The Role of Biomarkers of Oxidative Stress in Breast Cancer Risk and Prognosis: A Systematic Review of the Epidemiologic Literature

J Womens Health (Larchmt). 2017 May;26(5):467-482. doi: 10.1089/jwh.2016.5973. Epub 2017 Feb 2.


Background: Oxidative stress may play an important role in both initiation and progression of breast cancer. We conducted the first systematic epidemiologic review to summarize the published literature on oxidative stress biomarkers and breast cancer.

Materials and methods: We implemented systematic search strategies to identify published studies of oxidative stress biomarkers and (1) risk of developing breast cancer and (2) breast cancer prognosis using the PRISMA statement guidelines.

Results: We identified eleven case-control studies of oxidative stress biomarkers and breast cancer. Biomarkers utilized varied and menopausal status was a key modifying factor. Across three nested case-control studies with biomarkers measured before diagnosis, one reported increased risk of postmenopausal breast cancer in association with 8-oxodG (DNA damage biomarker), while two (one of F2-isoprostanes and one of fluorescent oxidation products) reported inverse associations for premenopausal breast cancer only. We identified eight prognostic studies. Two reported associations for lipid peroxidation and breast cancer prognosis; results for other studies were null.

Conclusions: DNA damage may increase risk of breast cancer among postmenopausal women, while lipid peroxidation may be inversely associated with premenopausal breast cancer. Lipid peroxidation may be associated with survival after breast cancer diagnosis; however, results require evaluation in large, prospective cohort studies.

Keywords: breast cancer; case–control studies; cohort studies; epidemiology; oxidative stress biomarkers; systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • 8-Hydroxy-2'-Deoxyguanosine
  • Adult
  • Biomarkers, Tumor / analysis*
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / metabolism*
  • Breast Neoplasms / mortality
  • Deoxyguanosine / analogs & derivatives
  • Female
  • Humans
  • Middle Aged
  • Oxidative Stress / physiology*
  • Prognosis
  • Risk Factors
  • Survival Analysis


  • Biomarkers, Tumor
  • 8-Hydroxy-2'-Deoxyguanosine
  • Deoxyguanosine