Negative Impact of 25-hydroxyvitamin D Deficiency on Breast Cancer Survival (original) (raw)
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Cancer Causes & Control, 2013
Purpose Despite limited evidence on the association of vitamin D with outcomes in breast cancer survivors, some clinicians advise breast cancer patients to use vitamin D supplements. More evidence is needed to inform these recommendations. Methods In the Health, Eating, Activity, and Lifestyle study, we examined associations of post-treatment serum concentrations of 25-hydroxyvitamin D (25(OH)D) on overall and breast cancer-specific mortality in 585 breast cancer survivors from western Washington State, New Mexico, and Los Angeles County. 25(OH)D was measured in stored blood collected 2 years post-enrollment. Outcomes were ascertained from the Surveillance, Epidemiology, and End Results registries and medical records. Cox proportional hazards models were fit to assess associations of serum 25(OH)D with overall and breast cancer-specific mortality. Results After a median follow-up of 9.2 years; 110 women died, including 48 from breast cancer. Standard cut points classified 211 (31.6 %) women as serum 25(OH)D deficient (\20 ng/mL), 189 (32.2 %) as insufficient (20-30 ng/mL), and 185 (36.2 %) as sufficient ([30 ng/mL). Compared to women with deficient 25(OH)D, those in the sufficient ranges had a decreased risk of overall mortality (age-adjusted HR = 0.58; 95 % CI 0.36-0.96); however, multivariate adjustments attenuated the association (HR = 0.90; 95 % CI 0.50-1.61). No association was found between serum 25(OH)D and breast cancer-specific mortality (sufficient: HR = 1.21; 95 % CI 0.52-2.80) in multivariate models. Conclusion In this breast cancer cohort, higher serum 25(OH)D may be associated with improved survival, but results were not statistically significant and must be interpreted with caution. The potential prognostic effect of vitamin D from diet, supplements, or both should be evaluated in future larger studies with additional endpoints from breast cancer patients.
Effect of Selected Factors on the Serum 25(OH)D Concentration in Women Treated for Breast Cancer
Nutrients, 2021
Maintaining an optimal vitamin D concentration reduces the risk of recurrence and extends survival time in patients after breast cancer treatment. Data on vitamin D deficiency among Polish women after breast cancer therapy are limited. Thus, the aim of the study was the analysis of vitamin D status in post-mastectomy patients, considering such factors as seasons, social habits, vitamin D supplementation and its measurements. The study involved 94 women after breast cancer treatment. Serum vitamin D concentration was measured, and a questionnaire, gathering demographic and clinical data regarding cancer, diet, exposure to sun radiation, and knowledge of recommendations on vitamin D supplementation, was delivered twice, in both winter and in summer. The control group consisted of 94 age-matched women with no oncological history. In women after breast cancer treatment, 25-hydroxyvitamin D (25(OH)D) deficiency was much more frequent than in the general population. Only about half of the...
Cancer Causes & Control, 2012
Purpose We investigated the association between serum levels of 25-hydroxyvitamin D (25-OHD) and risk of death in Norwegian cancer patients. Methods The study population was 658 patients with cancers of the breast (n = 251), colon (n = 52), lung (n = 210), and lymphoma (n = 145), obtained from JANUS, a population-based serum bank in Norway. Serum samples were collected within 90 days of cancer diagnosis and were analyzed for 25-OHD. Patients were diagnosed during 1984-2004 and were followed for death throughout 2008. We used Cox regression models to assess the relationship between serum 25-OHD and risk of death. Results Three hundred and ninety-nine patients died during follow-up, of whom 343 (86%) died from cancer. Adjusted for sex, age at diagnosis, and season of blood sampling, patients with 25-OHD levels below 46 nmol/L at diagnosis experienced shorter survival. Compared to patients in the lowest quartile of serum 25-OHD, the risk of cancer death among patients in the highest quartile was significantly reduced (HR 0.36 95% CI 0.27, 0.51). The estimated change in risk of cancer death was most pronounced between the first and the second quartile. The associations between 25-OHD levels and survival were observed for all four cancers. Conclusions Higher circulating serum levels of 25-OHD were positively associated with the survival for cancers of the breast, colon, lung, and lymphoma.
