Topic Highlight
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Oct 10, 2014; 5(4): 705-712
Published online Oct 10, 2014. doi: 10.5306/wjco.v5.i4.705
Phytoestrogens and prevention of breast cancer: The contentious debate
Iqra Bilal, Avidyuti Chowdhury, Juliet Davidson, Saffron Whitehead
Iqra Bilal, Avidyuti Chowdhury, Juliet Davidson, Saffron Whitehead, Department of Basic Medical Sciences, St George’s University of London, London SW17 0RE, United Kingdom
Author contributions: Bilal I, Chowdhury A, Davidson J were MBBS project students in my laboratory and contributed towards collecting and assessing the references and synthesising the available data; Whitehead S wrote the review based on the students assessment.
Correspondence to: Saffron Whitehead, Professor, Department of Basic Medical Sciences, St George’s University of London, Cranmer Terrace, London SW17 0RE, United Kingdom. saffron@sgul.ac.uk
Telephone: +44-20-88707287 Fax: + 44-20-87250993
Received: December 23, 2013
Revised: April 28, 2014
Accepted: May 16, 2014
Published online: October 10, 2014
Processing time: 220 Days and 19.5 Hours
Abstract

Phytoestrogens have multiple actions within target cells, including the epigenome, which could be beneficial to the development and progression of breast cancer. In this brief review the action of phytoestrogens on oestrogen receptors, cell signalling pathways, regulation of the cell cycle, apoptosis, steroid synthesis and epigenetic events in relation to breast cancer are discussed. Phytoestrogens can bind weakly to oestrogen receptors (ERs) and some have a preferential affinity for ERβ which can inhibit the transcriptional growth-promoting activity of ERα. However only saturating doses of phytoestrogens, stimulating both ERα and β, exert growth inhibitory effects. Such effects on growth may be through phytoestrogens inhibiting cell signalling pathways. Phytoestrogens have also been shown to inhibit cyclin D1 expression but increase the expression of cyclin-dependent kinase inhibitors (p21 and p27) and the tumour suppressor gene p53. Again these effects are only observed at high (> 10) µmol/L doses of phytoestrogens. Finally the effects of phytoestrogens on breast cancer may be mediated by their ability to inhibit local oestrogen synthesis and induce epigenetic changes. There are, though, difficulties in reconciling epidemiological and experimental data due to the fact experimental doses, both in vivo and in vitro, far exceed the circulating concentrations of “free” unbound phytoestrogens measured in women on a high phytoestrogen diet or those taking phytoestrogen supplements.

Keywords: Phytoestrogens; Breast cancer; Cell signalling; Cell cycle; Epigenomics

Core tip: Phytoestrogens have multiple actions within target cells, including the epigenome, which could be beneficial to the development and progression of breast cancer. In this brief review the action of phytoestrogens on oestrogen receptors, cell signalling pathways, regulation of the cell cycle, apoptosis, steroid synthesis and epigenetic events in relation to breast cancer are discussed. The difficulties in interpreting experimental evidence relating to the beneficial effects of phytoestrogens in light of dietary/supplementary intake and bioavailability of ingested phytoestrogens is also addressed.