Breast cancer is the most common cancer in the world. Although there has been progress in cancer treatment, breast cancer remains a challenge. Women that carry the breast cancer gene (BRCA) mutation have an increased risk of breast cancer, and there is no consensus regarding a safe and effective chemoprevention strategy.

 A compound found in cruciferous vegetables, 3,3-diindolylmethane (DIM), has been shown to potentially prevent carcinogenesis and tumor growth. Estrogen metabolism plays a role in breast cancer, and DIM supplementation has been shown to improve estrogen metabolism by increasing the 2-hydroxyestrone to 16α-hydroxyestrone ratio.

 According to a recent study published in Carcinogenesis, researchers investigated the effect of DIM supplementation on breast density (a predictive factor in breast cancer risk) in healthy BRCA carriers. This is the first study to examine the impact of DIM supplementation on the amount of fibroglandular tissue (FGT) and background parenchymal enhancement (BPE) on breast magnetic resonance imaging (MRI) in BRCA carriers.

 This prospective, single-arm study included 23 healthy females who carry the BRCA mutation. Eighteen women had the BRAC1 mutation and five women had the BRAC2 mutation. Seventy-eight percent of the women were postmenopausal with an average age of 47 years. Each participant consumed 100 mg of DIM-Evail™ once daily for 1 year. Assessments included the amount of FGT and BPE on MRI at baseline and at the end of the study. In addition, urinary estrogen metabolism and a serum hormone profile included follicle-stimulating hormone (FSH), luteinizing hormone, estradiol, progesterone, prolactin, testosterone, sex hormone binding globulin, and thyroid stimulating hormone (TSH) were measured at baseline and at the end of the study. MRI scans of the matched untreated women attending the clinic were evaluated for the same primary endpoints. The results were scored using the Breast Imaging and Reporting Data System (BI-RADS).

 As a result, supplementation with DIM-Evail™ for 1 year showed a decrease in the average score for the amount of fibroglandular tissue. There were no significant changes in BPE. In addition, mean estradiol and testosterone levels decreased. Matched untreated women attending the clinic did not show any significant changes in FGT or BPE.

This study demonstrated that supplementation with DIM-Evail™  for 1 year in BRCA carriers was associated with a significant decrease in the amount of fibroglandular tissue on MRI and a decrease in the average BI-RADS score. Other nutrients to consider include delta and gamma tocotrienols, fish oil, curcumin, and resveratrol.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

 Source: Yerushalmi R, Bargil S, Ber Y, et al. 3,3-Diindolylmethane (DIM): a nutritional intervention and its impact on breast density in healthy BRCA carriers. A prospective clinical trial [published online ahead of print May 27, 2020]. Carcinogenesis. doi.org/10.1093/carcin/bgaa050.