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Vitamin D Levels in Patients with Breast Cancer: Importance of Dressing Style

  • Alco, Gul (Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital) ;
  • Igdem, Sefik (Department of Radiation Oncology, Istanbul Bilim University) ;
  • Dincer, Maktav (Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital) ;
  • Ozmen, Vahit (Department of Breast Surgery, Istanbul Florence Nightingale Hospital) ;
  • Saglam, Sezer (Department of Medical Oncology, Istanbul Bilim University) ;
  • Selamoglu, Derya (Department of Breast Surgery, Istanbul Florence Nightingale Hospital) ;
  • Erdogan, Zeynep (Department of Physical Therapy & Rehabilitation, Istanbul Florence Nightingale Hospital) ;
  • Ordu, Cetin (Department of Medical Oncology, Istanbul Bilim University) ;
  • Pilanci, Kezban Nur (Department of Medical Oncology, Istanbul Bilim University) ;
  • Bozdogan, Atilla (Department of Biostatistics, Istanbul Florence Nightingale Hospital) ;
  • Yenice, Sedef (Department of Biochemistry, Gayrettepe Florence Nightingale Hospital) ;
  • Tecimer, Coskun (Department of Medical Oncology, Istanbul Bilim University) ;
  • Demir, Gokhan (Department of Medical Oncology, Istanbul Bilim University) ;
  • Koksal, Gulistan (Department of Medical Oncology, Gayrettepe Florence Nightingale Hospital) ;
  • Okkan, Sait (Department of Radiation Oncology, Gayrettepe Florence Nightingale Hospital)
  • Published : 2014.02.01

Abstract

Background: Vitamin D deficiency is a potentially modifiable risk factor that may be targeted for breast cancer (BC) prevention. It may also be related to prognosis after diagnosis and treatment. The aim of our study was to determine the prevalence of vitamin D deficiency as measured by serum 25-hydroxy vitamin D (25-OHD) levels in patients with BC and to evaluate its correlations with life-style and treatments. Materials and Methods: This study included 186 patients with stage 0-III BC treated in our breast center between 2010-2013. The correlation between serum baseline 25-OHD levels and supplement usage, age, menopausal status, diabetes mellitus, usage of bisphosphonates, body-mass index (BMI), season, dressing style, administration of systemic treatments and radiotherapy were investigated. The distribution of serum 25-OHD levels was categorized as deficient (<10ng/ml), insufficient (10-24 ng/ml), and sufficient (25-80 ng/ml). Results: The median age of the patients was 51 years (range: 27-79 years) and 70% of them had deficient/insufficient 25-OHD levels. On univariate analysis, vitamin D deficiency/insufficiency was more common in patients with none or low dose vitamin D supplementation at the baseline, high BMI (${\geq}25$), no bisphosphonate usage, and a conservative dressing style. On multivariate analysis, none or low dose vitamin D supplementation, and decreased sun-exposure due to a conservative dressing style were found as independent factors increasing risk of vitamin D deficiency/insufficiency 28.7 (p=0.002) and 13.4 (p=0.003) fold, respectively. Conclusions: The prevalence of serum 25-OHD deficiency/insufficiency is high in our BC survivors. Vitamin D status should be routinely evaluated for all women, especially those with a conservative dressing style, as part of regular preventive care, and they should take supplemental vitamin D.

