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Odebeatu CC, Darssan D, Roscoe C, Ahmed M, Reid S, Osborne NJ. Greenspace and risk of obesity-related cancer in the UK Biobank cohort: An analysis of private residential gardens and other greenspace types. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 943:173833. [PMID: 38866159 DOI: 10.1016/j.scitotenv.2024.173833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/23/2024] [Accepted: 06/05/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Cohort studies linking greenspace exposure to a lower risk of obesity-related cancer (ORC) are scarce. Existing evidence on site-specific cancers has predominantly relied on non-specific greenspace measures, including vegetation indices. We examined the associations of total greenspace, private residential gardens, and other greenspace types with the risk of being diagnosed with overall and site-specific ORC. METHODS We used data from the participants in the UK Biobank recruited between 2006 and 2010 and censored until December 31, 2016. We defined greenspace variables using Ordnance Survey MasterMap™ greenspace categories. The incidence of ORC was ascertained through data linkage to cancer registries. Hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated using Cox proportional hazard models and adjusted for covariates. We conducted mediation and modification analysis by physical activity, serum 25-hydroxyvitamin D [25(OH)D], and particulate matter air pollution with an aerodynamic diameter ≤ 2.5 (PM2.5) and nitrogen dioxide (NO2), as well as subgroup analysis by covariates. RESULTS Among 279,326 participants, 9550 developed ORC over a median follow-up period of 7.82 years. An increase in private residential gardens within a 100 m buffer was associated with a decreased risk of overall ORC (HR:0.92; 95 % CI: 0.88, 0.96), breast cancer (HR: 0.91; 95 % CI: 0.84, 0.98), and uterine cancer (HR:0.80; 95 % CI: 0.67, 0.96). There was no association between other greenspace types and ORC, except for uterine cancer. The association for ORC was partly mediated by NO2 and modified by physical activity levels, 25(OH)D, PM2.5, and NO2, and sociodemographic factors, including sex and neighbourhood socioeconomic status. CONCLUSION Increased exposure to private residential gardens may lower the risk of being diagnosed with obesity-related cancer, particularly breast and uterine cancer. Future studies might move beyond considering greenspace quantity to explore functional types of greenspace exposure that should be prioritized for targeted health intervention and cancer prevention.
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Affiliation(s)
| | - Darsy Darssan
- School of Public Health, The University of Queensland, Herston, Brisbane, Australia
| | - Charlotte Roscoe
- Department of Environmental Health, Harvard T. H Chan School of Public Health, Channing Division of Network Medicine, Boston, MA, USA; Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA; Environmental Systems and Human Health, Oregon Health & Science University Portland State University OHSU-PSU School of Public Health, Portland, OR, USA
| | - Muktar Ahmed
- Cancer Epidemiology & Population Research Group, University of South Australia, Australia; Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
| | - Simon Reid
- School of Public Health, The University of Queensland, Herston, Brisbane, Australia
| | - Nicholas J Osborne
- School of Public Health, The University of Queensland, Herston, Brisbane, Australia; European Centre for Environment and Human Health, University of Exeter, Truro, UK; School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
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Huss L, Gulz-Haake I, Nilsson E, Tryggvadottir H, Nilsson L, Nodin B, Jirström K, Isaksson K, Jernström H. The Vitamin D Receptor as a Prognostic Marker in Breast Cancer-A Cohort Study. Nutrients 2024; 16:931. [PMID: 38612962 PMCID: PMC11013402 DOI: 10.3390/nu16070931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/15/2024] [Accepted: 03/17/2024] [Indexed: 04/14/2024] Open
Abstract
Previous research has indicated an association between the presence of the vitamin D receptor (VDR) in breast cancer tissue and a favorable prognosis. This study aimed to further evaluate the prognostic potential of VDR located in the nuclear membrane or nucleus (liganded). The VDR protein levels were analyzed using immunohistochemistry in tumor samples from 878 breast cancer patients from Lund, Sweden, included in the Breast Cancer and Blood Study (BCBlood) from October 2002 to June 2012. The follow-up for breast cancer events and overall survival was recorded until 30 June 2019. Univariable and multivariable survival analyses were conducted, both with complete case data and with missing data imputed using multiple imputation by chained equations (MICE). Tumor-specific positive nuclear membrane VDR(num) staining was associated with favorable tumor characteristics and a longer breast cancer free interval (BCFI; HR: 0.64; 95% CI: 0.44-0.95) and overall survival (OS; HR: 0.52; 95% CI: 0.34-0.78). Further analyses indicated that VDRnum status also was predictive of overall survival when investigated in relation to ER status. There were significant interactions between VDR and invasive tumor size (Pinteraction = 0.047), as well as mode of detection (Pinteraction = 0.049). VDRnum was associated with a longer BCFI in patients with larger tumors (HR: 0.36; 95% CI: 0.14-0.93) or clinically detected tumors (HR: 0.28; 95% CI: 0.09-0.83), while no association was found for smaller tumors and screening-detected tumors. Further studies are suggested to confirm our results and to evaluate whether VDR should and could be used as a prognostic and targetable marker in breast cancer diagnostics.
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Affiliation(s)
- Linnea Huss
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
- Department of Surgery, Helsingborg Hospital, 251 87 Helsingborg, Sweden
| | - Igis Gulz-Haake
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
| | - Emma Nilsson
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
| | - Helga Tryggvadottir
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
- Department of Hematology, Oncology, and Radiation Physics, Skåne University Hospital, 221 85 Lund, Sweden
| | - Linn Nilsson
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
- Department of Medical Physics and Engineering, Växjö Central Hospital and Department of Research and Development, Region Kronoberg, 352 34 Växjö, Sweden
| | - Björn Nodin
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
| | - Karin Jirström
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
| | - Karolin Isaksson
- Department of Clinical Sciences, Division of Surgery, Lund University, 221 85 Lund, Sweden;
- Department of Surgery, Kristianstad Hospital, 291 85 Kristianstad, Sweden
| | - Helena Jernström
- Department of Clinical Sciences, Division of Oncology, Lund University, 221 85 Lund, Sweden; (I.G.-H.); (E.N.); (H.T.); (L.N.); (B.N.); (K.J.)
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Kacar M, Erzurum Alim N. The dietary risk factors on cancer patients receiving chemotherapy and correlation between serum vitamin D and B12 levels, depression and anxiety status. NUTR HOSP 2024; 41:112-121. [PMID: 37073746 DOI: 10.20960/nh.04530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
Introduction Objective: the aim of this study is to evaluate the relationship between serum vitamin D and B12 levels, nutritional levels, depression, and anxiety in adult cancer patients before and after chemotherapy. Methods: a case-controlled study was carried out on 44 patients who were diagnosed with cancer and applied to the Chemotherapy Unit for treatment (patient group, PG) and 44 volunteer individuals (control group, CG) with similar characteristics to the age and gender-matched patient group but with no diagnosis of cancer. Results: the average age of individuals in PG is 52.50 ± 12.21 years and for those in CG is 52.84 ± 10.98 years. Serum D and B12 levels in the first cure in individuals in PG are higher than in the last treatment (p > 0.05). It was determined that vitamin C taken with a daily diet reduces the risk of cancer (OR: 0.920, 95 % CI: 0.899-0.942, p = 0.042). No correlation was found between depression and anxiety scores of both groups and serum vitamin D and B12 levels (p > 0.05). It was determined that the Beck Anxiety Inventory (BAI) score increased with decrease in body mass index (BMI) (β = 0.311, p = 0.040) and serum vitamin B12 level (β = -0.406, p = 0.006). In addition, it was found that the increase in the Patient-Generated Subjective Global Assessment (PG-SGA) score, which reflects the nutritional status of cancer patients, worsened the level of anxiety (β = 0.389, p = 0.009). Conclusions: as stated in the findings of the study, chemotherapy treatment mediated the development of anxiety in cancer patients by changing the vitamin B12 levels and anthropometric characteristics with its negative effect on nutritional status. It should be ensured that cancer patients treated with chemotherapy follow a healthy and balanced diet plan that is suitable for their needs and has adequate vitamin and mineral content.
