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The better your vitamin D level, the better your breast cancer markers?

Posted on: April 13, 2012   by  John Cannell, MD


Breast cancer does not lack for prognostic indicators. If you are unlucky enough to get breast cancer, one of the first things the oncologists will do is obtain prognostic indicators. Some of these indicators, like estrogen receptivity, also help determine treatment. At least six such indicators exist, such as the more aggressive molecular pattern under the microscope, called “basal-like” or the dreaded prognostic indicators such as “estrogen receptor negative” and “triple negative.” For our purposes, all one needs to know is that such prognostic indicators exist.

Dr. Luke Peppone and colleagues from the University of Rochester Medical Center wanted to know more. They wanted to know if any of these prognostic indicators were associated with vitamin D levels.

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 Mar 24.

This was a case control trial of 194 women with breast cancer and 194 cancer free women. The women with breast cancer had significantly (.02) lower vitamin D levels. Peppone et al discovered just about every marker was worse with low vitamin D. Most of the results were significant, such as the feared “basal-like” pattern on microscopy. Women were 3.5 times more likely to have that “basal-like” pattern if their vitamin D levels were low. Women were 3.1 times more likely to have the dreaded “triple negative” if they were vitamin D deficient.

What I liked the best was, after calling for a randomized controlled trial, he said:

“For now, because of the importance of vitamin D in other health issues directly relevant to breast cancer patients [bone loss, arthralgias (painful joints), and falls], clinicians should screen for vitamin D deficiency and treat accordingly.”

Dr. Peppone called for diagnosis and treatment now, not just more studies. He knows both science and ethics. Dr. Peppone and colleagues had previously documented that most women with breast cancer are vitamin D deficient and that their physicians can safely treat that deficiency with weekly high dose vitamin D.

Peppone LJ, Huston AJ, Reid ME, Rosier RN, Zakharia Y, Trump DL, Mustian KM, Janelsins MC, Purnell JQ, Morrow GR. The effect of various vitamin D supplementation regimens in breast cancer patients. Breast Cancer Res Treat. 2011 May;127(1):171-7.

Women with (or without) breast cancer should take vitamin D3, at least 5,000 IU/day.

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