19 |
Selenium | 1.8 | 2.2 | 1.9 | 0.3 | 1.5 | 0.16 |
Thiamin (B1) | 0.8 | 0.9 | 0.0 | 0.6 | 1.1 | 0.64 |
Use of vitamin/mineral supplements after diagnosis
| ||||||
Any vitamin/mineral | 82.0 | 84.7 | 79.4 | 77.3 | 71.3 | <.0001 |
Multivitamins | 60.8 | 63.6 | 51.6 | 57.6 | 50.5 | <.0001 |
Vitamin C | 24.7 | 26.5 | 18.1 | 22.3 | 18.9 | 0.003 |
Calcium, tums, or antacids with calcium | 51.8 | 56.2 | 38.7 | 44.0 | 38.5 | <.0001 |
Vitamin E | 11.6 | 12.8 | 7.7 | 7.8 | 10.5 | 0.02 |
Vitamin D | 43.1 | 45.4 | 40 | 36.2 | 37.5 | 0.003 |
Iron | 7.5 | 6.9 | 14.8 | 7.4 | 7.0 | 0.009 |
Vitamin B12 | 13.8 | 14.6 | 16.1 | 10.4 | 11.3 | 0.11 |
Folic acid (folate) | 9.1 | 10.1 | 7.1 | 5.8 | 7.3 | 0.04 |
Magnesium | 13.8 | 15.6 | 7.1 | 10.0 | 10.2 | 0.0004 |
Zinc | 7.6 | 8.6 | 5.2 | 6.5 | 3.6 | 0.01 |
Vitamin A | 3.1 | 3.2 | 1.9 | 2.6 | 3.3 | 0.75 |
Chromium | 3.0 | 3.2 | 1.9 | 2.3 | 2.9 | 0.66 |
Niacin (B3) | 7.4 | 8.3 | 5.2 | 4.5 | 5.5 | 0.03 |
Beta carotene | 1.7 | 1.9 | 0.65 | 1.6 | 1.5 | 0.67 |
Selenium | 3.1 | 3.5 | 1.9 | 1.9 | 2.2 | 0.27 |
Thiamin (B1) | 6.5 | 7.1 | 3.9 | 5.5 | 5.8 | 0.31 |
Overall vitamin/mineral supplement use
Changes in vitamin/mineral supplement use
Doses of vitamin/mineral supplements
Initiatorsb
| Discontinuersc
| Continuous users | ||||||
---|---|---|---|---|---|---|---|---|
IOM reference intakesd
| Change in dose from diagnosis to 6 months | P-valuee
| Change in dose from diagnosis to 6 months | P-valuef
| Dose at diagnosis | Dose at 6 months | Change from diagnosisg
| |
Multivitamins (pills) | n/a | 1.45 | 0.53 | −1.32 | 0.34 | 1.39 | 1.23 | −0.17 |
Vitamin C (mg) | 75 mg | 615.95 | 0.01 | −557.97 | <.0001 | 780.10 | 740.57 | −26.07 |
Calcium (mg) | 1200 mg | 859.31 | <.0001 | −743.69 | 0.56 | 704.55 | 815.69 | 119.70 |
Vitamin E (IU) | 15 mcgh
| 280.89 | <.0001 | −391.09 | 0.66 | 400.97 | 357.97 | −41.32 |
Vitamin D (IU) | 600 mcgg
| 1064.94 | <.0001 | −2505.33 | 0.26 | 1800.20 | 2306.79 | 609.09 |
Iron (mg) | 8 mg | 184.13 | 0.56 | −80.08 | 0.38 | 129.99 | 79.66 | −73.85 |
Vitamin B12 (mcg) | 2.4 mcg | 245.80 | <.0001 | −612.35 | 0.18 | 794.29 | 625.99 | −126.84 |
Folic acid (folate) (mcg) | 400 mcg | 416.38 | <.0001 | −475.81 | 0.05 | 616.75 | 552.73 | −42.47 |
Magnesium (mg) | 320 mg | 289.02 | 0.91 | −315.55 | 0.62 | 293.46 | 319.25 | 57.69 |
Zinc (mg) | 8 mg | 12.79 | <.0001 | −17.56 | 0.004 | 42.14 | 38.08 | 4.46 |
Vitamin B6 (mg) | 1.3-1.5 mg | 63.77 | 0.07 | −110.61 | 0.56 | 88.96 | 91.34 | −16.14 |
Vitamin A (IU) | 700 mcgi,h
| 5966.11 | 0.02 | −11113.52 | 0.93 | 10736.26 | 7283.16 | −3425.60 |
Chromium (mg) | 0.02 mg | 165.46 | 0.03 | −176.16 | 0.09 | 280.96 | 284.16 | 13.65 |