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Affiliation(s)
- Mihrican Kacar
- Department of Nutrition and Dietetics. Faculty of Health Sciences. Erzincan Binali Yildirim University
| | - Nural Erzurum Alim
- Department of Nutrition and Dietetics. Faculty of Health Sciences. Ankara Yildirim Beyazit University
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4
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Afzal M, Noreen R, Aslam N, Alam MM, Momenah MA. Novel Noninvasive Serum Biomarkers for Prompt Diagnosis of Breast Carcinoma. ACS OMEGA 2024; 9:1174-1182. [PMID: 38222620 PMCID: PMC10785289 DOI: 10.1021/acsomega.3c07431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 01/16/2024]
Abstract
Immune cell infiltration is associated with improved prognosis in the microenvironment of breast cancer. The incidence of breast cancer in Pakistan is 2.5 times higher than that in neighboring countries of Asia, accounting for 34.6% of female cancers. The objectives of this study were to compare and determine apoptotic mediators and biomarkers for breast carcinoma, such as serum granzyme B, cytochrome C, and vitamin D by ELIZA and calcium spectrophotometrically. Study groups were differentiated into malignant breast disease G-I, benign proliferative breast disease G-II, and healthy control group G-III. The immune-related prognostic markers and therapeutic targets were determined through the interaction of proteins by molecular docking and AutoDock Vina software. The level of granzyme B and cyt C was higher in Group-I, -II, and -III. Likewise, the mean vitamin D level was greater in Group-I than those in other groups. Through SwissDock, the proteins granzyme B and cyt C with vitamin D, single amino acid residue MET34 (H-bond 2.75 Å), and ILE81(H-bond 2.092 Å) were revealed to actively participate in interactions. This study reveals granzyme B and cyt C as biomarkers for malignant breast disease and benign proliferative breast disease, while hypovitaminosis D and hypocalcemia are complications or comorbidities of breast cancer.
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Affiliation(s)
- Muhammad Afzal
- Department
of Biochemistry, Government College University
Faisalabad, Faisalabad 38000, Pakistan
| | - Razia Noreen
- Department
of Biochemistry, Government College University
Faisalabad, Faisalabad 38000, Pakistan
| | - Nosheen Aslam
- Department
of Biochemistry, Government College University
Faisalabad, Faisalabad 38000, Pakistan
| | - Mohammad Mahtab Alam
- Department
of Basic Medical Sciences, College of Applied Medical Science, King Khalid University, Abha 61421, Saudi Arabia
| | - Maha Abdullah Momenah
- Department
of Biology, College of Science, Princess
Nourah bint Abdulrahman University, P.O.
Box 84428, Riyadh 11671, Saudi Arabia
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Narvaez CJ, Bak MJ, Salman N, Welsh J. Vitamin K2 enhances the tumor suppressive effects of 1,25(OH) 2D 3 in triple negative breast cancer cells. J Steroid Biochem Mol Biol 2023; 231:106307. [PMID: 37030416 PMCID: PMC10752295 DOI: 10.1016/j.jsbmb.2023.106307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/10/2023]
Abstract
K vitamins are well known as essential cofactors for hepatic γ-carboxylation of coagulation factors, but their potential role in chronic diseases including cancer is understudied. K2, the most abundant form of vitamin K in tissues, exerts anti-cancer effects via diverse mechanisms which are not completely understood. Our studies were prompted by previous work demonstrating that the K2 precursor menadione synergized with 1,25 dihydroxyvitamin D3 (1,25(OH)2D3) to inhibit growth of MCF7 luminal breast cancer cells. Here we assessed whether K2 modified the anti-cancer effects of 1,25(OH)2D3 in triple negative breast cancer (TNBC) cell models. We examined the independent and combined effects of these vitamins on morphology, cell viability, mammosphere formation, cell cycle, apoptosis and protein expression in three TNBC cell models (MDA-MB-453, SUM159PT, Hs578T). We found that all three TNBC cell lines expressed low levels of the vitamin D receptor (VDR) and were modestly growth inhibited by 1,25(OH)2D3 in association with cell cycle arrest in G0/G1. Induction of differentiated morphology by 1,25(OH)2D3 was observed in two of the cell lines (MDA-MB-453, Hs578T). Treatment with K2 alone reduced viability of MDA-MB-453 and SUM159PT cells but not Hs578T cells. Co-treatment with 1,25(OH)2D3 and K2 significantly reduced viable cell number relative to either treatment alone in Hs578T and SUM159PT cells. The combination treatment induced G0/G1 arrest in MDA-MB-453 cells, Hs578T and SUM159PT cells. Combination treatment altered mammosphere size and morphology in a cell specific manner. Of particular interest, treatment with K2 increased VDR expression in SUM159PT cells suggesting that the synergistic effects in these cells may be secondary to increased sensitivity to 1,25(OH)2D3. The phenotypic effects of K2 in TNBC cells did not correlate with γ-carboxylation suggesting non-canonical actions. In summary, 1,25(OH)2D3 and K2 exert tumor suppressive effects in TNBC cells, inducing cell cycle arrest leading to differentiation and/or apoptosis depending on the specific cell line. Further mechanistic studies to clarify common and unique targets of these two fat soluble vitamins in TNBC are warranted.
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Affiliation(s)
- Carmen J Narvaez
- Cancer Research Center, University at Albany, Rensselaer, NY 12144, United States
| | - Min Ji Bak
- Cancer Research Center, University at Albany, Rensselaer, NY 12144, United States
| | - Natalia Salman
- Cancer Research Center, University at Albany, Rensselaer, NY 12144, United States
| | - JoEllen Welsh
- Cancer Research Center, University at Albany, Rensselaer, NY 12144, United States.
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6
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Manocha A, Brockton NT, Cook L, Kopciuk KA. Low Serum Vitamin D Associated With Increased Tumor Size and Higher Grade in Premenopausal Canadian Women With Breast Cancer. Clin Breast Cancer 2023:S1526-8209(23)00155-6. [PMID: 37357130 DOI: 10.1016/j.clbc.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/22/2023] [Accepted: 06/09/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION This study investigated the association of Vitamin D with tumor characteristics in pre and postmenopausal women. PATIENTS AND METHODS A prospective cohort of 476 women with incident stage I-III breast cancer (BC) in Alberta, Canada comprised the study population. Vitamin D was measured as 25(OH)D concentration in serum samples collected at diagnosis (presurgery and prior to treatment initiation). Tumor characteristics including size, grade, receptor status, stage and nodal status were evaluated in regression models for association with Vitamin D and measured cytokines in models adjusted for menopausal status. RESULTS More than half of the women were diagnosed as stage I and Luminal A/B, most were postmenopausal, had sufficient Vitamin D levels, and were 56.6 years of age on average. Higher vitamin D levels were associated with decreased tumor size for all women with larger effect seen in premenopausal status. Insufficient vitamin D levels were significantly associated with increased risk of higher grade, but only in premenopausal women. Elevated human granulocyte macrophage colony-stimulating factor was an independent risk factor associated with increased risk of higher-grade tumors. CONCLUSION Women with sufficient Vitamin D levels at BC diagnosis had smaller and lower grade tumors compared to women with insufficient vitamin D, especially among premenopausal women. Maintaining adequate vitamin D levels in premenopausal women could improve prognostically important BC characteristics at diagnosis.
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Affiliation(s)
- Amit Manocha
- Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Nigel T Brockton
- American Institute for Cancer Research, Arlington, VA; Department of Community Health Sciences Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Linda Cook
- Department of Community Health Sciences Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO
| | - Karen A Kopciuk
- Cancer Epidemiology and Prevention Department, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada; Departments of Community Health Sciences, Oncology, & Mathematics and Statistics, University of Calgary, Calgary, AB, Canada.
