Breast cancer in folate's Point of view

 By Kyle J. Norton(Draft article)

Folate, also known as folic acid, vitamin B9, is a water soluble vitamin, found abundantly in leafy vegetables, citrus fruits, beans, whole grain, etc. The vitamin plays an important role in synthesize DNA, repair DNA, and methylate DNA as well as to act as a cofactor in certain biological reactions, production of red blood cells for anemia prevention.
Scientific studies, linking folate in reduced risk of breast cancer have produced inconsistent results. It may be due to associated vary by race, menopausal status or ER status(1). In comparison of the dietary intakes of folate, B-vitamins (B2, B6, B12) and methionine, showed that high intake of folate is marginally associated with a reduced lower risk for ER- breast cancer(1a), among Hispanic and non-Hispanic white women(2), but  among Brazilian women, dietary intake of folate,  had no overall association with breast cancer risk and high folate intake increased risk of breast cancer in premenopausal women with the MTR 2756GG genotype(women carry this gene have a subtly reduced risk of breast cancer(3))(4). In breast cancer risk defined by oestrogen receptor (ER) and progesterone receptor (PR) status, dietary folate intake showed an significant inverse association of breast cancer risk  in all subtypes of ER and PR status(5).
In Japanese women with genotypes of MTHFR or MTR, dietary intake of folate and related B vitamins have no overall association with breast cancer risk in Japanese women(6).
Unfortunately. in rat model study, folate supplementation was found to be associated with significantly higher weight and volume of all mammary tumors and might enhance the progression of established mammary tumors(7). Also in the study of at weaning, female pups, maternal folic acid supplementation also significantly accelerated the rate of mammary adenocarcinoma appearance and significantly decreased DNA methyltransferase (protect host DNA against degradation by restriction enzymes) activity in nonneoplastic(not tumors) mammary glands of the offspring(8). In the finding an anti breast caner conjugat used conjuction with Doxorubicin (Dox) which used for breast cancer treatment but causes serious side effects including cardiotoxicity, conjugation of  Dox-conjugated hairpin (DCH) with folic acid (FA) is found to be effective in increased internalization into breast cancer cells for safer and more effective chemotherapy with Dox(9). In MCF-7 and MDA-MB-231 breast cancer cells, hydrogel, based on ellagic acid and glycine containing folate acid significantly inhibit cell viability(10). In nude mice carrying xenograft MCF-7 tumours,  folate inTMX(Tamoxifen)-loaded folate-targeted systems anticancer action of TMX(11). Lipotropes are methyl group-containing essential nutrients (methionine, choline, folate and vitamin B12) in the experiment in MCF-7 cells, showed to significantly reduced cell growth and increased apoptosis, through upregulation of caspase-3(mechanisms of apoptosis) and P53(tumor antigen) enzyme activities(12). Also in the evaluation of MTHFR C677T-A1298C polymorphisms in patients with breast cancer, showed that at dose of 120 nmol/L FA could enhance apoptosis in cases with women who carry MTHFR C677T-A1298C genotype(13).

Taking together, folate used conjunction with other chem-drugs have shown effectively in enhancing the function the medicine in prevention and treatment of breast cancer cell lines with reduced side effects. Overdoses of folate may cause stomach problems, sleep problems, skin reactions, seizures, etc., please
 make sure you follow the guideline of the Institute of Medicine of the National Academies.
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References
(1) Associations of dietary folate, Vitamins B6 and B12 and methionine intake with risk of breast cancer among African American and European American women by Gong Z, Ambrosone CB, McCann SE, Zirpoli G, Chandran U, Hong CC, Bovbjerg DH, Jandorf L, Ciupak G, Pawlish K, Lu Q, Hwang H, Khoury T, Wiam B, Bandera EV.(PubMed)

(1a) Dietary intake of folate, B-vitamins and methionine and breast cancer risk among Hispanic and non-Hispanic white women by Yang D, Baumgartner RN, Slattery ML, Wang C, Giuliano AR, Murtaugh MA, Risendal BC, Byers T, Baumgartner KB.(PubMed)
(2) Dietary folate, vitamin B6, vitamin B12 and methionine intake and the risk of breast cancer by oestrogen and progesterone receptor status by Zhang CX, Ho SC, Chen YM, Lin FY, Fu JH, Cheng SZ.(PubMed)
(3) Cancer: New Insights for the Healthcare Professional: 2012 Edition
(4) Dietary intake of folate, vitamin B6, and vitamin B12, genetic polymorphism of related enzymes, and risk of breast cancer: a case-control study in Brazilian women by Ma E, Iwasaki M, Junko I, Hamada GS, Nishimoto IN, Carvalho SM, Motola J Jr, Laginha FM, Tsugane S.(PubMed)
(5) Dietary folate, vitamin B6, vitamin B12 and methionine intake and the risk of breast cancer by oestrogen and progesterone receptor status by Zhang CX, Ho SC, Chen YM, Lin FY, Fu JH, Cheng SZ.(PubMed)
(6) Dietary intake of folate, vitamin B2, vitamin B6, vitamin B12, genetic polymorphism of related enzymes, and risk of breast cancer: a case-control study in Japan by Ma E, Iwasaki M, Kobayashi M, Kasuga Y, Yokoyama S, Onuma H, Nishimura H, Kusama R, Tsugane S.(PubMed)
(7) Folic Acid supplementation promotes mammary tumor progression in a rat model. by Deghan Manshadi S¹, Ishiguro L¹, Sohn KJ², Medline A³, Renlund R⁴, Croxford R⁵, Kim Y1(PubMed)
(8) Effect of maternal and postweaning folic acid supplementation on mammary tumor risk in the offspring by Ly A, Lee H, Chen J, Sie KK, Renlund R, Medline A, Sohn KJ, Croxford R, Thompson LU, Kim YI.(PubMed)
(9)Site-Specific DNA-Doxorubicin Conjugates Display Enhanced Cytotoxicity to Breast Cancer Cells by Stuart CH, Horita DA, Thomas MJ, Salsbury FR Jr, Lively MO, Gmeiner WH.(PubMed)
(10) Anticancer activity of a hydrogel containing folic acid towards MCF-7 and MDA-MB-231 cells by Trombino S, Ferrarelli T, Pellegrino M, Ricchio E, Mauro L, Andò S, Picci N, Cassano R.(PubMed)
(11) Targeting Tamoxifen to Breast Cancer Xenograft Tumours: Preclinical Efficacy of Folate-Attached Nanoparticles Based on Alginate-Cysteine/Disulphide-Bond-Reduced Albumin by Martínez A, Muñiz E, Teijón C, Iglesias I, Teijón JM, Blanco MD.(PubMed)
(12) Lipotropes enhance the anti-proliferative effect of chemotherapeutic drugs in MCF-7 human breast cancer cells by Cho K, Mabasa L, Walters MW, Park CS.(PubMed)
(13) Interactions between MTHFR C677T-A1298C variants and folic acid deficiency affect breast cancer risk in a Chinese population by Wu XY, Ni J, Xu WJ, Zhou T, Wang X.(PubMed)