Niacin (B3) (mg) | 14 mg | 167.02 | <.0001 | −368.21 | 0.02 | 850.00 | 915.86 | 94.52 |
Beta carotene (IU) | 12552.93 | 0.10 | −12750.00 | 0.15 | 19722.22 | 13437.50 | −4166.67 | |
Selenium (mcg) | 55 mg | 101.96 | 0.11 | −111.01 | 0.21 | 144.25 | 137.41 | −1.28 |
Thiamin (B1) (mg) | 1.1 mg | 57.81 | 0.07 | −28.35 | 0.17 | 164.06 | 179.76 | 57.14 |
Predictors of supplement initiation, discontinuation and continuous use
Covariates | Multivitamins (n = 751) | Vitamin C (n = 1,661) | Calcium (n = 1,941) | Vitamin E (n = 1,897) | Vitamin D (n = 2,129) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
OR | 95% CI | P-value | OR | 95% CI | P-value | OR | 95% CI | P-value | OR | 95% CI | P-value | OR | 95% CI | P-value | |
Age
| |||||||||||||||
<50 years | Ref | Ref | Ref | Ref | Ref | ||||||||||
50-59 years | 1.03 | 0.59, 1.81 | 0.97 | 0.78 | 0.48, 1.25 | 0.30 | 2.56 | 1.84, 3.55 | <.0001 | 0.68 | 0.37, 1.26 | 0.22 | 1.82 | 1.34, 2.48 | .0001 |
60-69 years | 0.62 | 0.34, 1.14 | 0.13 | 0.92 | 0.56, 1.49 | 0.72 | 3.01 | 2.13, 4.23 | <.0001 | 0.42 | 0.22, 0.83 | 0.01 | 2.19 | 1.59, 3.02 | <.0001 |
70+ years | 0.68 | 0.32, 1.42 | 0.30 | 0.98 | 0.56, 1.74 | 0.95 | 3.08 | 2.06, 4.60 | <.0001 | 0.45 | 0.21, 0.97 | 0.04 | 2.02 | 1.38, 2.95 | .0003 |
Race
| |||||||||||||||
Non-Hispanic white | Ref | Ref | Ref | Ref | Ref | ||||||||||
African American | 0.69 | 0.30, 1.30 | 0.39 | 0.76 | 0.36, 1.61 | 0.47 | 0.72 | 0.45, 1.16 | 0.17 | 0.75 | 0.28, 2.01 | 0.56 | 0.89 | 0.55, 1.43 | 0.63 |
Asian | 0.91 | 0.47, 1.75 | 0.77 | 1.61 | 0.99, 2.62 | 0.05 | 0.83 | 0.58, 1.19 | 0.31 | 1.07 | 0.52, 2.21 | 0.85 | 0.87 | 0.62, 1.23 | 0.43 |
Hispanic | 0.85 | 0.46, 1.56 | 0.60 | 0.77 | 0.38, 1.26 | 0.23 | 0.58 | 0.40, 0.83 | 0.004 | 1.20 | 0.60, 2.41 | 0.61 | 0.96 | 0.68, 1.37 | 0.83 |
Education
| |||||||||||||||
Highschool or less | Ref | Ref | Ref | Ref | Ref | ||||||||||
Some college | 2.58 | 1.35, 4.94 | 0.004 | 1.09 | 0.63, 1.91 | 0.75 | 0.91 | 0.64, 1.29 | 0.59 | 1.51 | 0.66, 3.45 | 0.33 | 0.84 | 0.58, 1.13 | 0.22 |
College graduate | 1.61 | 0.78, 3.29 | 0.20 | 1.62 | 0.92, 2.86 | 0.10 | 1.14 | 0.79, 1.65 | 0.49 | 2.06 | 0.88, 4.83 | 0.10 | 1.00 | 0.70, 1.41 | 0.98 |
Post graduate | 2.80 | 1.35, 5.78 | 0.006 | 0.99 | 0.53, 1.83 | 0.62 | 1.23 | 0.84, 1.81 | 0.30 | 2.11 | 0.87, 5.12 | 0.10 | 1.11 | 0.77, 1.60 | 0.59 |
Household income
| |||||||||||||||
≤$25,000 | Ref | Ref | Ref | Ref | Ref | ||||||||||
$25,000-49,999 | 0.43 | 0.23, 0.82 | 0.01 | 1.12 | 0.59, 2.13 | 0.73 | 1.21 | 0.81, 1.82 | 0.35 | 0.93 | 0.40, 2.17 | 0.87 | 1.18 | 0.79, 1.75 | 0.42 |
$50,000-89,999 | 0.25 | 0.13, 0.49 | <.0001 | 1.28 | 0.69, 2.36 | 0.44 | 1.37 | 0.92, 2.03 | 0.12 | 1.04 | 0.46, 2.33 | 0.93 | 1.35 | 0.91, 2.0 | 0.13 |