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Mohamed RF, Barakat DBS, Eid S, Kamal DT, Elnaggar MS. Low baseline vitamin D levels increase the risk of bone metastases among females with breast cancer - Hospital based cohort study. Cancer Epidemiol 2023; 85:102374. [PMID: 37148827 DOI: 10.1016/j.canep.2023.102374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 04/11/2023] [Accepted: 04/21/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Serum vitamin D (Vit-D) has been linked to the development of breast cancer (BC); however, their effect on pathological features and outcomes is undetermined. The purpose of this study was to examine the prognostic significance of baseline Vit-D levels and their effect on clinical outcomes. METHODS We evaluated baseline serum Vit-D levels and baseline clinic-pathological features of female patients with non-metastatic BC between October 2018 and December 2019. A low Vit-D level was described as less than 30 nanogram per liter (ng/l). Patients were observed for a median of 24 months. To evaluate relationships between qualitative variables, the chi-square test was used. The Kaplan-Meier technique was used for survival analysis, and the log-rank test was used to compare the two survival curves. Correlation analysis was also used to examine the link between Vit-D levels and clinical outcomes. RESULTS The eligibility criteria were fulfilled by 221 patients. The median age of onset was (50.7). The median Vit-D level was (23.1 ng/l) with a range of (4-46 ng/l). Approximately half of the patients (56.5%) had Vit-D levels < 30 ng/l, with HER2 positive and triple negative (TNBC) patients having a greater proportion of low Vit-D levels (p = <0.001). Patients with low baseline Vit-D levels had a larger tumor size, more positive lymph nodes, and were diagnosed at a later stage. Following follow-up, Vit-D deficiency was associated with a significantly increased risk of bone metastases (HR 3.37, 95% CI 1.32-8.59, p = 0.006), and Vit-D levels were significantly correlated with disease-free survival (DFS) and overall survival (OS) (r = 0.850, r = 0.573, p < 0.00, p < 0.001, respectively). CONCLUSIONS Low serum Vit-D is associated with advanced stage and adverse characteristics. It is more prevalent in HER-2 positive and TNBC patients; it increases the chance of bone metastases, and has a significant correlation with DFS and OS.
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Affiliation(s)
- Rehab F Mohamed
- Clinical Oncology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
| | - Dina B S Barakat
- Clinical Oncology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Samir Eid
- Clinical Oncology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Dalia T Kamal
- Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Maha S Elnaggar
- Clinical Oncology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
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8
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Alnimer A, Bhamidimarri PM, Talaat IM, Alkhayaal N, Eltayeb A, Ali N, Abusnana S, Hamoudi R, Bendardaf R. Association Between Expression of Vitamin D Receptor and Insulin-Like Growth Factor 1 Receptor Among Breast Cancer Patients. World J Oncol 2023; 14:67-74. [PMID: 36895995 PMCID: PMC9990736 DOI: 10.14740/wjon1550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 12/30/2022] [Indexed: 03/01/2023] Open
Abstract
Background Vitamin D receptor (VDR) and insulin-like growth factor 1 receptor (IGF1R) are known to be involved in breast cancer (BC) progression. Our previous work reported a correlation of differential localization of IGF1R with hormone receptor status in BC. A recent report described VDR and IGF1R as potential indicators of BC prognosis, but their interplay was not discussed. The present study focused on understanding the association of VDR expression with IGF1R activation, different molecular markers, and subtypes of BC. Methods A retrospective study was designed to evaluate the VDR expression among 48 BC patients pathologically diagnosed as invasive BC and were surgically treated at Sharjah Breast Care Center, University Hospital Sharjah (UHS), United Arab Emirates (UAE). Formalin-fixed paraffin-embedded (FFPE) tumor blocks with appropriate clinicopathological data were subjected to immunohistochemistry (IHC), and VDR protein expression was interpreted based on the staining intensity (SI) and the percentage of the positively stained cells (PP). Results Nearly 44% of cases in the study were vitamin D deficient. A positive VDR expression with strong intensity (score > 4) was seen in 27 cases (56.3%). The expression pattern for VDR was equally distributed in cytoplasm and nucleus. For the IGF1R intensity, 24 cases (50%) of total cohort showed strong expression. A significant association was detected between IGF1R and VDR expression (P = 0.031). Conclusions The present study identified positive association between IGF1R and VDR expression where most of the cases with strong VDR expression displayed strong IGF1R expression. These findings may contribute to current understanding on the role of VDR in BC and its interaction with IGF1R.
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Affiliation(s)
- Ayaa Alnimer
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,These authors contributed equally to the study
| | - Poorna Manasa Bhamidimarri
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,These authors contributed equally to the study
| | - Iman M Talaat
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Noura Alkhayaal
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,University Hospital Sharjah, Sharjah, United Arab Emirates
| | - Abdalla Eltayeb
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nival Ali
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Salah Abusnana
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,University Hospital Sharjah, Sharjah, United Arab Emirates
| | - Rifat Hamoudi
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Division of Surgery and Interventional Science, University College London, London, UK
| | - Riyad Bendardaf
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,University Hospital Sharjah, Sharjah, United Arab Emirates.,Department of Oncology, University Hospital Sharjah, Sharjah, United Arab Emirates
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9
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Rosso C, Fera N, Murugan NJ, Voutsadakis IA. Vitamin D Levels in Newly Diagnosed Breast Cancer Patients according to Tumor Sub-Types. J Diet Suppl 2022; 20:926-938. [PMID: 36373265 DOI: 10.1080/19390211.2022.2144582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Vitamin D is an important regulator of bone health. In addition, as a ligand for a nuclear receptor expressed in breast cancer cells, vitamin D exerts neoplasia modulating effects in breast cancer. However, despite extensive investigations, associations of vitamin D levels with breast cancer patient characteristics and disease sub-types are conflicting. A retrospective review of medical records of consecutive breast cancer patients treated and followed in a single cancer center was undertaken. All patients with 25-hydroxyvitamin D (25-OHD, the circulating form of vitamin D) measurements available within 3 months of their diagnosis and before the start of any systemic treatment were included. Characteristics of patients and tumors with sufficient levels of 25-OHD were compared with those of patients with 25-OHD insufficiency. Two hundred ninety-two patients were included in the study. Almost two-thirds of the patients were 25-OHD insufficient, defined as having 25-OHD levels below 75 nmol/L. Compared with the group of patients who were 25-OHD sufficient, patients with 25-OHD insufficiency were younger and more often obese. Tumors of patients with 25-OHD insufficiency were more often ductal, of higher grade, and ER negative. 25-OHD insufficiency is prevalent in breast cancer patients and even more prevalent in younger and obese patients. 25-OHD insufficiency is associated with cancers that have aggressive characteristics, including higher grade and ER negativity.
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Affiliation(s)
- Christopher Rosso
- Department of Biology, Algoma University, Sault Ste. Marie, ON, Canada
| | - Nicolas Fera
- Department of Biology, Algoma University, Sault Ste. Marie, ON, Canada
| | - Nirosha J Murugan
- Department of Biology, Algoma University, Sault Ste. Marie, ON, Canada
| | - Ioannis A Voutsadakis
- Algoma District Cancer Program, Sault Area Hospital, Sault Ste. Marie, ON, Canada
- Section of Internal Medicine, Division of Clinical Sciences, Northern Ontario School of Medicine, Sudbury, ON, Canada
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10
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Ezeome ER, Yawe KDT, Ayandipo O, Badejo O, Adebamowo SN, Achusi B, Fowotade A, Ogun G, Adebamowo CA. The African Female Breast Cancer Epidemiology Study Protocol. Front Oncol 2022; 12:856182. [PMID: 35494056 PMCID: PMC9044037 DOI: 10.3389/fonc.2022.856182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/08/2022] [Indexed: 11/21/2022] Open
Abstract
Breast cancer is now the commonest cancer in most sub-Saharan African countries. Few studies of the epidemiology and genomics of breast cancer and its molecular subtypes in these countries have been done. The African Female Breast Cancer Epidemiology (AFBRECANE) study, a part of the Human Heredity and Health in Africa (H3Africa) initiative, is designed to study the genomics and epidemiology of breast cancer and its molecular subtypes in Nigerian women. We link recruitment of breast cancer cases at study sites with population-based cancer registries activities to enable ascertainment of the incidence of breast cancer and its molecular subtypes. We use centralized laboratory processing to characterize the histopathological and molecular diagnosis of breast cancer and its subtypes using multiple technologies. By combining genome-wide association study (GWAS) data from this study with that generated from 12,000 women participating in our prospective cohort study of cervical cancer, we conduct GWAS of breast cancer in an entirely indigenous African population. We test associations between dietary intakes and breast cancer and focus on vitamin D which we measure using dietary intakes, serum vitamin D, and Mendelian randomization. This paper describes the AFBRECANE project, its design, objectives and anticipated contributions to knowledge and understanding of breast cancer.