Keywords

References

  1. Chen Z, Maricic M, Bassford TL, et al (2005). Fracture risk among breast cancer survivors: Results from the Women's Health Initiative Observational Study. Arch Intern Med, 165, 552-8. https://doi.org/10.1001/archinte.165.5.552
  2. Colston KW, Berger U, Coombes RC (1989). Possible role for vitamin D in controlling breast cancer cell proliferation. Lancet, 1, 188-91.
  3. Crew KD, Shane E, Cremers S, et al (2009). High prevalence of vitamin D deficiency despite supplementation in premenopausal women with breast cancer undergoing adjuvant chemotherapy. J Clin Oncol, 27, 2151-6. https://doi.org/10.1200/JCO.2008.19.6162
  4. Friedman CF, DeMichele A, Su HI, et al (2012). Vitamin D deficiency in postmenopausal breast cancer survivors. J Women's Health, 21, 456-62. https://doi.org/10.1089/jwh.2011.3009
  5. Gannage-Yared MH, Maalouf G, Khalife S, et al (2009). Prevalence and predictors of vitamin D inadequacy amongst Lebanese osteoporotic women. Br J Nutr, 101, 487-91.
  6. Garland FC, Garland CF, Gorham ED,Young JF (1990). Geographic variation in breast cancer mortality in the United States: a hypothesis involving exposure to solar radiation. Prev Med, 19, 614-22. https://doi.org/10.1016/0091-7435(90)90058-R
  7. Goodwin PJ (2009). Vitamine D in cancer patients: Above all, do no harm. J Clin Oncol, 27, 2117-9. https://doi.org/10.1200/JCO.2008.20.8629
  8. Goodwin PJ, Ennis M, Pritchard KI, Koo J, Hood N (2009). Prognostic effects of 25-hydroxyvitamin D levels in early breast cancer. J Clin Oncol, 27, 3757-63. https://doi.org/10.1200/JCO.2008.20.0725
  9. Gorham ED, Garland FC, Garland CF (1990). Sunlight and breast cancer incidence in the USSR. Int J Epidemiol, 19, 820-4. https://doi.org/10.1093/ije/19.4.820
  10. Grant WB (2002). An ecologic study of dietary and solar ultraviolet-B links to breast carcinoma mortality rates. Cancer, 94, 272-81 https://doi.org/10.1002/cncr.10196
  11. Halicioglu O, Aksit S, Koc F, et al (2012). Vitamin D deficiency in pregnant women and their neonates in spring time in western Turkey. Paediatr Perinat Epidemiol, 26, 53-60. https://doi.org/10.1111/j.1365-3016.2011.01238.x
  12. Hans D, Downs RW Jr, Duboeuf F et al (2006). Skeletal sites for osteoporosis diagnosis: the 2005 ISCD Official Positions. J Clin Densitom, 9, 15-21. https://doi.org/10.1016/j.jocd.2006.05.003
  13. Hathcock JN, Shao A, Vieth R, Heaney R (2007). Risk assessment for vitamin D. Am J Clin Nutr, 85, 6-18.
  14. Hatse S, Lambrechts D, Verstuyf A et al (2012). Vitamin D status at breast cancer diagnosis: correlation with tumor characteristics, disease outcome, and genetic determinants of vitamin D insufficiency. Carcinogenesis, 33, 1319-26. https://doi.org/10.1093/carcin/bgs187
  15. Hatun S, Islam O, Cizmecioglu F, et al (2005). Subclinical Vitamin D deficiency is increased in adolescent girls who wear concealing clothing. J Nutr, 135, 218-22
  16. Holick MF (2006). Resurrection of vitamin D deficiency and rickets. J Clin Invest, 116, 2062-72. https://doi.org/10.1172/JCI29449
  17. Holick MF (2007). Vitamin D deficiency. N Engl J Med, 357, 266-81. https://doi.org/10.1056/NEJMra070553
  18. Jacot W, Pouderoux S, Thezenas S et al (2012). Increased prevalence of vitamin D insufficiency in patients with breast cancer after neoadjuvant chemotherapy. Breast Cancer Res Treat, 134, 709-17. https://doi.org/10.1007/s10549-012-2084-7