PloS one, 2018
While numerous epidemiologic studies have found an association between higher serum 25-hydroxyvitamin D [25(OH)D] concentrations and lower breast cancer risk, few have assessed this association for concentrations >40 ng/ml. To investigate the relationship between 25(OH)D concentration and breast cancer risk across a broad range of 25(OH)D concentrations among women aged 55 years and older. Analyses used pooled data from two randomized clinical trials (N = 1129, N = 2196) and a prospective cohort (N = 1713) to examine a broad range of 25(OH)D concentrations. The outcome was diagnosis of breast cancer during the observation periods (median: 4.0 years). Three analyses were conducted: 1) Incidence rates were compared according to 25(OH)D concentration from <20 to ≥60 ng/ml (<50 to ≥150 nmol/L), 2) Kaplan-Meier plots were developed and 3) multivariate Cox regression was used to examine the association between 25(OH)D and breast cancer risk using multiple 25(OH)D measurements. Wi...
Meta-analysis of vitamin D sufficiency for improving survival of patients with breast cancer
Anticancer Research, 2014
Background/Aim: To determine whether higher serum 25-hydroxyvitamin D [25(OH)D] at diagnosis is associated with longer survival of patients with breast cancer. Materials and Methods: A meta-analysis was performed of five studies of the relationship between 25(OH)D and mortality from breast cancer. A pooled hazard ratio was calculated using a random-effects model. The Der Simonian-Laird test was used to assess homogeneity. Results: Higher serum concentrations of 25(OH)D were associated with lower casefatality rates after diagnosis of breast cancer. Specifically, patients in the highest quintile of 25(OH)D had approximately half the death rate from breast cancer as those in the lowest. Conclusion: High serum 25(OH)D was associated with lower mortality from breast cancer. Serum 25(OH)D in all patients with breast cancer should be restored to the normal range (30-80 ng/ml), with appropriate monitoring. Clinical or field studies should be initiated to confirm that this association was not due to reverse causation. There were approximately 234,580 new cases and 40,030 deaths from breast cancer in the United States in 2013 (1). Breast cancer is the most common cancer in women worldwide, with 1.7 million new cases and approximately onehalf million deaths in 2012 (2). While most studies have focused on the relationship between vitamin D and incidence of breast cancer, only a few studies have investigated the possible relationship between serum 25-hydroxyvitamin D 25(OH)D status and cancer survival rates (3-7). The purpose of this study was to pool the results of known studies of the association between 25(OH)D status and breast cancer survival.
Prognostic Impact of 25-Hydroxyvitamin D Levels in Egyptian Patients with Breast Cancer
Journal of Cancer Science & Therapy, 2017
Background: According to the literature, vitamin D (Vit D) deficiency is a risk factor for breast cancer developing with lack of information on its direct prognostic effects in breast cancer. Patients and methods: A total of 168 women with proven breast cancer diagnosed in Zagazig university hospitals-Egypt were enrolled in this study. Serum level of 25 (OH) Vit D was measured in stored blood just after diagnosis. Vit D levels were classified into three groups: deficient: <10 ng/ml; insufficient: 10 ng/ml to 30 ng/ml; and sufficient: >30 ng/ml. Clinical-pathological data and disease outcome were accessed to examine prognostic effect of vitamin D in breast cancer. Results: Median age was 51.5 (26-77) years, Metastasis was present in 13.1% of the cases. The median serum level of 25(OH) Vit D was 20 (5-98) ng/ml; it was deficient in 36.9% of patients, insufficient in 32.1% of patients, and sufficient in 31% of patients. Serum level of 25 (OH) VitD levels decreased significantly with increasing body mass index (BMI) (P=0.00), also the relations of 25 (OH) Vit D level with the number of positive lymph nodes, tumor size, tumor stage and KI 67 level were statistically significant (p= 0.01, p=0.011, p=0.002, p= 0.001 respectively). The level of 25 (OH) vitamin D was significantly low in metastatic patients (p=0.01). For those non-metastatic BC patients; there was no statistically significant difference in mean Disease-Free Survival (DFS) times across the 3 categories of serum Vitamin D (p=0.13), also for metastatic patients, serum vit D level didn't affect the median PFS (p=0.98). The mean OS of the 3 different categories of serum vit D (sufficient, insufficient and deficient) were 45.8 months, 39.7 months and 39 months respectively (p=0.047). Univariate analysis, showed that OS was significantly affected by age, BMI, grade, stage, molecular type and vit D levels (p=0.014, p=0.002, p=0.002, p<0.0001, and p=0.047 respectively), but in Multivariate analysis: age, BMI, stage, and vit D levels were the only independent factors significantly affect the OS (p=0.01, 0.001, p<0.0001 and p=0.022, respectively). Conclusion: There may be an association between serum 25 (OH) Vit D level and breast cancer prognosis.