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Affiliation(s)
- Emmanuel R. Ezeome
- Department of Surgery, College of Medicine, University of Nigeria, Enugu, Nigeria
- Oncology Center, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - King-David T. Yawe
- Department of Surgery, University of Abuja Teaching Hospital, Abuja, Nigeria
| | | | - Olawale Badejo
- Department of Pathology, National Hospital, Abuja, Nigeria
| | - Sally N. Adebamowo
- Department of Epidemiology and Public Health, and Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Benerdin Achusi
- Department of Anatomic Pathology, Federal Medical Center, Abuja, Nigeria
| | - Adeola Fowotade
- Department of Medical Microbiology, University College Hospital, Ibadan, Nigeria
| | - Gabriel Ogun
- Department of Pathology, University College Hospital, Ibadan, Nigeria
| | | | - Clement A. Adebamowo
- Department of Epidemiology and Public Health, and Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States
- Institute of Human Virology Nigeria, Abuja, Nigeria
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11
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Welsh J. Vitamin D and Breast Cancer: Mechanistic Update. JBMR Plus 2021; 5:e10582. [PMID: 34950835 PMCID: PMC8674767 DOI: 10.1002/jbm4.10582] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/12/2021] [Accepted: 11/14/2021] [Indexed: 12/13/2022] Open
Abstract
The presence of the vitamin D receptor (VDR) in mammary gland and breast cancer has long been recognized, and multiple preclinical studies have demonstrated that its ligand, 1,25-dihydroxyvitamin D (1,25D), modulates normal mammary gland development and inhibits growth of breast tumors in animal models. Vitamin D deficiency is common in breast cancer patients, and some evidence suggests that low vitamin D status enhances the risk for disease development or progression. Although many 1,25D-responsive targets in normal mammary cells and in breast cancers have been identified, validation of specific targets that regulate cell cycle, apoptosis, autophagy, and differentiation, particularly in vivo, has been challenging. Model systems of carcinogenesis have provided evidence that both VDR expression and 1,25D actions change with transformation, but clinical data regarding vitamin D responsiveness of established tumors is limited and inconclusive. Because breast cancer is heterogeneous, the relevant VDR targets and potential sensitivity to vitamin D repletion or supplementation will likely differ between patient populations. Detailed analysis of VDR actions in specific molecular subtypes of the disease will be necessary to clarify the conflicting data. Genomic, proteomic, and metabolomic analyses of in vitro and in vivo model systems are also warranted to comprehensively understand the network of vitamin D-regulated pathways in the context of breast cancer heterogeneity. This review provides an update on recent studies spanning the spectrum of mechanistic (cell/molecular), preclinical (animal models), and translational work on the role of vitamin D in breast cancer. © 2021 The Author. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- JoEllen Welsh
- Department of Environmental Health SciencesSUNY Albany Cancer Research CenterRensselaerNYUSA
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12
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Tahir DES, Madiha B, Zia MA. An Ignored Contributing Factor of Vitamin-D Deficiency, despite the Strong Association with Breast Carcinoma among Women in Punjab, Pakistan. Nutr Cancer 2021; 74:1766-1769. [PMID: 34490801 DOI: 10.1080/01635581.2021.1974499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 06/30/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
Pakistani females are at elevated risk of breast cancer, hence there is a need to explore every possible potential contributing factor. The present study was performed to analyze the perception of women about their Vit-D levels in both urban and rural areas. Women included 154 clinically diagnosed breast cancer patients from different hospitals and 248 randomly selected females as control group were recruited from Punjab, Pakistan. Statistical analysis was done using SPSS to find the association of Vit-D deficiency with breast carcinoma in different age groups. Out of a total of 402 respondent, 51.5% were completely ignorant of their Vit-D level. Pearson's Chi- square test for those who had perception about Vit-D deficiency among the breast cancer patients and control group revealed asymptotic 2-sided significance of 0.004 while among different age groups, 41 to 50 years were most prone to deficiency with P = 0.003. Urban women were found to had 12% greater association of Vit-D deficiency as compared to women living in rural areas. It was concluded that Vit-D deficiency is a highly contributing factor for breast cancer so every female must be aware of the importance of Vit-D and should maintain a sufficient level of this crucially important vitamin.
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Affiliation(s)
- Durr-E-Samin Tahir
- Abdus Salam School of Sciences, Nusrat Jahan College, Rabwah, Pakistan
- Department of Biochemistry, University of Agriculture, Faisalabad, Pakistan
| | - Bareah Madiha
- Abdus Salam School of Sciences, Nusrat Jahan College, Rabwah, Pakistan
| | - Muhammad Anjum Zia
- Department of Biochemistry, University of Agriculture, Faisalabad, Pakistan
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13
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Association Between Endemic Vitamin D Deficiency in India and High Prevalence of Poor-Prognosis Triple-Negative Breast Cancer: a Cross-Sectional Study. Indian J Surg 2021. [DOI: 10.1007/s12262-021-03065-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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14
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Association of vitamin D deficiency and insulin resistance with breast cancer in premenopausal Algerian women: A cross-sectional study. ANNALES D'ENDOCRINOLOGIE 2021; 82:597-605. [PMID: 34166649 DOI: 10.1016/j.ando.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/19/2021] [Accepted: 05/03/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND Low 25(OH)D levels are mainly related to breast cancer (BC) risk in postmenopausal women, while the impact of insulin resistance (IR) on BC prognosis is controversial. OBJECTIVE Considering the high prevalence of BC in younger Algerian women, this cross-sectional study analyzed whether vitamin D status and IR are biomarkers for breast tumor status in premenopausal women. METHODS In 96 women (mean age, 40.96±0.65years) newly diagnosed with BC, tumor status was determined immunohistochemically, classified by molecular subtype, then correlated with body-mass index, total plasma 25(OH)D, insulin and glucose levels and HOMA-IR, using chi², Student t, Spearman and ANOVA tests and multivariate logistic regression. RESULTS 66 of the 98 patients (68.75%) showed vitamin D deficiency (9.74ng/mL). Overweight and obese patients with HOMA-IR >2.5, positive for HER2 and with high Ki-67 index had the most severe vitamin D deficiency. There was a significant association between vitamin D deficiency, high Ki-67 index (OR, 14.55; 95% CI, 3.43-82.59; p=0.00078) and IR (OR, 4.99; 95% CI, 1.27-24.47; p=0.03), and between IR and HER2-positivity (OR, 3.23; 95% CI, 1.05-10.56; p=0.04). CONCLUSIONS Vitamin D deficiency and IR are potential biomarkers for poorer prognosis in BC patients, independently of and/or synergically with high Ki-67 index and HER2-positivity in premenopausal overweight or obese women. The potential relationship of vitamin D receptor gene expression with breast cancer survival in Algerian patients will be investigated in a large cohort.
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15
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Li Y, Cook KL, Yu W, Jin L, Bouker KB, Clarke R, Hilakivi-Clarke L. Inhibition of Antiestrogen-Promoted Pro-Survival Autophagy and Tamoxifen Resistance in Breast Cancer through Vitamin D Receptor. Nutrients 2021; 13:nu13051715. [PMID: 34069442 PMCID: PMC8159129 DOI: 10.3390/nu13051715] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 01/07/2023] Open
Abstract
We determined how vitamin D receptor (VDR) is linked to disease outcome in estrogen receptor-positive (ER+) breast cancer patients treated with tamoxifen (TAM). Breast cancer patients (n = 581) in four different datasets were divided into those expressing higher (above median) and lower levels of VDR in pretreatment ER+ tumors. Across all datasets, TAM-treated patients with higher pretreatment tumor VDR expression exhibited significantly longer recurrence-free survival. Ingenuity pathway analysis identified autophagy and unfolded protein response (UPR) as top differentially expressed pathways between high and low VDR-expressing ER+ cancers. Activation of VDR with vitamin D (VitD), either calcitriol or its synthetic analog EB1089, sensitized MCF-7-derived, antiestrogen-resistant LCC9 human breast cancer cells to TAM, and attenuated increased UPR and pro-survival autophagy. Silencing of VDR blocked these effects through the IRE1α-JNK pathway. Further, silencing of VDR impaired sensitivity to TAM in antiestrogen-responsive LCC1 cells, and prevented the effects of calcitriol and EB1089 on UPR and autophagy. In a preclinical mouse model, dietary VitD supplementation induced VDR activation and reduced carcinogen-induced ER+ mammary tumor incidence. In addition, IRE1α-JNK signaling was downregulated and survival autophagy was inhibited in mammary tumors of VitD-supplemented mice. Thus, activation of VDR is predictive of reduced risk of breast cancer recurrence in ER+ patients, possibly by inhibiting antiestrogen-promoted pro-survival autophagy.