$90,000+ | 0.29 | 0.15, 0.56 | .0003 | 1.25 | 0.66, 2.36 | 0.49 | 1.49 | 0.99, 2.26 | 0.06 | 0.53 | 0.22, 1.28 | 0.16 | 1.22 | 0.81, 1.82 | 0.34 |
Family history of breast cancer
| |||||||||||||||
No | Ref | Ref | Ref | Ref | Ref | ||||||||||
Yes | 0.97 | 0.60, 1.57 | 0.91 | 1.17 | 0.80, 1.70 | 0.43 | 0.98 | 0.75, 1.26 | 0.86 | 1.54 | 0.95, 2.50 | 0.08 | 0.97 | 0.76, 1.24 | 0.80 |
Stage at diagnosis
| |||||||||||||||
I | Ref | Ref | Ref | Ref | Ref | ||||||||||
II | 1.0 | 0.54, 1.85 | 1.0 | 0.77 | 0.46, 1.28 | 0.31 | 0.71 | 0.51, 0.97 | 0.03 | 0.94 | 0.48, 1.84 | 0.86 | 0.88 | 0.65, 1.19 | 0.40 |
III+ | 0.50 | 0.12, 2.08 | 0.34 | 1.33 | 0.46, 3.82 | 0.59 | 0.49 | 0.23, 1.05 | 0.07 | 2.09 | 0.53, 8.30 | 0.30 | 0.65 | 0.31, 1.38 | 0.26 |
Number of positive nodes
| |||||||||||||||
None | Ref | Ref | Ref | Ref | Ref | ||||||||||
1-3 | 1.08 | 0.55, 2.1 | 0.82 | 1.47 | 0.82, 2.62 | 0.20 | 0.97 | 0.67, 1.41 | 0.89 | 1.15 | 0.52, 2.56 | 0.73 | 0.99 | 0.70, 1.42 | 0.97 |
≥4 | 1.52 | 0.41, 5.7 | 0.53 | 0.62 | 0.20, 1.91 | 0.40 | 1.47 | 0.67, 3.23 | 0.34 | 0.48 | 0.11, 2.20 | 0.35 | 1.29 | 0.60, 2.77 | 0.51 |
Hormone-receptor positivity
| |||||||||||||||
ER- and PR - | Ref | Ref | Ref | Ref | Ref | ||||||||||
ER + and/or PR+ | 1.14 | 0.63, 2.06 | 0.66 | 1.19 | 0.70, 2.01 | 0.52 | 1.26 | 0.91, 1.73 | 0.17 | 1.25 | 0.60, 2.59 | 0.55 | 1.38 | 1.01, 1.88 | 0.04 |
HER2/Neu status
| |||||||||||||||
Negative | Ref | Ref | Ref | Ref | Ref | ||||||||||
Positive | 1.11 | 0.57, 2.16 | 0.76 | 1.12 | 0.67, 1.88 | 0.66 | 0.69 | 0.50, 0.97 | 0.03 | 0.62 | 0.27, 1.42 | 0.26 | 1.05 | 0.76, 1.43 | 0.78 |
Not performed | 0.96 | 0.29, 2.93 | 0.89 | 1.56 | 0.69, 3.54 | 0.29 | 1.93 | 1.0, 3.71 | 0.05 | 1.73 | 0.65, 4.60 | 0.27 | 2.11 | 1.21, 3.69 | 0.009 |
Surgery type
| |||||||||||||||
Conserving or none | Ref | Ref | Ref | Ref | Ref | ||||||||||
Mastectomy | 1.12 | 0.67, 1.89 | 0.67 | 0.86 | 0.56, 1.32 | 0.48 | 1.09 | 0.81, 1.46 | 0.57 | 1.03 | 0.56, 1.88 | 0.93 | 1.22 | 0.93, 1.60 | 0.15 |
Treatment status
| |||||||||||||||
None | Ref | Ref | Ref | Ref | Ref | ||||||||||
Chemotherapy only | 1.08 | 0.53, 2.20 | 0.84 | 0.55 | 0.31, 0.96 | 0.03 | 0.89 | 0.62, 1.28 | 0.53 | 0.45 | 0.21, 0.96 | 0.04 | 0.71 | 0.50, 1.0 | 0.05 |
Radiation only | 1.22 | 0.61, 2.41 | 0.57 | 0.72 | 0.43, 1.21 | 0.22 | 1.14 | 0.72, 1.51 | 0.83 | 0.87 | 0.43, 1.75 | 0.69 | 1.02 | 0.73, 1.43 | 0.90 |
Both | 0.94 | 0.42, 2.10 | 0.88 | 0.67 | 0.35, 1.29 | 0.23 | 0.89 | 0.57, 1.39 | 0.60 | 0.46 | 0.18, 1.18 | 0.10 | 0.75 | 0.50, 1.15 | 0.19 |
BMI
| |||||||||||||||
<25 kg/m2
| Ref | Ref | Ref | Ref | Ref | ||||||||||
