Evaluation of the Benefits of Brassicaceae on Menopausal Symptoms in Patients With a History of Breast Cancer Treated With Anti-estrogens.

Breast cancer treatment in women of childbearing age may require antiestrogen therapy, which can result in iatrogenic menopause. Vasomotor symptoms, particularly hot flashes and night sweats, are among the most common symptoms of this condition and may substantially affect patients' quality of life. The sudden reduction in estrogen levels may also be associated with increased cardiovascular risk and alterations in bone formation and resorption, potentially contributing to osteopenia and osteoporosis.

Nutritional interventions are of particular interest in breast cancer survivors. Vegetables belonging to the Brassicaceae family are rich in micronutrients, vitamins, fiber, folates, glucosinolates, and other bioactive compounds. Glucosinolates are converted into isothiocyanates through the action of myrosinase or the intestinal microbiota. Isothiocyanates have been shown to release hydrogen sulfide (H2S) in the presence of organic thiols, suggesting that some of the potential beneficial effects associated with glucosinolate-rich vegetables may involve the H2S pathway.

Brassicaceae vegetables also contain compounds, including thiocyanates and goitrin, that may potentially affect thyroid function. However, available preclinical and clinical evidence indicates that the amounts generally consumed as part of the diet are not expected to reach levels associated with clinically relevant thyroid toxicity. Thyroid-related conditions are therefore considered in the eligibility criteria of the study.

The BRASSICA study is a randomized, controlled, parallel-group nutritional intervention study designed to evaluate the effect of increasing the dietary intake of Brassicaceae vegetables on menopausal symptoms in women with histologically confirmed hormone-sensitive breast cancer receiving adjuvant antiestrogen therapy. Participants are randomized in a 1:1 ratio, with stratification according to age, to either a nutritional intervention group or a control group. Randomization is performed by the oncologist.

The primary objective is to evaluate whether the inclusion of at least five servings per week of vegetables belonging to the Brassicaceae family can improve vasomotor menopausal symptoms, particularly hot flashes, compared with a control group receiving no specific dietary advice regarding Brassicaceae intake. Secondary objectives include the evaluation of other menopausal symptoms and cardiovascular and osteopenic risk factors.