Up to 25% of breast cancers overexpress the HER2/neu gene, which has a role in signaling pathways leading to cell growth and differentiation, accounting for its relative aggressiveness. However, there are some foods and spices that have been shown to inhibit HER2 positive (HER2+ or ERBB2) breast cancer cell growth and proliferation.
Some other foods have been found to amplify the effects of Herceptin, which is used to treat HER2+ breast cancer.
Apigenin, a flavone found in foods such as parsley, celery, guava berries, bell peppers and Chinese cabbage, has been found to increase HER2+ cell death, as well as enhancing the effectiveness of Taxol and 5-FU, which are sometimes used to treat HER2+ breast cancer. Certain anthocyanins such as cyanidin-3-glucoside have also been shown to reduce HER2+ cell proliferation, as well as potentiating the treatment effects of Herceptin.
Melatonin, which is found in almonds, cherries, tomatoes, walnuts and oats, has been shown to induce apoptosis (programmed cell death) and reduce proliferation of HER2+ breast cancer cells. Note that red meat consumption has been shown to reduce circulating melatonin.
A relatively high omega-3 to omega-6 polyunsaturated fatty acid ratio in the diet is associated with reduced risk of HER2+ breast cancer. The combination of docosahexaenoic acid (DHA, found in fatty fish) and curcumin (the main active ingredient of turmeric), has been shown to be more effective in increasing programmed cell death of HER2+ breast cancer cells than either compound used separately.
Women with HER2+ breast cancer should also review the appropriate webpage concerning their individual hormone receptor subtype (ER+/PR+, ER+/PR-, ER-/PR+, or ER-/PR-).
Foods that inhibit HER2+ breast cancer growth and proliferation
The following foods and spices or their components have been found specifically to inhibit the growth or proliferation of HER2/neu overexpressing breast cancer cells and have also been found to reduce breast cancer risk in general:
- Apples
- Arctic char
- Artichokes
- Arugula
- Basil
- Bell peppers
- Black pepper
- Black cumin
- Blackberries
- Blueberries & bilberries
- Bok choy
- Boysenberries
- Broccoli & broccoli sprouts
- Brussels sprouts
- Cabbage, white or red
- Carrots, orange or purple
- Cauliflower
- Celery & celery hearts
- Cherries, sweet or sour
- Collard greens
- Cranberries & ligonberries
- Cucumbers
- Currants, black
- Flaxseed & flaxseed oil
- Ginger
- Grapes, red
- Green tea
- Herring
- Honey, minimally processed
- Horseradish & wasabi
- Hot peppers
- Kale
- Kefir
- Lake trout
- Lettuce, especially romaine
- Mackerel
- Mustard greens
- Olive oil, extra-virgin & olives
- Onions, red
- Parsley & cilantro
- Pomegranates & pomegranate juice
- Pumpkins
- Raspberries, black or red
- Rice, brown, black or purple
- Saffron
- Salmon, wild
- Sardines
- Scallions or green onions
- Strawberries
- Sweet potatoes, purple
- Thyme
- Tomatoes
- Turmeric
- Turnips & turnip greens
- Walnuts & walnut oil
- Watercress & garden cress
- Zucchini
Foods that promote HER2+ breast cancer growth
The following foods have been shown to promote HER2+ breast cancer growth or increase HER2+ expression:
- Alcohol
- Beef
- Foods with high cadmium content (e.g., some dried apricots, most flaxseed, Indian mustard, some rice, most shellfish, sunflower seeds)
- Foods with high copper content (e.g., most nuts, liver, shellfish)
- Partially hydrogenated soybean oil
- Sugar
Estrogen positive HER2+ patients (ER+/PR+/HER2+ or ER+/PR-/HER2+) should also avoid foods and supplements listed in the Limit or avoid sections of the ER+/PR+ food page. There is some evidence that diets high in saturated fat also increase risk of HER2+ breast cancer. Although alcohol is to be avoided by all breast cancer patients and survivors, evidence to date suggests that it is particularly harmful for those with HER2+ breast cancer.