25-30 kg/m2
| 0.68 | 0.42, 1.09 | 0.11 | 0.98 | 0.67, 1.45 | 0.93 | 0.81 | 0.63, 1.05 | 0.10 | 1.21 | 0.72, 2.05 | 0.47 | 0.86 | 0.67, 1.09 | 0.20 |
>30 kg/m2
| 1.04 | 0.63, 1.72 | 0.88 | 1.39 | 0.92, 2.09 | 0.12 | 0.81 | 0.61, 1.07 | 0.14 | 1.53 | 0.88, 2.67 | 0.13 | 0.96 | 0.74, 1.24 | 0.74 |
Fruit and vegetable intake
| |||||||||||||||
<35 servings/week | Ref | Ref | Ref | Ref | Ref | ||||||||||
≥35 servings/week | 1.14 | 0.76, 1.72 | 0.52 | 1.42 | 1.02, 1.97 | 0.04 | 1.60 | 1.28, 1.99 | <.0001 | 0.91 | 0.58, 1.42 | 0.68 | 1.48 | 1.20, 1.83 | .0002 |
Hrs/wk of moderate-vigorous activity
| |||||||||||||||
<2.5 | Ref | Ref | Ref | Ref | Ref | ||||||||||
2.5 - 5 | 0.89 | 0.52, 1.52 | 0.56 | 1.05 | 0.68, 1.64 | 0.82 | 1.42 | 1.06, 1.93 | 0.02 | 1.05 | 0.54, 2.07 | 0.88 | 1.27 | 0.96, 1.69 | 0.10 |
>5 | 0.89 | 0.55, 1.43 | 0.74 | 0.94 | 0.64, 1.39 | 0.77 | 1.18 | 0.91, 1.54 | 0.27 | 1.69 | 0.98, 2.91 | 0.06 | 1.17 | 0.91, 1.50 | 0.23 |
Smoking status
| |||||||||||||||
Never | Ref | Ref | Ref | Ref | Ref | ||||||||||
Ever | 1.19 | 0.79, 1.78 | 0.40 | 1.40 | 1.0, 1.95 | 0.05 | 1.40 | 1.12, 1.74 | 0.003 | 1.61 | 1.03, 2.52 | 0.04 | 1.0 | 0.81, 1.23 | 0.96 |
Covariates | Multivitamins (n = 1,563) | Vitamin C (n = 723) | Calcium (n = 542) | Vitamin E (n = 496) | Vitamin D (n = 287) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
OR | 95% CI | P-value | OR | 95% CI | P-value | OR | 95% CI | P-value | OR | 95% CI | P-value | OR | 95% CI | P-value | |
Age
| |||||||||||||||
<50 years | Ref | Ref | Ref | Ref | Ref | ||||||||||
50-59 years | 0.73 | 0.52, 1.04 | 0.08 | 0.81 | 0.48, 1.38 | 0.44 | 0.51 | 0.28, 0.93 | 0.03 | 0.87 | 0.39, 1.92 | 0.72 | 0.69 | 0.22, 2.13 | 0.52 |
60-69 years | 0.58 | 0.40, 0.85 | 0.005 | 0.98 | 0.58, 1.67 | 0.94 | 0.59 | 0.32, 1.08 | 0.09 | 0.73 | 0.33, 1.60 | 0.43 | 0.45 | 0.14, 1.42 | 0.17 |
70+ years | 0.37 | 0.23, 0.56 | <.0001 | 1.26 | 0.69, 2.30 | 0.46 | 0.73 | 0.36, 1.46 | 0.37 | 0.77 | 0.32, 1.85 | 0.56 | 0.86 | 0.25, 2.92 | 0.81 |
Race
| |||||||||||||||
Non-Hispanic white | Ref | Ref | Ref | Ref | Ref | ||||||||||
African American | 1.38 | 0.82, 2.31 | 0.22 | 1.83 | 0.86, 3.89 | 0.12 | 1.77 | 0.75, 4.16 | 0.19 | 1.93 | 0.72, 5.19 | 0.19 | 0.70 | 0.18, 2.70 | 0.61 |
Asian | 0.86 | 0.56, 1.31 | 0.48 | 1.71 | 0.92, 3.16 | 0.09 | 1.71 | 0.87, 3.37 | 0.12 | 1.48 | 0.60, 3.63 | 0.40 | 1.58 | 0.51, 4.89 | 0.43 |
Hispanic | 1.18 | 0.76, 1.84 | 0.45 | 0.99 | 0.54, 1.82 | 0.97 | 0.88 | 0.43, 1.80 | 0.73 | 0.80 | 0.37, 1.74 | 0.57 | 3.07 | 1.19, 7.94 | 0.02 |
Education
| |||||||||||||||
High School or less | Ref | Ref | Ref | Ref | Ref | ||||||||||