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16
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Voutsadakis IA. Vitamin D baseline levels at diagnosis of breast cancer: A systematic review and meta-analysis. Hematol Oncol Stem Cell Ther 2020; 14:16-26. [PMID: 33002425 DOI: 10.1016/j.hemonc.2020.08.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/17/2020] [Accepted: 08/14/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Vitamin D is a steroid hormone that exerts its actions through ligation of the vitamin D receptor (VDR), a transcription factor of the nuclear receptor family. VDR has not only physiologic actions in calcium metabolism but also several other cellular effects through extensive binding to the DNA and modification of genome expression. In cancer, it has neoplasia-suppressive effects and various mechanisms of action mediating cancer cell inhibition have been described. Vitamin D deficiency has been linked to increased risk of breast cancer. A role of the vitamin once the disease has been diagnosed is also probable. METHODS A systematic review and meta-analysis of studies that report on vitamin D levels (in the form of its main circulating metabolite, 25-hydroxyvitamin D [25-OHD]) in patients with newly diagnosed breast cancer was performed. Outcomes of interest included the levels of serum 25-OHD in patients with breast cancer, those of matched controlled, in studies that included controls, as well as respective percentages of patients and controls with deficient and insufficient 25-OHD levels. RESULTS A total of 25 studies (10 with controls and 15 without controls) provided data on the outcomes of interest. Populations from all continents, besides Australia, were represented in the studies. The mean level of 25-OHD in patients with breast cancer was 26.88 ng/mL (95% CI 22.8-30.96 ng/mL) and the mean level of 25-OHD in control patients was 31.41 ng/mL (95% CI 19.31-43.5 ng/mL). In the patients with breast cancer group, 45.28% (95% CI 24.37%-53.51%) had levels of 25-OHD below 20 ng/mL, whereas this percentage was 33.71% (95% CI 21.61%-45.82%) in controls. Similarly, 67.44% (95% CI 48.32%-86.55%) of patients with breast cancer had a baseline level of 25-OHD below 30 ng/mL, whereas this percentage was 33.71% (95% CI 21.61%-45.82%) in controls. CONCLUSION A high prevalence of vitamin D insufficiency is observed in patients with newly diagnosed breast cancer and may be linked pathophysiologically with breast cancer development or progression. Therapeutic benefits may be provided by manipulation of the vitamin D pathway in breast cancer.
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Affiliation(s)
- Ioannis A Voutsadakis
- Algoma District Cancer Program, Sault Area Hospital, Sault Ste. Marie, ON, Canada; Section of Internal Medicine, Division of Clinical Sciences, Northern Ontario School of Medicine, Sudbury, ON, Canada.
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17
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Kim JA, Choi R, Won H, Kim S, Choi HJ, Ryu JM, Lee SK, Yu J, Kim SW, Lee JE, Lee SY. Serum Vitamin Levels and Their Relationships with Other Biomarkers in Korean Breast Cancer Patients. Nutrients 2020; 12:nu12092831. [PMID: 32947849 PMCID: PMC7550996 DOI: 10.3390/nu12092831] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/11/2020] [Accepted: 09/12/2020] [Indexed: 12/23/2022] Open
Abstract
Numerous studies have shown that vitamins reduce the risk of cancers, but the relationship between serum vitamin levels and breast cancer is still controversial. In this study, we evaluated serum levels of vitamins in Korean patients with benign breast disease or breast cancer and investigated their associations with clinical and laboratory parameters. Concentrations of vitamin A, D, and E, together with homocysteine and methylmalonic acid as biomarkers of vitamin B12 deficiency, were measured by high-performance liquid chromatography (HPLC) or liquid chromatography with tandem mass spectrometry (LC-MS/MS) in the serum of 104 breast cancer patients, 62 benign breast disease patients, and 75 healthy Korean females. We further assessed possible associations between vitamin levels and breast cancer subtypes, the presence of lymph node metastasis, and tumor stages. Serum concentrations of vitamins A and E were significantly lower in breast cancer patients and in benign breast disease patients than in healthy controls. Severe vitamin D deficiency was more prevalent in breast cancer patients than in healthy controls. Vitamin D level was significantly lower in breast cancer patients with estrogen receptor-negative or triple-negative subtypes than in those with other subtypes. Further research with a larger study population is required to elucidate the role of vitamins in breast cancer.
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Affiliation(s)
- Jee Ah Kim
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (J.A.K.); (R.C.)
| | - Rihwa Choi
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (J.A.K.); (R.C.)
- Department of Laboratory Medicine, Green Cross Laboratories, Gyeonggi, Yongin 16924, Korea
| | - Hojeong Won
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul 06351, Korea; (H.W.); (S.K.)
| | - Seonwoo Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul 06351, Korea; (H.W.); (S.K.)
| | - Hee Jun Choi
- Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, Korea;
| | - Jai Min Ryu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (J.M.R.); (S.K.L.); (J.Y.); (S.W.K.)
| | - Se Kyung Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (J.M.R.); (S.K.L.); (J.Y.); (S.W.K.)
| | - Jonghan Yu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (J.M.R.); (S.K.L.); (J.Y.); (S.W.K.)
| | - Seok Won Kim
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (J.M.R.); (S.K.L.); (J.Y.); (S.W.K.)
| | - Jeong Eon Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (J.M.R.); (S.K.L.); (J.Y.); (S.W.K.)
- Correspondence: (J.E.L.); (S.-Y.L.); Tel.: +82-2-3410-3479 (J.E.L.); +82-2-3410-1834 (S.-Y.L.); Fax: +82-2-3410-6982 (J.E.L.); +82-2-3410-2719 (S.-Y.L.)
| | - Soo-Youn Lee
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea; (J.A.K.); (R.C.)
- Correspondence: (J.E.L.); (S.-Y.L.); Tel.: +82-2-3410-3479 (J.E.L.); +82-2-3410-1834 (S.-Y.L.); Fax: +82-2-3410-6982 (J.E.L.); +82-2-3410-2719 (S.-Y.L.)
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18
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Patel SR, Patel KD, Patel KR, Gokani RA, Patel JB, Patel PS, Shah FD. Clinical significance of serum 25 hydroxyvitamin D in breast cancer: An Indian scenario. J Steroid Biochem Mol Biol 2020; 202:105726. [PMID: 32682059 DOI: 10.1016/j.jsbmb.2020.105726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 05/20/2020] [Accepted: 07/13/2020] [Indexed: 12/24/2022]
Abstract
Recent evidences suggest a protective mechanism of vitamin D signaling against breast cancer by the autocrine/paracrine manner and may modestly reduce the risk of breast cancer. Despite lots of sunshine, vitamin D deficiency is widespread in India. Moreover, there are limited studies from Indian population regarding circulatory 25(OH) D and breast cancer risk. Thus, the aim of the present study is to investigate circulatory 25(OH) D in relation to breast cancer risk and its association with various clinico-pathological parameters from Indian population. Total 297 subjects, comprising of 157 controls and 140 breast cancer patients were enrolled for the study. Circulatory 25(OH) D was analyzed by HPLC. Statistical analysis was carried out by SPSS software version 15. Further, subjects were categorized into severe, moderate, mild vitamin D deficiency and sufficiency. The prevalence of severe and moderate 25(OH) D deficiency was higher in breast cancer patients as compared to controls. Mean values of 25(OH) D were lower in breast cancer patients as compared to controls in mild, moderate and severe deficient groups (p = 0.07, p = 0.003 and p = 0.001). Moreover, 25(OH) D was significantly lower in postmenopausal breast cancer patients as compared to premenopausal breast cancer patients, particularly in severe deficient group. The levels of 25(OH) D were lower in ER and PR negative receptor status as compared to the positive receptor in severe deficient category (p = 0.06 and p = 0.09 respectively). Whereas, the mean values of 25(OH) D were lower in HER 2 negative receptor status as compared to positive receptor status in the moderate deficient category (p = 0.09). Further, severe deficient group showed significantly lower levels of 25(OH) Din TNBC as compared to luminal A subtype (p = 0.01). Thus, Results indicate that 25(OH) D deficiency might be associated with increased risk of breast cancer. Moreover, severe 25(OH) D deficiency is associated with aggressive behavior of breast cancer.