There have been reports that copper could promote HER2+ angiogenesis and metastasis. While copper is a vital nutrient, women with breast cancer should not exceed the RDA (recommended dietary allowance) of approximately 0.9 mg. High copper foods such as calf's liver and beef liver should be avoided. Foods with moderate copper content, such as shellfish, textured soy protein, chocolate, peanuts, most tree nuts, and sunflower seeds should also be limited or avoided. Walnuts should be consumed in moderation since they contain some copper (approximately 0.45 mg per ounce). Refined walnut oil has negligible levels of copper. Multivitamins and copper jewelry (including red, rose or pink gold) are other potential sources of copper exposure.
Supplements for HER2+ patients and survivors
There is no supplement or combination of supplements that has been proven to reliably reduce the risk of HER2+ breast cancer recurrence in women. Attempting to increase the treatment effects of micronutrients and other dietary components by using supplements carries the risk of adverse and paradoxical effects, including promoting breast cancer growth and metastasis.
What is known is that when a beneficial micronutrient is administered at low doses by consuming food, it is likely to have subtle chemopreventive effects, whereas when the same micronutrient is administered at high doses, it is more likely to have pharmacological effects, with mostly unknown results. It is best to obtain beneficial compounds by consuming food, if possible. Supplements make sense if medically necessary or to make up for deficiencies that are difficult to correct through diet.
The following supplements generally have been found to be safe and beneficial for HER2+ patients and survivors:
Please consult your oncology team for advice concerning your situation and dosages. It might make sense to be tested for deficiency in vitamin D and plan for follow up to determine if your reading has reached a desirable level.
Supplements that promote HER2+ breast cancer growth
The supplements below have been reported to promote HER2+ breast cancer growth or increase HER2+ expression. That is not to say that most other supplements are safe to take; there are no relevant scientific studies concerning the interactions between most supplements and HER2+ breast cancer. The supplements followed by (ER+/PR+/HER2+) have estrogenic properties that can promote the growth and proliferation of ER+ breast cancer. The remaining compounds apply to all combinations of HER2+ and hormone receptors.
- Apigenin supplements (ER+/PR+/HER2+)
- Astragalus or huang qi supplements (ER+/PR+/HER2+)
- CLA supplements
- Copper supplements & multivitamins containing copper
- Folic acid supplements
- Genistein, daidzein or equol supplements (ER+/PR+/HER2+)
- HRT, combined (estrogen plus progestin), including bioidentical hormones (ER+/PR+/HER2+)
- Licorice root supplements (ER+/PR+/HER2+)
- Ligusticum chuanxiong supplements
- Milk thistle supplements (ER+/PR+/HER2+)
- Propolis or royal jelly supplements (ER+/PR+/HER2+)
- Quercetin supplements (ER+/PR+/HER2+)
- Resveratrol supplements
- Sage supplements & sage essential oil
- Si-Wu-Tang supplements
- Suan-Tsao-Ren-Tang supplements
Other exposures that promote HER2+ breast cancer growth
Women with HER2+/ER+/PR+ disease should make a point of avoiding personal care and other products containing parabens. Exposure to bisphenol A (BPA) has also been shown to increase proliferation of HER2+ breast cancer cells. In addition, cigarette smoking is associated with significantly poorer outcomes for HER2+ patients.
Sources of information provided in this webpage
The food lists above, which are updated continually as new research becomes available, have been developed based solely on the results of academic studies. Clicking on any of the foods will take you to its webpage, which contains specific information concerning that food's relationship to breast cancer (including its overall ranking), as well as links to supporting studies.
Additional comments
It makes sense for HER2+ breast cancer patients and survivors to eat a wide variety of the foods on our recommended food list and limit or avoid those on our avoid list in addition to emphasizing the foods and spices on the lists above. Please see our article on how to optimize your breast cancer diet for information on what to eat during all stages of treatment and recovery.
Below are links to 20 recent studies concerning this topic. For a more complete list of studies, please click on HER2+.