Some college | 0.60 | 0.40, 0.90 | 0.01 | 1.47 | 0.84, 2.55 | 0.18 | 1.32 | 0.66, 2.63 | 0.44 | 1.33 | 0.68, 2.61 | 0.41 | 2.17 | 0.67, 6.99 | 0.20 |
College graduate | 0.56 | 0.37, 0.87 | 0.01 | 1.17 | 0.65, 2.10 | 0.61 | 0.57 | 0.27, 1.18 | 0.13 | 0.68 | 0.33, 1.39 | 0.29 | 1.05 | 0.31, 3.58 | 0.94 |
Post graduate | 0.60 | 0.39, 0.94 | 0.03 | 1.29 | 0.71, 2.33 | 0.40 | 1.10 | 0.54, 2.26 | 0.79 | 0.91 | 0.44, 1.89 | 0.80 | 0.73 | 0.21, 2.50 | 0.61 |
Household income
| |||||||||||||||
≤$25,000 | Ref | Ref | Ref | Ref | Ref | ||||||||||
$25,000-49,999 | 1.21 | 0.72, 2.04 | 0.47 | 1.20 | 0.63, 2.31 | 0.58 | 0.46 | 0.20, 1.05 | 0.06 | 1.60 | 0.76, 3.36 | 0.21 | 1.80 | 0.56, 5.75 | 0.32 |
$50,000-89,999 | 0.88 | 0.53, 1.47 | 0.63 | 1.38 | 0.72, 2.63 | 0.33 | 0.50 | 0.22, 1.11 | 0.09 | 2.39 | 1.15, 4.95 | 0.02 | 0.88 | 0.28, 2.78 | 0.82 |
$90,000+ | 0.94 | 0.56, 1.60 | 0.83 | 2.43 | 1.24, 4.78 | 0.01 | 0.74 | 0.32, 1.68 | 0.46 | 2.91 | 1.35, 6.25 | 0.01 | 0.81 | 0.25, 2.67 | 0.73 |
Family history of breast cancer
| |||||||||||||||
No | Ref | Ref | Ref | Ref | Ref | ||||||||||
Yes | 0.93 | 0.69, 1.27 | 0.65 | 0.88 | 0.60, 1.30 | 0.51 | 0.67 | 0.41, 1.08 | 0.10 | 1.18 | 0.71, 1.94 | 0.53 | 0.82 | 0.38, 1.77 | 0.61 |
Stage at diagnosis
| |||||||||||||||
I | Ref | Ref | Ref | Ref | Ref | ||||||||||
II | 1.05 | 0.72, 1.52 | 0.81 | 0.89 | 0.55, 1.44 | 0.64 | 0.69 | 0.37, 1.29 | 0.24 | 0.82 | 0.42, 1.60 | 0.56 | 1.01 | 0.37, 2.79 | 0.98 |
III+ | 1.69 | 0.75, 3.83 | 0.21 | 1.77 | 0.49, 6.38 | 0.39 | 0.33 | 0.07, 1.52 | 0.16 | 0.45 | 0.08, 2.53 | 0.36 | 1.97 | 0.21, 18.57 | 0.55 |
Number of positive nodes
| |||||||||||||||
None | Ref | Ref | Ref | Ref | Ref | ||||||||||
1-3 | 1.12 | 0.73, 1.71 | 0.60 | 1.17 | 0.66, 2.07 | 0.59 | 1.35 | 0.67, 2.73 | 0.40 | 1.27 | 0.58, 2.79 | 0.56 | 1.50 | 0.45, 5.00 | 0.51 |
≥4 | 1.09 | 0.47, 2.56 | 0.84 | 1.05 | 0.27, 4.03 | 0.94 | 4.47 | 0.95, 21.18 | 0.06 | 1.49 | 0.24, 9.17 | 0.67 | 0.93 | 0.08, 10.23 | 0.95 |
Hormone-receptor positivity
| |||||||||||||||
ER- and PR - | Ref | Ref | Ref | Ref | Ref | ||||||||||
ER + and/or PR+ | 0.80 | 0.56, 1.14 | 0.21 | 0.76 | 0.48, 1.21 | 0.25 | 0.74 | 0.43, 1.29 | 0.29 | 1.30 | 0.69, 2.45 | 0.42 | 0.68 | 0.28, 1.62 | 0.38 |
HER2/Neu status
| |||||||||||||||
Negative | Ref | Ref | Ref | Ref | Ref | ||||||||||
Positive | 1.04 | 0.73, 1.49 | 0.81 | 1.31 | 0.78, 2.20 | 0.31 | 0.61 | 0.33, 1.13 | 0.12 | 0.79 | 0.40, 1.58 | 0.50 | 0.92 | 0.32, 2.63 | 0.88 |
Not performed | 1.46 | 0.76, 2.80 | 0.26 | 0.80 | 0.33, 1.97 | 0.63 | 0.90 | 0.32, 2.54 | 0.84 | 0.87 | 0.24, 3.12 | 0.83 | 0.82 | 0.14, 4.89 | 0.83 |
Surgery type
| |||||||||||||||
Conserving or none | Ref | Ref | Ref | Ref | Ref | ||||||||||
