A team of American researchers found that patients who received a combination of traditional therapies and complementary and alternative medicine were less likely to receive endocrine therapy and radiation versus patients treated exclusively with traditional therapies, reports Clinical Adviser.
While uncommon, use of complementary and alternative medicine (CAM) instead of traditional therapies is associated with lower survival time in females with breast cancer, suggested the research published online in JAMA Network Open.
Oluwaseun Ayoade, MD, from Yale University in New Haven, Connecticut, and colleagues examined the association of CAM with survival in females with breast cancer. Analysis included ~2.16m female patients with breast cancer identified from the National Cancer Database (2011 to 2021).
The researchers found that most patients (97.6%) received traditional therapy, <0.1% received CAM alone, <0.1% received a combination of CAM and traditional therapies, and 2.3% received no treatment.
Patients treated with CAM alone (adjusted hazard ratio [aHR], 3.67) or no treatment (aHR, 3.53) had the highest risks for five-year mortality, compared with patients treated with traditional therapies.
Additionally, patients who received a combination of traditional therapies and CAM were less likely to receive endocrine therapy (40.7 versus 65.2% in stage II) and radiation (59.5 versus 36.6% in stage II) versus patients treated exclusively with traditional therapies.
The combination of traditional therapies and CAM also was associated with a higher mortality compared with being treated exclusively with traditional therapy (aHR, 1.45).
“Inviting patients to share their interest in CAM may present an opportunity to enhance shared decision-making, particularly as patients may be planning to forego traditional treatments,” the authors write.
Study details
Use of complementary and alternative medicine in the management of breast cancer
Oluwaseun Ayoade, Giorgio Caturegli, Maureen Canavan et al.
Key Points
Question
What is the association of complementary and alternative medicine (CAM) with survival in female patients with breast cancer?
Findings
In this cohort study involving 2 157 219 women with breast cancer, those who combined traditional therapies, such as surgery, chemotherapy, radiation, endocrine therapy, and immunotherapy, with CAM therapies were less likely to receive endocrine therapy and radiation compared with patients treated exclusively with traditional therapies. Combination of CAM and traditional therapies was associated with higher mortality compared with being treated exclusively with traditional therapy.
Meaning
Findings of this study suggest that the use of CAM instead of traditional therapies could be associated with a reduction in survival in breast cancer, and further study is warranted.
Abstract
Importance
Innovations in both the surgical and medical management of breast cancer over the past few decades have led to reductions in treatment-related morbidity and increases in overall survival. Despite these advancements in traditional therapies, including surgery, chemotherapy, radiation, endocrine therapy, and immunotherapy, a subset of patients continues to choose complementary and alternative medicine (CAM).
Objective
To describe the association of CAM with survival in patients with breast cancer.
Design, Setting, and Participants
This cohort study analysed data from the National Cancer Database on female patients diagnosed with breast cancer from 2011 through 2021. Survival time was compared among patients who received traditional treatment, traditional treatment and CAM, and no treatment. Data were analysed from May 2025 to December 2025.
Exposure
Complementary or alternative treatment, defined in the NCDB as treatment administered by nonmedical personnel.
Main Outcomes and Measures
The primary outcome was 5-year survival. Unadjusted 5-year survival was assessed by Kaplan-Meier analysis, and adjusted survival was assessed with a Cox proportional hazards model controlled for age, race and ethnicity, Charlson Comorbidity index, insurance type, facility type, region, year of diagnosis, cancer stage, and income.
Results
Of 2 169 202 female patients with breast cancer identified, 2 157 219 (median [IQR] age, 62 [52-71] years) were included in the sample. A total of 2 106 665 patients (97.6%) received traditional therapy, 273 (<0.1%) received CAM alone, 568 (<0.1%) received a combination of CAM and traditional therapies, and 49 713 (2.3%) received no treatment. Compared with patients treated with traditional therapies, those treated with CAM alone (adjusted hazard ratio [AHR], 3.67; 95% CI, 3.03-4.44; P < .001) or no treatment (AHR, 3.53; 95% CI, 3.48-3.58; P < .001) had the highest risks for mortality. Patients who received a combination of traditional therapies and CAM were less likely to receive endocrine therapy (eg, 40.7% vs 65.2% in stage II; P < .001) and radiation (59.5% vs 36.6% in stage II; P < .001) compared with patients treated exclusively with traditional therapies. Receipt of a combination of traditional therapies and CAM was associated with a higher mortality compared with being treated exclusively with traditional therapy (AHR, 1.45; 95% CI, 1.22-1.72; P < .001).
Conclusions and Relevance
In this cohort study of data from female patients with breast cancer included in the NCDB, the use of CAM instead of traditional therapies was uncommon but was associated with a reduction in survival time. Further study is warranted.
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Dangers of alternative medicine in advanced breast cancer
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