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Affiliation(s)
- Shruti R Patel
- Biochemistry Research Division, Cancer Biology Department, India
| | - Kinjal D Patel
- Biochemistry Research Division, Cancer Biology Department, India
| | - Kinjal R Patel
- Biochemistry Research Division, Cancer Biology Department, India
| | - Riddhi A Gokani
- Biochemistry Research Division, Cancer Biology Department, India
| | - Jayendra B Patel
- Biochemistry Research Division, Cancer Biology Department, India
| | - Prabhudas S Patel
- Biochemistry Research Division, Cancer Biology Department, India; Cancer Biology Department, The Gujarat Cancer & Research Institute, Ahmedabad, Gujarat, India
| | - Franky D Shah
- Biochemistry Research Division, Cancer Biology Department, India.
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19
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Role of vitamin D 3 in selected malignant neoplasms. Nutrition 2020; 79-80:110964. [PMID: 32877827 DOI: 10.1016/j.nut.2020.110964] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 02/07/2023]
Abstract
Vitamin D3 is a fat-soluble essential nutrient that affects multiple biologic functions in the organism through calcitriol and the vitamin D3 receptor. This review article focuses on the results of studies on the relationship between the level of vitamin D3 and cancer incidence or mortality, but also on the anticancer properties of vitamin D3 that support its significant role in the prevention, clinical course, and overall survival rates of selected cancers (colorectal, prostate, breast, ovarian, endometrial, bladder, and malignant melanoma). The mechanisms of vitamin D3 action involve, among others, polymorphism of vitamin D3 receptor, cell cycle, caspases, and cancer stem cells. The level of vitamin D3 has been also demonstrated to serve as a biomarker in some cancers, and high levels of vitamin D3 can be conducive to successful cancer therapy.
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20
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Blasiak J, Pawlowska E, Chojnacki J, Szczepanska J, Fila M, Chojnacki C. Vitamin D in Triple-Negative and BRCA1-Deficient Breast Cancer-Implications for Pathogenesis and Therapy. Int J Mol Sci 2020; 21:E3670. [PMID: 32456160 PMCID: PMC7279503 DOI: 10.3390/ijms21103670] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 02/08/2023] Open
Abstract
Several studies show that triple-negative breast cancer (TNBC) patients have the lowest vitamin D concentration among all breast cancer types, suggesting that this vitamin may induce a protective effect against TNBC. This effect of the active metabolite of vitamin D, 1α,25-dihydroxyvitamin D3 (1,25(OH)2D), can be attributed to its potential to modulate proliferation, differentiation, apoptosis, inflammation, angiogenesis, invasion and metastasis and is supported by many in vitro and animal studies, but its exact mechanism is poorly known. In a fraction of TNBCs that harbor mutations that cause the loss of function of the DNA repair-associated breast cancer type 1 susceptibility (BRCA1) gene, 1,25(OH)2D may induce protective effects by activating its receptor and inactivating cathepsin L-mediated degradation of tumor protein P53 binding protein 1 (TP53BP1), preventing deficiency in DNA double-strand break repair and contributing to genome stability. Similar effects can be induced by the interaction of 1,25(OH)2D with proteins of the growth arrest and DNA damage-inducible 45 (GADD45) family. Further studies on TNBC cell lines with exact molecular characteristics and clinical trials with well-defined cases are needed to determine the mechanism of action of vitamin D in TNBC to assess its preventive and therapeutic potential.
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Affiliation(s)
- Janusz Blasiak
- Department of Molecular Genetics, Faculty of Biology and Environmental Protection, University of Lodz, 90-236 Lodz, Poland
| | - Elzbieta Pawlowska
- Department of Orthodontics, Medical University of Lodz, 92-216 Lodz, Poland;
| | - Jan Chojnacki
- Department of Clinical Nutrition and Gastroenterological Diagnostics, Medical University of Lodz, 90-647 Lodz, Poland; (J.C.); (C.C.)
| | - Joanna Szczepanska
- Department of Pediatric Dentistry, Medical University of Lodz, 92-216 Lodz, Poland;
| | - Michal Fila
- Department of Neurology, Polish Mother Memorial Hospital Research Institute, 93-338 Lodz, Poland;
| | - Cezary Chojnacki
- Department of Clinical Nutrition and Gastroenterological Diagnostics, Medical University of Lodz, 90-647 Lodz, Poland; (J.C.); (C.C.)
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21
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Shamsi U, Khan S, Azam I, Habib Khan A, Maqbool A, Hanif M, Gill T, Iqbal R, Callen D. A multicenter case control study of association of vitamin D with breast cancer among women in Karachi, Pakistan. PLoS One 2020; 15:e0225402. [PMID: 31967989 PMCID: PMC6975526 DOI: 10.1371/journal.pone.0225402] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 11/04/2019] [Indexed: 12/12/2022] Open
Abstract
Background The prevalence of vitamin D inadequacy and breast cancer are both high among women living in Karachi, Pakistan. Methods A matched case control study was conducted in two hospitals of Karachi, Pakistan to evaluate the association of vitamin D (serum 25-hydroxyvitamin D) concentrations, vitamin D supplementation and sun exposure with breast cancer among Pakistani women. A total of 411 newly diagnosed histologically confirmed primary breast cancer cases were enrolled and 784 controls, free of breast and any other cancers, were matched by age (year of birth ± 5 years), residence in the same geographic area and study site. Information was collected on sociodemographic history, history of vitamin D supplementation, past medical and obstetrical history, family history of breast cancer, sun exposure history, histopathology reports and anthropometric measurement and venous blood was collected to measure serum 25-hydroxyvitamin D (25(OH)D) concentration. Results Compared to patients with sufficient serum vitamin D (>30 ng/ml), women with serum vitamin D deficiency (<20ng/ml), had a higher risk of breast cancer (OR = 1.65, 95%CI: 1.10, 2.50). Women with history of vitamin D supplementation one year prior to enrollment, had significant protective effect against breast cancer (OR = 0.32, 95% CI: 0.24, 0.43). Conclusions and recommendation Serum vitamin D deficiency was associated with increased risk of breast cancer, while vitamin D supplementation was associated with decreased risk of breast cancer. In Pakistani women, where vitamin D deficiency is common, raising and maintaining serum vitamin D at population level is a safe and affordable strategy. It may play a role in reducing the incidence of both vitamin D deficiency and breast cancer, particularly among poor women where the breast cancer mortality is highest due to limited resources for early detection, diagnosis, and treatment. The effects of vitamin D with regard to breast cancer risk in Karachi Pakistan should be further evaluated.
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Affiliation(s)
- Uzma Shamsi
- School of Medicine, University of Adelaide, Adelaide, Australia
- * E-mail:
| | - Shaista Khan
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Iqbal Azam
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Aysha Habib Khan
- Department of Pathology & Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Amir Maqbool
- Department of Oncology, Karachi Institute of Radiation and Nuclear Medicine Hospital (KIRAN), Karachi, Pakistan
| | - Mohammad Hanif
- Department of Oncology, Karachi Institute of Radiation and Nuclear Medicine Hospital (KIRAN), Karachi, Pakistan
| | - Tiffany Gill
- School of Medicine, University of Adelaide, Adelaide, Australia
| | - Romaina Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - David Callen
- School of Medicine, University of Adelaide, Adelaide, Australia
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22
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Song D, Deng Y, Liu K, Zhou L, Li N, Zheng Y, Hao Q, Yang S, Wu Y, Zhai Z, Li H, Dai Z. Vitamin D intake, blood vitamin D levels, and the risk of breast cancer: a dose-response meta-analysis of observational studies. Aging (Albany NY) 2019; 11:12708-12732. [PMID: 31884419 PMCID: PMC6949087 DOI: 10.18632/aging.102597] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/02/2019] [Indexed: 12/24/2022]
Abstract
Epidemiological studies have indicated that blood vitamin D levels are linked to cancer. Here we conducted a dose-response meta-analysis based on published observational studies to evaluate the association of vitamin D intake and blood vitamin D levels with breast cancer susceptibility. PubMed, EMBASE, and Web of Science databases were searched up to January 2019. The pooled odds ratio (OR) and 95% confidence intervals (CIs) were extracted to estimate the risk. We identified 70 relevant studies on blood vitamin D levels (50 studies) and vitamin D intake (20 studies), respectively. Linear and nonlinear trend analyses were performed and showed that an increase in blood vitamin D levels by 5 nmol/l was associated with a 6% decrease in breast cancer risk (OR = 0.94, 95% CI = 0.93-0.96). Similar results were obtained for premenopausal (OR = 0.96, 95% CI = 0.93-0.99) and postmenopausal women (OR = 0.96, 95% CI = 0.94-0.98). The pooled OR of breast cancer risk for a 400IU/day increase in vitamin D intake was 0.97 (95% CI = 0.92-1.02). In conclusion, we found that breast cancer risk was inversely related to blood vitamin D levels; however, no significant association was observed in vitamin D intake.