  19. Khan QJ, Reddy PS, Kimler BF, et al (2010). Effect of vitamin D supplementation of serum 25-hydroxy vitamin D levels, joint pain, and fatigue in women starting adjuvant letrozole treatment for breast cancer. Breast Cancer Res Treat, 119, 111-8. https://doi.org/10.1007/s10549-009-0495-x
  20. Lagunova Z, Porojnicu AC, Grant WB, Bruland O, Moan JE (2010). Obesity and increased risk of cancer: Does decrease of serum 25-hydroxyvitamin D level with increasing body mass index explain some of the association? Mol Nutr Food Res, 54, 1127-33.
  21. Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP (2007). Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr, 85, 1586-91.
  22. Mantell DJ, Owens PE, Bundred NJ, Mawer EB, Canfield AE (2000). 1 alpha,25-dihydroxyvitamin D(3) inhibits angiogenesis in vitro and in vivo. Circ Res, 87, 214-20. https://doi.org/10.1161/01.RES.87.3.214
  23. Moan J, Porojnicu AC, Robsahm TE et al (2005). Solar radiation, vitamin D and survival rate of colon cancer in Norway. J Photochem Photobiol B, 78, 189-93. https://doi.org/10.1016/j.jphotobiol.2004.11.004
  24. Nagpal S, Na S, Rathnachalam R (2005). Noncalcemic actions of vitamin D receptor glands. Endocr Rev, 26, 662-87. https://doi.org/10.1210/er.2004-0002
  25. Neuhouser ML, Sorensen B, Hollis BW, et al (2008). Vitamin D insufficiency in a multiethnic cohort of breast cancer survivors. Am J Clin Nutr, 88, 133-9.
  26. Palmieri C, MacGregor T, Girgis S, Vigushin D (2006). Serum 25-hydroxyvitamin D levels in early and advanced breast cancer. J Clin Pathol, 59, 1334-6. https://doi.org/10.1136/jcp.2006.042747
  27. Peppone LJ, Huston AJ, Reid ME et al (2011) The effect of various vitamin D supplementation regimens in breast cancer patients. Breast Cancer Res Treat, 127, 171-7. https://doi.org/10.1007/s10549-011-1415-4
  28. Porojnicu A, Robsahm TE, Berg JP, Moan J (2007). Season of diagnosis is a predictor of cancer survival. Sun-induced vitamin D may be involved: A possible role of sun-induced Vitamin D. J Steroid Biochem Mol Biol, 103, 675-8. https://doi.org/10.1016/j.jsbmb.2006.12.031
  29. Robsahm TE, Tretli S, Dahlback A, Moan J (2004). Vitamin D3 from sunlight may improve the prognosis of breast-, colon- and prostate cancer (Norway). Cancer Causes Control, 15, 149-58. https://doi.org/10.1023/B:CACO.0000019494.34403.09
  30. Santini D, Galluzzo S, Vincenzi B, et al (2010). Longitudinal evaluation of vitamin D plasma levels during anthracycline- and docetaxel based adjuvant chemotherapy in early-stage breast cancer patients. Ann Oncol, 21, 185-6. https://doi.org/10.1093/annonc/mdp497
  31. Shao T, Klein P, Grossbard ML (2012). Vitamin D and breast cancer. The Oncologist, 17, 36-45. https://doi.org/10.1634/theoncologist.2011-0278
  32. Sundaram S, Gewirtz DA (1999). The vitamin D3 analog EB 1089 enhances the response of human breast tumor cells to radiation. Radiat Res, 152, 479-86. https://doi.org/10.2307/3580143
  33. Sundaram S, Chaudhry M, Reardon D, Gupta M, Gewirtz DA (2000). The vitamin D3 analog EB 1089 enhances the antiproliferative and apoptotic effects of adriamycin in MCF-7 breast tumor cells. Breast Cancer Res Treat, 63, 1-10. https://doi.org/10.1023/A:1006420708806
  34. Wang Q, Yang W, Uytingco MS, Christakos S, Wieder R (2000). 1,25-Dihydroxyvitamin D3 and all-trans-retinoic acid sensitize breast cancer cells to chemotherapy-induced cell death. Cancer Res, 60, 2040-8.
  35. Vrieling A, Hein R, Abbas S, et al (2011). Serum 25-hydroxyvitamin D and postmenopausal breast cancer survival: a prospective patient cohort study. Breast Cancer Res, 13, 74. https://doi.org/10.1186/bcr2920

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