Breast cancer in Vitamin B2's Points of view

 Kyle J. Norton

Vitamin B2 also known as  Riboflavin, is a water-soluble, yellow-orange organic compound found abundantly in milk, meat, eggs, nuts, enriched flour, green vegetables, etc. The vitamin is essential for normal cellular growth and function and best known for converting energy from protein, fat, and carbohydrates during metabolism and its antioxidant effects in oxidation-reduction reactions.
Breast cancer (malignant breast neoplasm) is a cancer that starts in the tissues of the breast either from the inner lining of milk ducts (Ductal carcinoma) or the lobules (Lobular carcinoma) suppled the ducts with milk. There is also rare cases that breast cancer starts in other areas of the breast. In 2010, over 250,000 new cases of breast cancer were expected to be diagnosed in women in the U.S. alone and the risk of getting invasive breast cancer during life time of a women is 1/8.

Epidemiological studies, focusing in the benefits of vitamin B2 in reduced risk and treatment of breast cancer have produced inconclusive results. Serum levels of riboflavin (RF) was found significantly be decreased in over-expressed of RF carrier protein women with breast cancer. Administration of RF-targeted MMC-conjugate (mitomycin C (MMC)-conjugated N-(2-hydroxypropyl) methacrylamide (HPMA) [used as macromolecular carriers to enhance therapeutic efficacy and limit side effects of anti-cancer chemotherapeutic agents] enabled an increase in MMC uptake and nuclear localization in cell cyle to induce cytotoxic activity in in both MCF-7 and SKBR-3 cells(1).  In a follow-up of 20,756 women from the Melbourne Collaborative Cohort Study, including modification by age, hormone receptor status and alcohol consumption showed a insignificant evidence for an inverse association between breast cancer risk and riboflavin intake(2). Other in breast cancer risk among Japanese women, found no correlation of vitamin B2 intake and no overall association with breast cancer risk(3)(3a). Unfortunately, a 5-year survival rate study for in ER-/PR- breast cancers among Korean women, showed that a high intake of vitamin B2 and folate statistically elevated the HR of breast cancer progression compared to a low intake(4).

In postmenopausal women with breast cancer, Tamoxifen (TAM) co administration with Coenzyme Q(10), Riboflavin and Niacin (CoRN)  exhibited a favorable impact on various blood chemistry profiles in reducing side effect of Tamoxifen causes of oxidative stress with various biochemical derangements(5), through increased the antioxidants status, while decreasing lipid and lipid peroxides(6)(7). In an 84 breast cancer patients randomized to receive a daily supplement of CoQ(10) 100 mg, riboflavin 10 mg and niacin 50 mg (CoRN), one dosage per day along with tamoxifen (TAM) 10 mg twice a day, supplementing CoRN  decreased the levels of pro-angiogenic factors, increased the levels of anti-angiogenic factors and enhanced the efficacy of the treatment and might even offer protection from cancer metastases and recurrence(8)(9)(10). Energy-modulating vitamins, riboflavin (45 mg/kg body weight per d), niacin (100 mg/kg body weight per d) and coenzyme Q10 (40 mg/kg body weight per d) for 28 days in the experiment against mammary carcinoma induced by the oral administration of 7,12-dimethylbenz[a]anthracene (25 mg/kg body weight), showed an decreasing of the Krebs cycle and oxidative phosphorylation enzymes and may be considered as a major therapeutic value in breast cancer(11).

Taking altogether, vitamin B2 used conjunction with other energy vitamins and in co administration with Tamixofen showed to enhance the efficacy of the chemo-agent by exerting its antioxidant effects. In fact, risk of breast cancer are associated to nutrient deficiency of vitamin B-12, thiamin, folacin, iron, and riboflavin(12). Over doses for a prolong period may cause symptoms of skin rashes, hypersensitivity, high blood pressure etc., please make sure you follow the guideline of the Institute of Medicine of the National Academies.



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References
(1) Riboflavin-targeted polymer conjugates for breast tumor delivery by Bareford LM, Avaritt BR, Ghandehari H, Nan A, Swaan PW.(PubMed)
(2) Dietary intake of B vitamins and methionine and breast cancer risk by Bassett JK, Baglietto L, Hodge AM, Severi G, Hopper JL, English DR, Giles GG.(PubMed)
(3) Dietary intake of folate, vitamin B2, vitamin B6, vitamin B12, genetic polymorphism of related enzymes, and risk of breast cancer: a case-control study in Japan by Ma E, Iwasaki M, Kobayashi M, Kasuga Y, Yokoyama S, Onuma H, Nishimura H, Kusama R, Tsugane S.(PubMed)
(3a) Folate, vitamin B12 and postmenopausal breast cancer in a prospective study of French women by Lajous M, Romieu I, Sabia S, Boutron-Ruault MC, Clavel-Chapelon F.(PubMed)
(4) Prognosis of breast cancer is associated with one-carbon metabolism related nutrients among Korean women by Lee Y, Lee SA, Choi JY, Song M, Sung H, Jeon S, Park SK, Yoo KY, Noh DY, Ahn SH, Kang D.(PubMed)
(5) Effect of Coenzyme Q(10), Riboflavin and Niacin on Tamoxifen treated postmenopausal breast cancer women with special reference to blood chemistry profiles by Yuvaraj S, Premkumar VG, Shanthi P, Vijayasarathy K, Gangadaran SG, Sachdanandam P.(PubMed)
(6) Augmented antioxidant status in Tamoxifen treated postmenopausal women with breast cancer on co-administration with Coenzyme Q10, Niacin and Riboflavin by Yuvaraj S, Premkumar VG, Vijayasarathy K, Gangadaran SG, Sachdanandam P.(PubMed)
(7) Augmented efficacy of tamoxifen in rat breast tumorigenesis when gavaged along with riboflavin, niacin, and CoQ10: effects on lipid peroxidation and antioxidants in mitochondria by Perumal SS, Shanthi P, Sachdanandam P.(PubMed)
(8) Anti-angiogenic potential of CoenzymeQ10, riboflavin and niacin in breast cancer patients undergoing tamoxifen therapy by Premkumar VG, Yuvaraj S, Sathish S, Shanthi P, Sachdanandam P.(PubMed)
(9) Serum cytokine levels of interleukin-1beta, -6, -8, tumour necrosis factor-alpha and vascular endothelial growth factor in breast cancer patients treated with tamoxifen and supplemented with co-enzyme Q(10), riboflavin and niacin by Premkumar VG, Yuvaraj S, Vijayasarathy K, Gangadaran SG, Sachdanandam P.(PubMed)
(10) Effect of coenzyme Q10, riboflavin and niacin on serum CEA and CA 15-3 levels in breast cancer patients undergoing tamoxifen therapy by Premkumar VG, Yuvaraj S, Vijayasarathy K, Gangadaran SG, Sachdanandam P.(PubNMed)
(11) Energy-modulating vitamins--a new combinatorial therapy prevents cancer cachexia in rat mammary carcinoma by Perumal SS, Shanthi P, Sachdanandam P.(PubMed)
(12) Taste perception and breast cancer: evidence of a role for diet by Ames HG, Gee MI, Hawrysh ZJ.(PubMed)