Clinical Epidemiology, 2019
Circulating 25-hydroxyvitamin D (25-OHD) levels have been inversely associated with cancer death, but the nature of this relationship is unclear. We investigated this association using repeated measurements of serum 25-OHD. Patients and methods: Pre-diagnostic serum samples were collected in population health surveys in Norway (1973-2004). Participants who subsequently developed cancer (1984-2004) provided a second serum sample at the time of cancer diagnosis. Samples were stored in the Janus Serum Bank. Repeated samples existed from 202 breast cancers, 193 lung cancers, 124 lymphomas, and 37 colon cancers. Serum 25-OHD was measured via competitive radioimmunoassay. Cox regression models assessed associations between 25-OHD and cancer-specific death (case fatality) through 2012, given as hazard ratios (HRs) with 95% confidence intervals (CIs). Results: The median time between pre-diagnostic and diagnostic samples was 14.4 years. The median 25-OHD levels were 63.3 and 62.5 nmol/L, respectively. During follow-up, 313 cancer deaths occurred. Compared to low pre-diagnostic 25-OHD levels (<46 nmol/L), higher levels (≥46 nmol/L) had significantly lower HRs (39-54%) of case fatality. This result was also seen for the diagnostic samples. Donors who had both samples at high (≥62 nmol/L) levels had 59% lower HR of case fatality, compared to those for whom both samples were at low levels (<46 nmol/L). Furthermore, versus a decline in serum 25-OHD (median −22.4 nmol/L) from pre-diagnostic to diagnostic samples, a rise (median 22.3 nmol/L) was associated with lower case fatality (HR 0.57, 95% CI 0.43−0.75). Conclusion: Our findings suggest a causal relationship between vitamin D and cancer case fatality.
The Journal of steroid biochemistry and molecular biology, 2016
To study the nutritional risk factors and status of serum 25(OH)D levels in patients with breast cancer. A total of 100 women (cases) with confirmed breast cancer (BC) matched with equal number of healthy females (controls) of similar age and socioeconomic status (SES) were included in study. Controls included were nonbreast cancer patients who accompanied the patients to a tertiary care hospital. All the subjects (cases and controls) were administered a questionnaires to collect data on socioeconomic status, dietary pattern and the frequency of food consumption using a validated food frequency questionnaire. Anthropometric assessment was done for waist and hip circumference to calculate waist to hip ratio (WHR). Non fasting blood samples were collected for serum 25-hydroxyvitamin D [25(OH)D] levels estimation using chemiluminescent immunoassay technique and total serum calcium levels by colorimetric assay technique. Serum 25(OH)D and total calcium levels were expressed in ng/ml and...
Association of serum level of 25 hydroxy-vitamin D with prognostic factors for breast cancer
Asian Pacific journal of cancer prevention : APJCP, 2011
In recent years, there has been considerable interest in whether vitamin D inhibits breast cancer development. Experimental studies have shown that vitamin D promotes cell differentiation and retards or terminates proliferation of breast cancer cells. However, there is little evidence supporting the association of vitamin D and prognosis of breast cancer. In this analytic-descriptive study, 119 female patients with histological proven breast cancer were recruited in Tabriz oncology clinics in a 15-month period of time. History of chemotherapy, radiotherapy or receiving vitamin D/Ca supplements and presence of other malignancies were exclusion criteria. Serum level of 25 hydroxy vitamin D (25(OH)D) was measured in all patients. One hundred and nineteen patients with a mean age of 50.4∓12.6 (26-76) years were enrolled in the study. Metastasis was present in 21.8% of the cases. Stage of tumor was I, II, III and IV in 11, 56, 26 and 26 patients, respectively. The Tumor grade was low in ...
Serum 25-hydroxyvitamin D and prevention of breast cancer: pooled analysis
Anticancer research, 2011
Low serum levels of 25-hydroxyvitamin D [25(OH)D] have been associated with a high risk of breast cancer. Since publication of the most current meta-analysis of 25(OH)D and breast cancer risk, two new nested case-control studies have emerged. A PubMed search for all case-control studies on risk of breast cancer by 25(OH)D concentration identified 11 eligible studies. Data from all 11 studies were combined in order to calculate the pooled odds ratio of the highest vs. lowest quantile of 25(OH)D across all studies. The overall Peto odds ratio summarizing the estimated risk in the highest compared to the lowest quantile across all 11 studies was 0.61 (95% confidence interval 0.47, 0.80). This study supports the hypothesis that higher serum 25(OH)D levels reduce the risk of breast cancer. According to the review of observational studies, a serum 25(OH)D level of 47 ng/ml was associated with a 50% lower risk of breast cancer.