乳腺癌患者食用大豆的安全性目前仍然存在争议,一方面认为大豆异黄酮可刺激活性氧类的产生,并对乳腺癌的 启动和癌细胞的增殖起到一定作用;另一方面认为摄取含大豆等食物后,血清中的异黄酮浓度增加较明显,乳腺组织中的异 黄酮浓度变化不大,对乳腺组织中的增殖活性分子标志物 Ki-67 水平无影响,也不会改变乳腺 X 线照片密度。 异黄酮摄入并 未增加绝经前后女性乳腺癌发病率,而是具有预防乳腺癌的作用,对乳腺组织中的增殖也没有影响。 对于乳腺癌治疗后的幸 存者,摄入大豆和异黄酮对预后亦没有明显的不良影响,甚至对绝经后乳腺癌患者具有保护作用。 根据目前所得到的流行病 学及临床研究证据,并结合中国居民膳食指南 2016 版建议:建议每人每天摄入 10 ~ 25 g 大豆或相当量的豆制品,可建议诊断 为乳腺癌的女性适当食用大豆。 本文拟从大豆异黄酮在预防乳腺癌方面的作用,是否对增殖产生影响,是否会对乳腺癌患者 发病率和预后影响及其机制等方面进行综述。

The safety of soybean consumption in patients with breast cancer is still controversial. On the one hand it is believed that soybean isoflavones may stimulate the generation of reactive oxygen species and play a certain role in the initiation of breast cancer and the proliferation of cancer cells. On the other hand other studies have shown that after ingesting foods containing soybeans the isoflavone concentration in the serum increased significantly but the isoflavone concentration in the breast tissue changes little. At the same time consumption of isoflavone had no effect on Ki-67 a molecular marker of proliferative activity in breast tissue and the density of mammograms. Isoflavone intake has no adverse effect on the incidence of breast cancer in premenopausal and postmenopausal women but has the effect of preventing breast cancer. At the same time the intake of isoflavones had no effect on the proliferation of breast tissue. For breast cancer survivors after treatment intake of soybean and isoflavones had no significant adverse effects on prognosis and even had a protective effect on postmenopausal breast cancer patients. Therefore according to the epidemiological and clinical evidence obtained at present combined with the 2016 edition of Chinese Dietary Guidelines it is suggested that 10~ 25 g of soybeans or a considerable amount of soybean products should be taken per person per day and women diagnosed with breast cancer should eat soybeans appropriately. This article reviews the role of soybean isoflavones in the prevention of breast cancer whether it has an impact on proliferation whether it will affect breast cancer patients and the mechanism of soybean isoflavones on the pathogenesis and prognosis of breast cancer