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Vitamin D Associated with Breast Cancer
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May 19, 2008
The American Society of Clinical Oncology released an abstract before their annual meeting (May 30-June 3, 2008) started related to Vitamin D and breast cancer. The abstract does not appear to draw any conclusions or suggest that there is causation, that vitamin D deficiency can be a causative factor leading to the development of breast cancer. Pamela Goodwin, M.D., of the University of Toronto, reports 512 consecutive women with newly diagnosed BC were enrolled at 3 U of Toronto hospitals between 1989 and 1995. Women were followed prospectively to 2006. Mean age was 50.4±9.7 yrs. 199 women received adjuvant chemotherapy (CXT) and 200 received tamoxifen.
Mean 25-OH Vit D was 58.1±23.4 nmol/L. Vit D levels were deficient (<50 nmol/L) in 192 (37.5%), insufficient (50-72 nmol/L) in 197 (38.5%) and adequate (>72 nmol/L) in 123 (24.0%).
Low Vit D levels were associated with premenopausal status, high body mass index (BMI), high insulin and high tumor grade (all p<0.03).
Low Vit D levels were associated with low dietary intake of retinol, Vitamin E, grains and alcohol (all p<0.02).
Vit D was marginally lower when drawn in winter (Oct-Mar) vs summer (Apr-Sept) months (56.7 vs 59.5 nmol/L, p=0.07).
Distant disease-free survival (DDFS) was significantly worse in women with deficient (vs adequate) Vit D levels (HR 1.94, 95% CI 1.16-3.24, p=0.02) as was overall survival (OS) (HR 1.73, 95% CI 1.05-2.86, p=0.02).
Vit D associations with DDFS were independent of age, BMI, insulin, T and N stage, ER and grade (all HR >1.55 Q1 vs Q4, all p < 0.04); they were not significantly modified by ER, adjuvant CXT or tamoxifen. Vit D associations with OS were attenuated by grade and were absent in ER negative BC.
Conclusions: Vit D deficiency is common at breast cancr diagnosis and is associated with poor prognosis. This research was funded by the Breast Cancer Research Foundation.
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