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Most of the early studies published on soy and breast cancer were not designed to test the effect of soy; the assessment of soy intake was usually crude and few potential confounders were considered in the analysis. In this review, we focused on studies with relatively complete assessment of dietary soy exposure in the targeted populations and appropriate consideration for potential confounders in the statistical analysis of study data.
Meta-analysis of the 8 1 cohort, 7 case—control studies conducted in high-soy-consuming Asians show a significant trend of decreasing risk with increasing soy food intake. In contrast, soy intake was unrelated to breast cancer risk in studies conducted in the 11 low-soy-consuming Western populations whose average highest and lowest soy isoflavone intake levels were around 0.
Thus, the evidence to date, based largely on case—control studies, suggest that soy food intake in the amount consumed in Asian populations may have protective effects against breast cancer. Soybeans and its products have been a staple in the Asian diet for centuries. Soybeans are the predominant source of isoflavones, one of the three main classes of phytoestrogens or plant oestrogens.
Genistein and daidzein are the two major isoflavones; glycitein is a minor component. Given the recognised aetiologic association between oestrogen and breast cancer risk, there is biological plausibility that dietary soy intake may have anti-carcinogenic effect on the breast. A favoured mechanism by which soy isoflavones may influence breast cancer development is via their affinity and competition with endogenous oestrogens and other substrates in binding with oestrogen receptors ERs.