The Association Between Breast Cancer Prognostic Indicators and Serum 25-OH Vitamin D Levels

Abstract

Purpose Vitamin D deficiency in patients treated for breast cancer is associated with numerous adverse effects (bone loss, arthralgia, and falls). The first aim of this study was to assess vitamin D status, determined by 25-OH vitamin D levels, among women diagnosed with breast cancer according to demographic/clinical variables and bone mineral density (BMD). The second aim of this study was to evaluate the effect of daily low-dose and weekly high-dose vitamin D supplementation on 25-OH vitamin D levels. Methods This retrospective study included 224 women diagnosed with Stage 0-III breast cancer who received treatment at the James P. Wilmot Cancer Center at the University of Rochester Medical Center. Total 25-OH vitamin D levels (D2 + D3) were determined at baseline for all participants. Vitamin D deficiency was defined as a 25-OH vitamin D level < 20 ng/mL, insufficiency as 20-31 ng/mL, and sufficiency as ≥ 32 ng/mL. BMD was assessed during the period between 3 months prior to and 6 months following the baseline vitamin D assessment. Based on the participants’ baseline levels, they received either no supplementation, low-dose supplementation (1,000 IU/day), or high-dose supplementation (≥ 50,000 IU/week), and 25-OH vitamin D was reassessed in the following 8-16 weeks. Results Approx 66.5% had deficient/insufficient vitamin D levels at baseline. Deficiency/insufficiency was more common among non-Caucasians, women with later-stage disease, and those who had previously received radiation therapy (p<0.05). Breast cancer patients with deficient/insufficient 25-OH vitamin D levels had significantly lower lumbar BMD (p=0.03). Compared to the no supplementation group, weekly high-dose supplementation significantly increased 25-OH vitamin D levels, while daily low-dose supplementation did not significantly increase levels. Conclusions Vitamin D deficiency and insufficiency were common among women with breast cancer and associated with reduced BMD in the spine. Clinicians should carefully consider vitamin D supplementation regimens when treating vitamin D deficiency/insufficiency in breast cancer patients.

Prognostic evaluation of vitamin D deficiency in breast cancer patients: a pilot study in India

“…[2,3,4] The present study also shows that levels of vitamin D in triple negative breast cancer with mean of 13.3ng/mL is lowest among all the subtypes. This finding conforms to the earlier studies where vitamin D levels in TNBC have been found to be lowest.…”

“…It is believed to retard tumor cell growth and proliferation, promote apoptosis, prevent tumor cell stimulation by growth factors and regulate inflammation, thus affecting tumor microenvironment [1] .Low levels of vitamin D have been shown to be associated with increased mortality and poor prognosis in breast cancer in various studies in different parts of the world. [2,3,4] Breast cancer is the most common cancer among Indian urban females. [5] It has classically been classified based on morphologyor histological grade into various types taking into account tumor cell's mitotic index, degree of differentiation and nuclear pleomorphism.…”

Circulating 25-hydroxyvitamin D Levels and Prognosis among Cancer Patients: A Systematic Review

“…For instance, non-Caucasian patients with breast cancer have a 2-fold increased risk of vitamin D deficiency compared with Caucasian patients with breast cancer, and obese patients with breast cancer have a 3-fold increased risk of vitamin D deficiency compared with normal-weight patients with breast cancer (42). Circulating 25-OHD levels are lower in patients with localized or regional disease than women with in situ disease (43) and in women with triple-negative breast cancer than women with other breast cancer subtypes (44). The EPIC study demonstrated survival advantage among patients with rectal cancer with elevated 25-OHD levels, but not among patients with colon cancer, which is in line with the null effect reported in a study limited to patients with colon cancer (15).…”

Levels of Serum 25-Hydroxy-Vitamin D in Benign and Malignant Breast Masses

“…They showed an inverse relationship for breast cancer risk in regard to vitamin D levels (Yao et al, 2011). Peppone et al (2012) measured serum vitamin D levels in 194 cases and the same number of controls, regarding their phenotypes and prognostic features. They demonstrated lower levels of the vitamin in more aggressive, less favorable tumors (Peppone et al, 2012).…”

“…Peppone et al (2012) measured serum vitamin D levels in 194 cases and the same number of controls, regarding their phenotypes and prognostic features. They demonstrated lower levels of the vitamin in more aggressive, less favorable tumors (Peppone et al, 2012). Shao et al (2012) reviewed the literature for in vitro or animal studies upon the relation of breast cancer and vitamin D up to February 2011.…”