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Use of dong quai (Angelica sinensis) to treat peri- or postmenopausal symptoms in women with breast cancer: is it appropriate?

Lau, Clara B. S PhD; Ho, Tony C. Y PhD; Chan, Terry W. L BPharm; Kim, Stephen C. F MPhil

doi: 10.1097/01.gme.0000184419.65943.01
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Objective: Regarding the growing use of alternative therapies for peri- or postmenopausal symptoms, we evaluated the effect of a water extract of Angelica sinensis (dong quai), used for peri- or postmenopausal relief, on the proliferation of estrogen receptor-positive (MCF-7) and negative (BT-20) breast cancer cells in vitro.

Design: The present study was designed to investigate the growth-modulating effect of dong quai water extract, alone or in the presence of 17β-estradiol and 4-hydroxytamoxifen, on MCF-7 and BT-20 cell cultures using MTT proliferation assay.

Results: The water extract of dong quai dose-dependently and significantly stimulated the proliferation of MCF-7 cells with a weak estrogen-agonistic activity in the presence of 17β-estradiol, as evidenced by the significant suppression by 4-hydroxytamoxifen. Meanwhile, the extract significantly exerted a growth-stimulating effect on BT-20 in a dose-dependent manner with or without 17β-estradiol. No obvious difference was found in the growth of BT-20 cells treated with the extract in the presence of 17β-estradiol or 4-hydroxytamoxifen.

Conclusions: The water extract of dong quai stimulated the growth of MCF-7 cells, possibly dependent of weak estrogen-agonistic activity, and augmented the BT-20 cell proliferation independent of estrogen receptor-mediated pathway. The present study provides data regarding the estrogen-like activity of dong quai, which might assist in decision making on herbal therapy use by women at risk for both estrogen-sensitive and insensitive breast cancer. Because of the lack of clinical data demonstrating the potential side effects of dong quai, its use in herbal preparations for the treatment of peri- or postmenopausal symptoms, especially in women with breast cancer, warrants caution pending further study.

This study showed that the water extract of dong quai stimulated growth of two breast cancer cells, and hence provides data regarding the estrogen-like activity of dong quai. Because of the lack of clinical data demonstrating the potential side effects of dong quai, its use in herbal preparations for the treatment of menopausal symptoms, especially in women with breast cancer, warrants caution pending further study.

From the School of Pharmacy, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.

Received February 1, 2005, revised and accepted April 13, 2005.

Address correspondence to: Professor Clara B. S. Lau, School of Pharmacy, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong. E-mail: claralau@cuhk.edu.hk.

©2005The North American Menopause Society