Vitamin D Levels Linked to Aggressive Breast Cancer
A recently published study finds low blood levels of vitamin D may promote more aggressive breast tumors.
The relationship between low vitamin D levels and higher risk of developing breast cancer has been previously documented in numerous studies. Women with inadequate intake of Viamin D or with low blood levels (below 55ng/ml) have very poor prognosis and higher risk of metastatic disease and death from breast cancer.
This study from a team at the University of Rochester Medical Center (URMC), is one of the first to look for links between vitamin D blood levels and the risk for aggressive tumors in women already diagnosed with breast cancer. This study highlights the importance of testing vitamin D levels in women diagnosed with breast cancer. If needed, Vitamin D should be supplemented and blood levels should be monitored. According to Michael Holick, M.D., authority on Vitamin D, immune modulating and cancer protective levels are between 55ng/ml-80ng/ml. More aggressive forms of breast cancer include Her2neu positive breast cancers. as well as triple negative breast cancers ( tumors which do not have receptors for estrogen, progesterone or Her2neu.)
This study links low vitamin D levels to a higher risk for aggressive breast cancers.
The study’s authors examined various key factors related to breast cancer prognosis among 155 women who underwent surgery for breast cancer between January 2009 and September 2010.
They also obtained blood samples for all the patients within the one-year period before and after surgery, to get accurate vitamin D levels.
Meanwhile, the researchers collected relevant breast cancer data on each patient including age, race, menopause status, stage of cancer at diagnosis, estrogen and progesterone status, HER2 expression, gene expression, and Oncotype Dx score.
Oncotype Dxis a newer diagnostic test for early-stage breast cancer that looks at a group of 21 genes within a woman’s tumor sample and issues a score between 0 and 100 that predicts the likelihood of a recurrence. A higher risk of recurrence is usually reflected in scores greater than 30.
Finally, the women were separated into two groups, based on whether their vitamin D levels were deemed “optimal” or “sub-optimal” – This study used greater or less than 32 ng/ml as a demarcation, far lower than Dr. Holick's recommended optimal levels.
The URMC team’s statistical analysis showed that cancers known to be more aggressive – such as triple-negative tumors – correlated with low vitamin D levels.
Lower vitamin D levels were also strongly linked to increasing (i.e., riskier) Oncotype scores.
Patients with invasive cancer were also more likely to have sub-optimal vitamin D levels.
The authors arrived at two key conclusions, which led them to recommend vitamin D blood tests for cancer patients, and vitamin D injections or supplements as needed: “Breast cancer patients with suboptimal vitamin D levels were more likely to have tumors with more aggressive tumor profiles and worse prognostic markers, lending support to previous research that found decreased breast cancer survival among vitamin D deficient individuals.” “In addition, this study found that suboptimal vitamin D levels were not only associated with poor prognostic markers of survival (ER- and triple negative tumors) but also increased risk of recurrence (Oncotype scores).”
It’s worth noting that the premenopausal and black women in this study were more likely to have sub-optimal vitamin D levels, compared to postmenopausal white women.
Food rich in Vitamin D include oily fish such as cod, salmon, oysters, herring, mackerel, sardines and trout. For more food sources see a list of foods high in Vitamin D.
Vitamin D blood levels can also be raised by exposing the skin to sunlight. Vitamin D is produced in the body by exposing the skin to sunlight for 30 minutes a day.
It seems clear that Breast Cancer prevention includes maintaining adequate Vitamin D levels by including cold water oily fish in the diet, using oral vitamin supplementation and with prudent exposure to sunlight.
Holick, M.F. 2006. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin. Proc. 81(3):353-373.
Grant, W.B., Lower vitamin-D production from solar ultraviolet-B Irradiance may explain some differences in cancer survival rates. Journal of the National Medical Association. 2006; 98(3):357-64.
Gorham ED, Garland CF, Garland FC, Grant WB, Mohr SB, Lipkin M, Newmark HL, Giovannucci E, Wei M, Holick MF. Vitamin D and prevention of colorectal cancer. J Steroid Biochem Mol Biol 2005; 97(1-2):179-194.
Rickles A, Peppone L, Huston A, Piazza K, Skinner K. Poster Presentation #1701 - Serum 25-Hydroxyvitamin D and Prognostic Tumor Characteristics in Breast Cancer Patients. Scientific Session Abstracts Official Proceedings Volume 18. The American Society of Breast Surgeons 12th Annual Meeting, April 27 - May 1, 2011, Washington, DC. Accessed at http://www.breastsurgeons.org/annual/documents/2011_ASBrS_official_proceedings.pdf
University of Rochester Medical Center (URMC). Aggressive Breast Tumors Linked to Vitamin D Deficiency. April 29, 2011. Accessed at http://www.urmc.rochester.edu/news/story/index.cfm?id=3182
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