Prognostic evaluation of vitamin D deficiency in breast cancer patients: a pilot study in India.
Keywords:
Vitamin D deficiency, Breast cancer, Her2neu enriched breast cancer, triple negative breast cancer.
Abstract
Background: Vitamin D deficiency has been associated with poor prognosis in breast cancer. A new molecular classification of breast cancer is being increasingly used that is based on expression of estrogen receptors, progesterone receptors and Her2/neu amplification and is found to correlate well with prognosis and outcome of disease. The present study was designed to determine serum vitamin D deficiency in these molecular subtypes of breast cancer.Methods: Estimation of serum vitamin D levels by chemiluminiscence was done in a cohort of 99 breast cancer patients and 25 age matched healthy controls. Breast cancer patients were further grouped into luminal A, luminal B, Her2/neu enriched and triple negative subtypes based on immunohistochemistry results. Non-parametric tests were performed to compare vitamin D levels in different groups.Results: 54.6%, 60%, 66.6% and 84.2% of patients with luminal A, luminal B, Her2/neu enriched and triple negative subtypes respectively were found to be vitamin D deficient (<20ng/mL) as compared to only 20% in healthy controls. More aggressive Her2/neu enriched and triple negative subtype patients had significantly lower serum vitamin D levels than the luminal subtypes of breast cancer. Conclusion: Vitamin D deficiency is more prevalent and significantly lower levels are found in more aggressive subtypes of breast cancer. Vitamin D supplementation must be considered in these forms of breast cancer to improve outcome.References
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17. Gissel T, Rejnmark L, Mosekilde L, Vestergaard P. Intake of vitamin D and risk of breast cancer—a meta-analysis. J. Steroid Biochem. Mol. Biol. 2008; 111:195–199.
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2. Tretli S, Schwartz GG, Torjesen PA, Robsahm TE. Serum levels of 25- hydroxyvitamin D and survival in Norwegian patients with cancer of breast, colon, lung, and lymphoma: a population-based study. Cancer Causes Control ;2012: 363–370.
3. Peppone LJ, Rickles AS, Janelsins MC, Insalaco MR, Skinner KA. The association between breast cancer prognostic indicators and serum 25-OH vitamin D levels. Ann. Surg. Oncol.2012;19:2590–2599.
4. Yao S, Ambrosone CB. Associations between vitamin D deficiency and risk of aggressive breast cancer in African–American women.J. Steroid Biochem. Mol. Biol. 2013;136:337–341
5. Consolidated Report of Population Based Cancer Registries 2001–2004. National Centre for Disease Informatics and Research National Cancer Registry Programme (Indian Council of Medical Research); 2006.
6. Rakha EA, Reis-Filho JS, Baehner F, et al. Breast cancer prognostic classification in the molecular era: the role of histological grade. Breast Cancer Res 2010; 12: 207.
7. Perou CM, Sorlie T, Eisen MB, et al. Molecular portraits of human breast tumours. Nature 2000; 406: 747–52.
8. Cummings MC, Chamber R, Simpson PT, Lakhani SR. Molecular classification of breast cancer. Is it time to pack up our microscopes? Pathology. 2011;43(1):1–8.
9. Rainville C, Khan Y, Tisman G. Triple negative breast cancer patients presenting with low serum vitamin D levels: a case series. Cases J. 2009;2:8390.
10. Ritu G, Gupta A. Vitamin D Deficiency in India: Prevalence, Causalities and Interventions. Nutrients 2014; 6:729-775.
11. Yousef FM, Jacobs ET, Kang PT, Hakim IA, Going S, Yousef JM et al. Vitamin D status and breast cancer in Saudi Arabian women: case–control study. Am. J. Clin. Nutr. 2013;98:105–110.
12. Rakha EA, Ellis IO. Triple-negative/basal-like breast cancer: review. Pathology .2009; 41:40–47.
13. Slamon DJ, Clark GM, Wong SG, Levin WJ, Ullrich A, McGuire RL. Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science. 1987;235:177 –182.
14. Lukong KE. Understanding breast cancer – The long and winding road. BBA Clinical.2017;7: 64 –77.
15. Kim HJ, Lee YM, Ko BS, Lee JW, Yu JH, Son BH et al.Vitamin D Deficiency is Correlated with Poor Outcomes in Patients with Luminal-type Breast Cancer Surg. Oncol.2011; 18 :1830–1836.
16. LaPorta E, Welsh J. Modeling vitamin D actions in triple negative/basal-like breast cancer. J. Steroid Biochem. Mol. Biol. 2014;144:65–73.
17. Gissel T, Rejnmark L, Mosekilde L, Vestergaard P. Intake of vitamin D and risk of breast cancer—a meta-analysis. J. Steroid Biochem. Mol. Biol. 2008; 111:195–199.
18. Peppone LJ, Huston AJ, Reid ME, Rosier RN, Zakharia Y, Trump DL, et al. The effect of various vitamin D supplementation regimens in breast cancer patients. Breast Cancer Res Treat. 2011;127:171–7.
Published
2017-12-19
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