Mastectomy | 0.94 | 0.68, 1.29 | 0.69 | 0.59 | 0.38, 0.90 | 0.01 | 0.71 | 0.43, 1.17 | 0.18 | 0.58 | 0.33, 1.03 | 0.06 | 0.66 | 0.28, 1.54 | 0.34 |
Treatment status
| |||||||||||||||
None | Ref | Ref | Ref | Ref | Ref | ||||||||||
Chemotherapy only | 1.57 | 1.02, 2.43 | 0.04 | 1.71 | 0.99, 2.97 | 0.05 | 1.48 | 0.74, 2.95 | 0.26 | 2.29 | 1.09, 4.79 | 0.03 | 0.97 | 0.31, 3.08 | 0.96 |
Radiation only | 1.25 | 0.81, 1.93 | 0.32 | 0.85 | 0.51, 1.41 | 0.52 | 0.76 | 0.41, 1.42 | 0.39 | 0.51 | 0.27, 0.98 | 0.04 | 0.54 | 0.19, 1.56 | 0.25 |
Both | 1.05 | 0.61, 1.81 | 0.85 | 1.31 | 0.67, 2.58 | 0.43 | 1.20 | 0.55, 2.65 | 0.65 | 0.99 | 0.42, 2.32 | 0.98 | 2.77 | 0.92, 8.39 | 0.07 |
BMI
| |||||||||||||||
<25 kg/m2
| Ref | Ref | Ref | Ref | Ref | ||||||||||
25-30 kg/m2
| 1.03 | 0.77, 1.39 | 0.83 | 0.78 | 0.53, 1.14 | 0.20 | 1.01 | 0.62, 1.64 | 0.97 | 1.23 | 0.74, 2.02 | 0.43 | 0.65 | 0.29, 1.46 | 0.29 |
>30 kg/m2
| 0.93 | 0.67, 1.29 | 0.68 | 0.78 | 0.51, 1.20 | 0.26 | 1.53 | 0.93, 2.52 | 0.10 | 1.01 | 0.57, 1.79 | 0.97 | 1.22 | 0.53, 2.80 | 0.64 |
Fruit and vegetable intake
| |||||||||||||||
<35 servings/week | Ref | Ref | Ref | Ref | Ref | ||||||||||
≥35 servings/week | 0.85 | 0.66, 1.11 | 0.23 | 1.19 | 0.85, 1.66 | 0.31 | 0.70 | 0.47, 1.04 | 0.08 | 0.82 | 0.54, 1.25 | 0.36 | 0.48 | 0.25, 0.94 | 0.03 |
Hrs/wk of moderate- vigorous activity
| |||||||||||||||
<2.5 | Ref | Ref | Ref | Ref | Ref | ||||||||||
2.5 - 5 | 0.71 | 0.49, 1.04 | 0.08 | 1.00 | 0.62, 1.60 | 0.99 | 1.63 | 0.93, 2.87 | 0.09 | 0.80 | 0.44, 1.46 | 0.46 | 1.92 | 0.77, 4.79 | 0.16 |
>5 | 1.15 | 0.85, 1.57 | 0.37 | 0.82 | 0.54, 1.24 | 0.34 | 1.62 | 0.99, 2.65 | 0.06 | 0.74 | 0.42, 1.28 | 0.27 | 1.05 | 0.48, 2.27 | 0.91 |
Smoking status
| |||||||||||||||
Never | Ref | Ref | Ref | Ref | Ref | ||||||||||
Ever | 0.95 | 0.73, 1.23 | 0.68 | 0.81 | 0.58, 1.12 | 0.20 | 0.88 | 0.59, 1.30 | 0.51 | 0.70 | 0.46, 1.08 | 0.10 | 0.96 | 0.49, 1.88 | 0.90 |
Covariates | Multivitamins (n = 1,563) | Vitamin C (n = 723) | Calcium (n = 542) | Vitamin E (n = 496) | Vitamin D (n = 287) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
OR | 95% CI | P-value | OR | 95% CI | P-value | OR | 95% CI | P-value | OR | 95% CI | P-value | OR | 95% CI | P-value | |
Age
| |||||||||||||||
<50 years | Ref | Ref | Ref | Ref | Ref | ||||||||||
50-59 years | 1.28 | 0.91, 1.8 | 0.16 | 1.26 | 0.84, 1.89 | 0.27 | 2.06 | 1.34, 3.16 | 0.001 | 1.78 | 0.91, 3.48 | 0.09 | 2.99 | 1.65, 5.4 | .0003 |
60-69 years | 1.10 | 0.77, 1.56 | 0.61 | 1.27 | 0.84, 1.92 | 0.27 | 2.48 | 1.6, 3.86 | <.0001 | 2.54 | 1.32, 4.89 | 0.01 | 5.31 | 2.95, 9.54 | <.0001 |
