Triple-negative breast cancer is 3X more frequent if less than 32 ng of vitamin D – March 2012

The Association Between Breast Cancer Prognostic Indicators and Serum 25-OH Vitamin D Levels.

Ann Surg Oncol. 2012 Mar 24.
Peppone LJ, Rickles AS, Janelsins MC, Insalaco MR, Skinner KA.
Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, NY, USA, luke_peppone@urmc.rochester.edu.

BACKGROUND: Studies show that women with low vitamin D levels have an increased risk of breast cancer (BC) incidence and mortality, but there is a lack of research examining vitamin D levels and prognostic variables in BC patients. The aim of this study is to examine 25-OH vitamin D levels between BC cases and controls and by prognostic indicators among BC cases.

METHODS: 25-OH vitamin D levels were collected from 194 women who underwent BC surgery and 194 cancer-free (CF) controls at the University of Rochester between January 2009 and October 2010. Mean 25-OH vitamin D levels and odds ratios (OR) were calculated by case/control status for the overall cohort and by prognostic indicators (invasiveness, ER status, triple-negative status, Oncotype DX score, molecular phenotype) for BC cases.

RESULTS: BC cases had significantly lower 25-OH vitamin D levels than CF controls (BC: 32.7 ng/mL vs. CF: 37.4 ng/mL; P = .02).
In case-series analyses, women with suboptimal 25-OH vitamin D concentrations (<32 ng/mL) had significantly higher odds of having

  • ER- (OR = 2.59, 95% confidence interval [95% CI] = 1.08-6.23) and
  • triple-negative cancer (OR = 3.15, 95% CI = 1.05-9.49)

than those with optimal 25-OH D concentrations.

Women with basal-like phenotype had lower 25-OH vitamin D levels than women luminal A phenotype (basal-like: 24.2 ng/mL vs. luminal A: 32.8 ng/mL; P = 0.04).

CONCLUSIONS: BC patients with a more aggressive molecular phenotype (basal-like) and worse prognostic indicators (ER- and triple-negative) had lower mean 25-OH vitamin D levels. Further research is needed to elucidate the biological relationship between vitamin D and BC progression.

PMID: 22446898
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Acronyms

  • WikiPedia say ER = Estrogen Receptor type of Breast Cancer: positive or negative
  • Wikipedia Triple Negative = no genes for estrogen receptor, progesterone receptor or Her2/neu =surrogate term for basal cell cancer. Triple negative breast cancers have a relapse pattern that is very different from hormone-positive breast cancers: the risk of relapse is much higher for the first 3-5 years but drops sharply and substantially bellow that of hormone-positive breast cancers after that

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  • Targeted Therapy for Breast Cancer Prevention PubMed, Sept 2013
    Several promising agents currently being tested in cancer prevention trials for the prevention of TNBC include poly(ADP-ribose) polymerase inhibitors, vitamin D, and rexinoids, both of which activate nuclear hormone receptors (the vitamin D and retinoid X receptors)
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