Abstract
A population-based relationship between low vitamin D status and increased cancer risk is now generally accepted. However there were only few studies reported on prognostic impact. To determine the effect of low vitamin D on progression of breast cancer, we conducted a cross-sectional analysis of vitamin D levels and clinico- pathological characteristics in 200 cases of breast cancer diagnosed during 2011-2012 at the National Cancer Institute of Thailand. Vitamin D levels were measured by high-performance liquid chromatography (HPLC). Clinical and pathological data were accessed to examine prognostic effects of vitamin D. We found that the mean vitamin D level was 23.0±6.61 ng/ml. High vitamin D levels (≥32 ng/ml) were detected in 7% of patients, . low levels (<32 ng/ml) in 93% Mean vitamin D levels for stages 1-4 were 26.1±6.35, 22.3±6.34, 22.2±6.46 and 21.3±5.42 ng/ml respectively (P=0.016) and 24.1 and 21.3 ng/ml for lymph node negative and positive cases (P=0.006). Low vitamin D level (<32 ng/ml) was significantly found in majority of cases with advanced stage of the disease (P=0.036), positive node involvement (P=0.030) and large tumors (P=0.038). Our findings suggest that low and decreased level of vitamin D might correlate with progression and metastasis of breast cancer.
Highlights
Breast cancer confers significant morbidity and mortality among women worldwide
Vitamin D function is most closely associated with the control of calcium and bone metabolism, it is proposed to have a variety of other biological roles including cellular proliferation, apoptosis, immunity to fight against bacteria and probably anticancer effects (Garland et al, 2006; Holick et al, 2006)
Our observation revealed that low levels of vitamin D were associated with advanced stage, positive-nodal involvement and large tumors, suggesting that the prognostic effect of vitamin D may be due to the aggressiveness of tumors in low vitamin D patients, consistent with a potential role of vitamin D in breast carcinagenesis
Summary
Breast cancer confers significant morbidity and mortality among women worldwide. Due to the magnitude of this disease, considerable research effort has been directed toward identifying breast cancer risk factors to target for prevention. Inverse correlation between circulating vitamin D levels measured at diagnosis and following breast cancer recurrence and mortality have been demonstrated (Palmieri et al, 2006; Goodwin et al, 2009). Lower serum vitamin D levels have been associated with more advanced stages of breast cancer. Serum levels of vitamin D were lower in patients with locally advanced or metastatic breast cancer than in those with early-stage disease (Palmieri et al, 2006). In a multi-ethnic cohort of breast cancer survivors, women with localized or regional breast cancer had lower serum vitamin D levels than those with in situ disease (Neuhouser et al, 2008). A study revealed that low levels of serum vitamin D at diagnosis were significantly associated with larger tumors (Hatse et al, 2012). We examined whether serum levels of vitamin D at the time of breast cancer diagnosis correlate with various clinical pathological characteristics
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