Cohort study of use of complementary and alternative medicine in the management of breast cancer

Despite advancements in traditional therapies (surgery, chemotherapy, radiation, endocrine therapy, and immunotherapy), a subset of breast cancer patients continues to choose complementary and alternative medicine (CAM). A cohort study using the National Cancer Database (2011 through 2021) evaluated the association of CAM use with survival in female patients with breast cancer. The study included 2,157,219 patients (median age 62 years, IQR 52-71): 2,106,665 (97.6%) received traditional therapies, 273 (< 0.1%) received CAM alone, 561 (< 0.1%) received a combination of CAM and traditional therapies, and 49,713 (2.3%) received no treatment. The unadjusted survival plot of these groups shows that, compared with patients receiving traditional therapies, those receiving CAM alone and no treatment had highest risks of mortality, whereas receiving a combination of traditional therapies and CAM was associated with higher mortality compared to receiving traditional therapies exclusively. In adjusted analyses, the aHRs for these groups were 3.67 (95% CI 3.03-4.44), 3.53 (3.48-3.58), and 1.45 (1.22-1.72) compared to traditional therapies alone. The authors conclude that in this cohort study, the use of CAM instead of traditional therapies was uncommon but was associated with a reduction in survival time.