70+ years | 1.51 | 0.99, 2.31 | 0.05 | 1.28 | 0.8, 2.04 | 0.30 | 2.36 | 1.41, 3.96 | 0.001 | 2.35 | 1.15, 4.79 | 0.02 | 7.14 | 3.75, 13.61 | <.0001 |
Race
| |||||||||||||||
Non-Hispanic white | Ref | Ref | Ref | Ref | Ref | ||||||||||
African American | 0.66 | 0.4, 1.08 | 0.10 | 0.58 | 0.32, 1.05 | 0.07 | 0.59 | 0.31, 1.15 | 0.12 | 0.57 | 0.24, 1.4 | 0.22 | 2.34 | 1.3, 4.2 | 0.005 |
Asian | 0.79 | 0.54, 1.14 | 0.21 | 0.57 | 0.35, 0.91 | 0.02 | 0.61 | 0.37, 1 | 0.05 | 0.47 | 0.23, 0.98 | 0.04 | 0.80 | 0.46, 1.38 | 0.42 |
Hispanic | 0.54 | 0.37, 0.78 | 0.001 | 0.73 | 0.47, 1.12 | 0.15 | 0.66 | 0.42, 1.06 | 0.09 | 0.87 | 0.48, 1.57 | 0.64 | 0.99 | 0.56, 1.75 | 0.97 |
Education
| |||||||||||||||
High School or less | Ref | Ref | Ref | Ref | Ref | ||||||||||
Some college | 1.82 | 1.27, 2.61 | 0.001 | 0.88 | 0.6, 1.31 | 0.53 | 0.97 | 0.6, 1.55 | 0.89 | 0.96 | 0.56, 1.66 | 0.89 | 1.02 | 0.59, 1.76 | 0.95 |
College graduate | 1.63 | 1.11, 2.39 | 0.01 | 1.01 | 0.66, 1.54 | 0.98 | 1.38 | 0.84, 2.25 | 0.20 | 1.28 | 0.72, 2.26 | 0.40 | 1.48 | 0.84, 2.62 | 0.17 |
Post graduate | 1.90 | 1.27, 2.85 | 0.002 | 1.12 | 0.73, 1.73 | 0.60 | 1.42 | 0.85, 2.37 | 0.18 | 1.12 | 0.62, 2.02 | 0.72 | 2.53 | 1.44, 4.46 | 0.001 |
Household income
| |||||||||||||||
≤$25,000 | Ref | Ref | Ref | Ref | Ref | ||||||||||
$25,000-49,999 | 1.03 | 0.65, 1.63 | 0.91 | 1.38 | 0.87, 2.17 | 0.17 | 2.15 | 1.17, 3.94 | 0.01 | 0.75 | 0.43, 1.29 | 0.30 | 1.08 | 0.61, 1.9 | 0.79 |
$50,000-89,999 | 1.26 | 0.81, 1.97 | 0.30 | 1.19 | 0.76, 1.87 | 0.45 | 2.13 | 1.17, 3.88 | 0.01 | 0.56 | 0.33, 0.98 | 0.04 | 1.29 | 0.75, 2.22 | 0.36 |
$90,000+ | 0.99 | 0.62, 1.57 | 0.97 | 0.74 | 0.45, 1.2 | 0.22 | 2.05 | 1.1, 3.8 | 0.02 | 0.49 | 0.27, 0.88 | 0.02 | 1.36 | 0.77, 2.41 | 0.28 |
Family history of breast cancer
| |||||||||||||||
No | Ref | Ref | Ref | Ref | Ref | ||||||||||
Yes | 1.05 | 0.8, 1.39 | 0.71 | 1.05 | 0.78, 1.4 | 0.77 | 1.04 | 0.75, 1.45 | 0.82 | 0.86 | 0.57, 1.3 | 0.48 | 1.28 | 0.91, 1.8 | 0.17 |
Stage at diagnosis
| |||||||||||||||
I | Ref | Ref | Ref | Ref | Ref | ||||||||||
II | 1.11 | 0.8, 1.56 | 0.53 | 1.00 | 0.69, 1.43 | 0.98 | 0.72 | 0.47, 1.09 | 0.12 | 0.97 | 0.58, 1.62 | 0.91 | 0.81 | 0.52, 1.28 | 0.37 |
III+ | 2.00 | 0.81, 4.96 | 0.14 | 0.64 | 0.22, 1.86 | 0.41 | 0.74 | 0.27, 2 | 0.55 | 1.58 | 0.45, 5.53 | 0.47 | 0.70 | 0.23, 2.13 | 0.53 |
Number of positive nodes
| |||||||||||||||
None | Ref | Ref | Ref | Ref | Ref | ||||||||||
1-3 | 1.02 | 0.69, 1.52 | 0.91 | 0.88 | 0.57, 1.37 | 0.57 | 0.98 | 0.6, 1.58 | 0.92 | 1.10 | 0.59, 2.05 | 0.78 | 1.27 | 0.74, 2.18 | 0.38 |
≥4 | 0.51 | 0.2, 1.29 | 0.15 | 0.86 | 0.29, 2.53 | 0.78 | 1.09 | 0.38, 3.11 | 0.87 | 0.90 | 0.25, 3.31 | 0.87 | 1.27 | 0.39, 4.07 | 0.69 |
