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Multivitamin supplementation similarly showed no improvement in radiation-related fatigue (351), while observational data from chemotherapy cohorts (e.g., SWOG S0221) raised concerns that concurrent antioxidant use during treatment may negatively influence survival, potentially by attenuating ROS-mediated cytotoxicity of chemotherapy (348) Coenzyme Q10, despite increasing plasma antioxidant levels, did not improve fatigue or quality of life outcomes, further highlighting the disconnect between biochemical antioxidant enhancement and clinical benefit (352) Although antioxidants exhibit important biological activity, supplementation has not consistently demonstrated significant benefits in breast cancer prevention or treatment, with outcomes varying according to clinical context, timing of use, and patient subgroup