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Affiliation(s)
- Dingli Song
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yujiao Deng
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Kang Liu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Linghui Zhou
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Na Li
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yi Zheng
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qian Hao
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Si Yang
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ying Wu
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhen Zhai
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hongtao Li
- Department of Breast Head and Neck Surgery, The 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Tumor Hospital), Urumqi, China
| | - Zhijun Dai
- Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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23
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Verma A, Cohen DJ, Schwartz N, Muktipaty C, Koblinski JE, Boyan BD, Schwartz Z. 24R,25-Dihydroxyvitamin D 3 regulates breast cancer cells in vitro and in vivo. Biochim Biophys Acta Gen Subj 2019; 1863:1498-1512. [PMID: 31125679 DOI: 10.1016/j.bbagen.2019.05.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/08/2019] [Accepted: 05/17/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Epidemiological studies indicate high serum 25(OH)D3 is associated with increased survival in breast cancer patients. Pre-clinical studies attributed this to anti-tumorigenic properties of its metabolite 1α,25(OH)2D3. However, 1α,25(OH)2D3 is highly calcemic and thus has a narrow therapeutic window. Here we propose another metabolite, 24R,25(OH)2D3, as an alternative non-calcemic vitamin D3 supplement. METHODS NOD-SCID-IL2γR null female mice with MCF7 breast cancer xenografts in the mammary fat pad were treated with 24R,25(OH)2D3 and changes in tumor burden and metastases were assessed. ERα66+ MCF7 and T47D cells, and ERα66- HCC38 cells were treated with 24R,25(OH)2D3in vitro to assess effects on proliferation and apoptosis. Effects on migration and metastatic markers were assessed in MCF7. RESULTS 24R,25(OH)2D3 reduced MCF7 tumor growth and metastasis in vivo. In vitro results indicate that this was not due to an anti-proliferative effect; 24R,25(OH)2D3 stimulated DNA synthesis in MCF7 and T47D. In contrast, markers of invasion and metastasis were decreased. 24R,25(OH)2D3 caused dose-dependent increases in apoptosis in MCF7 and T47D, but not HCC38 cells. Inhibitors to palmitoylation, caveolae integrity, phospholipase-D, and estrogen receptors (ER) demonstrate that 24R,25(OH)2D3 acts on MCF7 cells through caveolae-associated, phospholipase D-dependent mechanisms via cross-talk with ERs. CONCLUSION These results indicate that 24R,25(OH)2D3 shows promise in treatment of breast cancer by stimulating tumor apoptosis and reducing metastasis. GENERAL SIGNIFICANCE 24R,25(OH)2D3 regulates breast cancer cell survival through ER-associated mechanisms similar to 24R,25(OH)2D3 effects on chondrocytes. Thus, 24R,25(OH)2D3 may modulate cell survival in other estrogen-responsive cell types, and its therapeutic potential should be investigated in ER-associated pathologies.
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Affiliation(s)
- Anjali Verma
- Department of Biomedical Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, USA.
| | - D Joshua Cohen
- Department of Biomedical Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, USA.
| | - Nofrat Schwartz
- Department of Otolaryngology, Meir Hospital, Tchernichovsky St 59, Kfar Saba 4428164, Israel; Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel; Department of Otolaryngology/Head and Neck Surgery, University of North Caroline Chapel Hill, 170 Manning Drive, Chapel Hill, NC 27599, USA
| | - Chandana Muktipaty
- Department of Biomedical Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, USA.
| | - Jennifer E Koblinski
- Department of Pathology, Virginia Commonwealth University, 401 N 13th Street, Richmond, VA 23298, USA; Massey Cancer Center, 401 College Street, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Barbara D Boyan
- Department of Biomedical Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, USA; Massey Cancer Center, 401 College Street, Virginia Commonwealth University, Richmond, VA 23298, USA; Wallace H. Coulter Department of Biomedical Engineering, 313 Ferst Drive NW, Georgia Institute of Technology, Atlanta, VA, USA.
| | - Zvi Schwartz
- Department of Biomedical Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, USA; Department of Periodontics, University of Texas Health Science Center at San Antonio, 8210 Floyd Curl Drive, San Antonio, TX 78229, USA.
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24
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Oskooei VK, Ghafouri-Fard S. Are long non-coding RNAs involved in the interaction circuit between estrogen receptor and vitamin D receptor? Meta Gene 2019. [DOI: 10.1016/j.mgene.2018.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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25
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Kok DE, van den Berg MMGA, Posthuma L, van 't Erve I, van Duijnhoven FJB, de Roos WK, Grosfeld S, Los M, Sommeijer DW, van Laarhoven HWM, Winkels RM, Kampman E. Changes in Circulating Levels of 25-hydroxyvitamin D3 in Breast Cancer Patients Receiving Chemotherapy. Nutr Cancer 2019; 71:756-766. [PMID: 30661404 DOI: 10.1080/01635581.2018.1559938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cancer treatments, toxicities and their effects on lifestyle, may impact levels of vitamin D. The aim of this study was to determine serum 25-hydroxyvitamin D3 (25(OH)D3) levels before, directly after and 6 months after chemotherapy in breast cancer patients (n = 95), and a comparison group of women (n = 52) not diagnosed with cancer. Changes in 25(OH)D3 levels over time were compared using linear mixed models adjusted for age and season of blood sampling. Before start of chemotherapy, 25(OH)D3 levels were lower in patients (estimated marginal mean 55.8 nmol/L, 95% confidence interval (95%CI) 51.2-60.4) compared to the comparison group (67.2 nmol/L, 95%CI 61.1-73.3, P = 0.003). Directly after chemotherapy, 25(OH)D3 levels were slightly decreased (-5.1 nmol/L, 95%CI -10.7-0.5, P = 0.082), but ended up higher 6 months after chemotherapy (10.9 nmol/L, 95%CI 5.5-16.4, P < 0.001) compared to pre-chemotherapy values. In women without cancer, 25(OH)D3 levels remained stable throughout the study. Use of dietary supplements did not explain recovery of 25(OH)D3 levels after chemotherapy. We reported lower 25(OH)D3 levels in breast cancer patients, which decreased during chemotherapy, but recovered to levels observed in women without cancer within 6 months after chemotherapy. Suboptimal 25(OH)D3 levels in the majority of the participants highlight the relevance of monitoring in this vulnerable population.