Hormone-receptor positivity
| |||||||||||||||
ER- and PR - | Ref | Ref | Ref | Ref | Ref | ||||||||||
ER + and/or PR+ | 1.15 | 0.83, 1.61 | 0.41 | 0.97 | 0.66, 1.43 | 0.88 | 1.22 | 0.8, 1.85 | 0.36 | 0.84 | 0.5, 1.4 | 0.49 | 1.31 | 0.82, 2.11 | 0.26 |
HER2/Neu status
| |||||||||||||||
Negative | Ref | Ref | Ref | Ref | Ref | ||||||||||
Positive | 1.52 | 1.05, 2.2 | 0.03 | 0.83 | 0.54, 1.26 | 0.38 | 0.99 | 0.65, 1.5 | 0.96 | 1.01 | 0.58, 1.76 | 0.97 | 0.77 | 0.45, 1.32 | 0.34 |
Not performed | 0.86 | 0.45, 1.63 | 0.64 | 1.37 | 0.71, 2.66 | 0.35 | 1.90 | 0.84, 4.32 | 0.13 | 0.89 | 0.34, 2.32 | 0.81 | 1.70 | 0.7, 4.11 | 0.24 |
Surgery type
| |||||||||||||||
Conserving or none | Ref | Ref | Ref | Ref | Ref | ||||||||||
Mastectomy | 0.96 | 0.71, 1.3 | 0.80 | 1.28 | 0.9, 1.82 | 0.17 | 0.84 | 0.58, 1.23 | 0.37 | 1.22 | 0.75, 2 | 0.43 | 1.43 | 0.94, 2.18 | 0.10 |
Treatment status
| |||||||||||||||
None | Ref | Ref | Ref | Ref | Ref | ||||||||||
Chemotherapy only | 0.74 | 0.5, 1.1 | 0.13 | 0.71 | 0.47, 1.09 | 0.11 | 0.95 | 0.58, 1.54 | 0.83 | 0.55 | 0.29, 1.02 | 0.06 | 0.57 | 0.34, 0.96 | 0.03 |
Radiation only | 0.99 | 0.67, 1.46 | 0.96 | 1.05 | 0.69, 1.58 | 0.83 | 0.89 | 0.56, 1.44 | 0.65 | 1.35 | 0.77, 2.35 | 0.29 | 0.93 | 0.57, 1.52 | 0.78 |
Both | 0.58 | 0.36, 0.91 | 0.02 | 0.64 | 0.37, 1.12 | 0.12 | 0.66 | 0.36, 1.21 | 0.18 | 0.84 | 0.4, 1.74 | 0.63 | 0.84 | 0.44, 1.58 | 0.58 |
BMI
| |||||||||||||||
<25 kg/m2
| Ref | Ref | Ref | Ref | Ref | ||||||||||
25-30 kg/m2
| 0.85 | 0.65, 1.12 | 0.25 | 0.90 | 0.67, 1.21 | 0.50 | 0.92 | 0.66, 1.28 | 0.61 | 0.90 | 0.61, 1.34 | 0.61 | 1.10 | 0.77, 1.55 | 0.61 |
>30 kg/m2
| 1.12 | 0.83, 1.52 | 0.47 | 0.93 | 0.68, 1.29 | 0.67 | 0.88 | 0.61, 1.26 | 0.48 | 0.86 | 0.56, 1.33 | 0.49 | 0.82 | 0.55, 1.23 | 0.33 |
Fruit and vegetable intake
| |||||||||||||||
<35 servings/week | Ref | Ref | Ref | Ref | Ref | ||||||||||
≥35 servings/week | 1.59 | 1.26, 2.02 | .0001 | 1.06 | 0.82, 1.36 | 0.68 | 1.45 | 1.09, 1.93 | 0.01 | 1.11 | 0.78, 1.56 | 0.57 | 1.59 | 1.17, 2.16 | 0.003 |
Hrs/wk of moderate-vigorous activity
| |||||||||||||||
<2.5 | Ref | Ref | Ref | Ref | Ref | ||||||||||
2.5 - 5 | 1.15 | 0.84, 1.57 | 0.38 | 1.08 | 0.76, 1.55 | 0.66 | 1.01 | 0.68, 1.51 | 0.94 | 1.77 | 1.09, 2.87 | 0.02 | 0.74 | 0.47, 1.16 | 0.19 |
>5 | 1.20 | 0.91, 1.59 | 0.20 | 1.18 | 0.87, 1.61 | 0.29 | 1.04 | 0.74, 1.46 | 0.83 | 1.44 | 0.93, 2.23 | 0.11 | 1.07 | 0.74, 1.54 | 0.72 |
Smoking status
| |||||||||||||||
Never | Ref | Ref | Ref | Ref | Ref | ||||||||||
Ever | 0.94 | 0.74, 1.19 | 0.58 | 1.27 | 0.98, 1.63 | 0.07 | 1.18 | 0.89, 1.58 | 0.26 | 1.25 | 0.89, 1.75 | 0.20 | 0.89 | 0.66, 1.2 | 0.43 |