Description
Background   There are conflicting reports on the impact of soy on breast carcinogenesis. This study examines the effects of soy supplementation on breast cancer-related genes and pathways.  Methods   Women (n = 140) with early-stage breast cancer were randomized to soy protein supplementation (n = 70) or  placebo (n = 70) for 7 to 30 days, from diagnosis until surgery. Adherence was determined by plasma isoflavones:  genistein and daidzein. Gene expression changes were evaluated by NanoString inin pre- and post-treatment  tumor tissue. Genome-wide expression analysis was performed on post-treatment tissue. Proliferation (Ki67) and  apoptosis (Cas3) were assessed by immunohistochemistry.  Results   Plasma isoflavones rose in the soy group (two-sided Wilcoxon rank-sum test, P < .001) and did not change in  the placebo group. In paired analysis of pre- and post-treatment samples, 21 genes (out of 202) showed altered  expression (two-sided Students t-test, P < .05). Several genes including FANCC and UGT2A1 revealed different  magnitude and direction of expression changes between the two groups (two-sided Students t-test, P < .05).  A high-genistein signature consisting of 126 differentially expressed genes was identified from microarray analysis  of tumors. This signature was characterized by overexpression (>2 fold) of cell cycle transcripts, including  those which promote cell proliferation, such as FGFR2, E2F5, BUB1, CCNB2, MYBL2, CDK1, and CDC20 (P < .01).  Soy intake did not result in statistically significant changes in Ki67 or Cas3.  Conclusions   Gene expression associated with soy intake and high plasma genistein define a signature characterized by overexpression  of FGFR2 and genes that drive cell cycle and proliferation pathways. These findings raise the concerns  that in a subset of women soy could adversely affect gene expression in breast cancer.