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Affiliation(s)
- Dieuwertje E Kok
- a Division of Human Nutrition and Health , Wageningen University & Research , Wageningen , the Netherlands
| | - Maaike M G A van den Berg
- a Division of Human Nutrition and Health , Wageningen University & Research , Wageningen , the Netherlands
| | - Liesbeth Posthuma
- a Division of Human Nutrition and Health , Wageningen University & Research , Wageningen , the Netherlands
| | - Iris van 't Erve
- a Division of Human Nutrition and Health , Wageningen University & Research , Wageningen , the Netherlands
| | - Fränzel J B van Duijnhoven
- a Division of Human Nutrition and Health , Wageningen University & Research , Wageningen , the Netherlands
| | - Wilfred K de Roos
- b Department of Surgery , Hospital Gelderse Vallei , the Netherlands
| | | | - Maartje Los
- d Department of Medical Oncology, St. Antonius Hospital , Nieuwegein , the Netherlands
| | - Dirkje W Sommeijer
- e Department of Medical Oncology, Flevohospital , Almere , the Netherlands.,f Department of Medical Oncology , Academic Medical Center , Amsterdam , the Netherlands
| | | | - Renate M Winkels
- a Division of Human Nutrition and Health , Wageningen University & Research , Wageningen , the Netherlands.,g Department of Public Health Sciences, Penn State College of Medicine , Hershey , Pennsylvania , USA
| | - Ellen Kampman
- a Division of Human Nutrition and Health , Wageningen University & Research , Wageningen , the Netherlands
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Lope V, Castelló A, Mena-Bravo A, Amiano P, Aragonés N, Fernández-Villa T, Guevara M, Dierssen-Sotos T, Fernandez-Tardón G, Castaño-Vinyals G, Marcos-Gragera R, Moreno V, Salas-Trejo D, Diaz-Santos M, Oribe M, Romieu I, Kogevinas M, Priego-Capote F, Pérez-Gómez B, Pollán M. Serum 25-hydroxyvitamin D and breast cancer risk by pathological subtype (MCC-Spain). J Steroid Biochem Mol Biol 2018; 182:4-13. [PMID: 29679754 DOI: 10.1016/j.jsbmb.2018.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 04/13/2018] [Indexed: 12/14/2022]
Abstract
Epidemiologic evidence on the association between vitamin D and breast cancer is still inconclusive. This study analyzes the association between serum 25-hydroxyvitamin D (25(OH)D) and breast cancer risk by pathologic subtype, stage at diagnosis and specific breast cancer risk factors. We conducted a population-based multicase-control study where 546 histologically-confirmed breast cancer cases and 558 population controls, frequently matched by geographic area, age and body mass index, were recruited in 12 Spanish provinces (MCC-Spain). Information was collected by a questionnaire and plasma 25(OH)D was measured by solid-phase extraction on-line coupled to liquid chromatography-tandem mass spectrometry (SPE-LC-MS/MS). Odds ratios and 95% confidence intervals were calculated using logistic and multinomial mixed regression models. We found a clear protective effect between 25(OH)D levels and breast cancer risk, with a significant dose-response trend (OR per 10 nmol/L = 0.88; 95%CI = 0.82-0.94). While no differences were observed between pre and postmenopausal women, stage at diagnosis, or across strata of the main breast cancer risk factors, the protection was more pronounced for triple negative tumors (OR per 10 nmol/L = 0.64; p-heterogeneity = 0.038). Similar results were observed when only cases sampled in the first month after diagnosis were considered. The protective effect of vitamin D on breast cancer risk may be subtype specific, being stronger for more aggressive tumors, which provides a new approach to prevent this disease.
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Affiliation(s)
- Virginia Lope
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Adela Castelló
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Antonio Mena-Bravo
- Department of Analytical Chemistry, University of Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Spain
| | - Pilar Amiano
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Public Health Division of Gipuzkoa, BioDonostia Research institute, San Sebastian, Spain
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health of Madrid, Spain
| | - Tania Fernández-Villa
- Área de Medicina Preventiva y Salud Pública, Departamento de Ciencias Biomédicas, Universidad de León, León, Spain; Grupo de Investigación en Interacciones Gen-Ambiente y Salud (GIIGAS), Universidad de León, León, Spain
| | - Marcela Guevara
- Early Detection Section, Public Health Institute of Navarra, Pamplona, Spain
| | - Trinidad Dierssen-Sotos
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; University of Cantabria - IDIVAL, Santander, Spain
| | | | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute (IdiBGi), Girona, Spain
| | - Víctor Moreno
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Campus de Bellvitge, L'Hospitalet del Llobregat, Spain; Unit of Biomarkers and Susceptibility, Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO), IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Dolores Salas-Trejo
- Valencia Breast Cancer Screening Program, General Directorate Public Health, Valencia, Spain
| | - Marian Diaz-Santos
- Universidad de Huelva, Huelva, Spain; Centro de Investigación en Salud y Medio Ambiente (CYSMA), Huelva, Spain
| | - Madalen Oribe
- Public Health Division of Gipuzkoa, BioDonostia Research institute, San Sebastian, Spain
| | - Isabel Romieu
- Center for Research on Population Health, National Institute of Public Health, Mexico; Hubert Department of Global Health, Emory University, Atlanta, GA, USA
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Feliciano Priego-Capote
- Department of Analytical Chemistry, University of Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Spain
| | - Beatriz Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Marina Pollán
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.
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27
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Viala M, Chiba A, Thezenas S, Delmond L, Lamy PJ, Mott SL, Schroeder MC, Thomas A, Jacot W. Impact of vitamin D on pathological complete response and survival following neoadjuvant chemotherapy for breast cancer: a retrospective study. BMC Cancer 2018; 18:770. [PMID: 30060745 PMCID: PMC6066931 DOI: 10.1186/s12885-018-4686-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 07/22/2018] [Indexed: 12/31/2022] Open
Abstract
Background There has been interest in the potential benefit of vitamin D (VD) to improve breast cancer outcomes. Pre-clinical studies suggest VD enhances chemotherapy-induced cell death. Vitamin D deficiency was associated with not attaining a pathologic complete response (pCR) following neoadjuvant chemotherapy (NAC) for operable breast cancer. We report the impact of VD on pCR and survival in an expanded cohort. Methods Patients from Iowa and Montpellier registries who had serum VD level measured before or during NAC were included. Vitamin D deficiency was defined as < 20 ng/mL. Pathological complete response was defined as no residual invasive disease in the breast and lymph nodes. Survival was defined from the date of diagnosis to the date of relapse (PFS) or date of death (OS). Results The study included 327 women. Vitamin D deficiency was associated with the odds of not attaining pCR (p = 0.04). Fifty-four patients relapsed and 52 patients died. In multivariate analysis, stage III disease, triple-negative (TN) subtype and the inability to achieve pCR were independently associated with inferior survival. Vitamin D deficiency was not significantly associated with survival in the overall sample; however a trend was seen in the TN (5-years PFS 60.4% vs. 72.3%, p = 0.3), and in the hormone receptor positive /human epidermal growth factor receptor 2 negative (HER2-) subgroups (5-years PFS 89% vs 78%, p = 0.056). Conclusion Vitamin D deficiency is associated with the inability to reach pCR in breast cancer patients undergoing NAC. Electronic supplementary material The online version of this article (10.1186/s12885-018-4686-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marie Viala
- Department of Medical Oncology, Institut Régional Du Cancer de Montpellier ICM, 208 Avenue des Apothicaires, Cedex-5 34298, Montpellier, France.
| | - Akiko Chiba
- Division of Surgical Oncology, Department of Surgery, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Simon Thezenas
- Biometry unit, Institut Régional Du Cancer de Montpellier ICM, Montpellier, France
| | - Laure Delmond
- Department of Surgical Oncology, Institut Régional Du Cancer de Montpellier ICM, Montpellier, France
| | | | - Sarah L Mott
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, USA
| | | | - Alexandra Thomas
- Department of Internal Medicine Wake Forest University School of Medicine, Winston-Salem, USA
| | - William Jacot
- Department of Medical Oncology, Institut Régional Du Cancer de Montpellier ICM, 208 Avenue des Apothicaires, Cedex-5 34298, Montpellier, France
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28
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McDonnell SL, Baggerly CA, French CB, Baggerly LL, Garland CF, Gorham ED, Hollis BW, Trump DL, Lappe JM. Breast cancer risk markedly lower with serum 25-hydroxyvitamin D concentrations ≥60 vs <20 ng/ml (150 vs 50 nmol/L): Pooled analysis of two randomized trials and a prospective cohort. PLoS One 2018; 13:e0199265. [PMID: 29906273 PMCID: PMC6003691 DOI: 10.1371/journal.pone.0199265] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 06/01/2018] [Indexed: 12/12/2022] Open
Abstract
Background While numerous epidemiologic studies have found an association between higher serum 25-hydroxyvitamin D [25(OH)D] concentrations and lower breast cancer risk, few have assessed this association for concentrations >40 ng/ml. Objective To investigate the relationship between 25(OH)D concentration and breast cancer risk across a broad range of 25(OH)D concentrations among women aged 55 years and older. Methods Analyses used pooled data from two randomized clinical trials (N = 1129, N = 2196) and a prospective cohort (N = 1713) to examine a broad range of 25(OH)D concentrations. The outcome was diagnosis of breast cancer during the observation periods (median: 4.0 years). Three analyses were conducted: 1) Incidence rates were compared according to 25(OH)D concentration from <20 to ≥60 ng/ml (<50 to ≥150 nmol/L), 2) Kaplan-Meier plots were developed and 3) multivariate Cox regression was used to examine the association between 25(OH)D and breast cancer risk using multiple 25(OH)D measurements. Results Within the pooled cohort (N = 5038), 77 women were diagnosed with breast cancer (age-adjusted incidence: 512 cases per 100,000 person-years). Results were similar for the three analyses. First, comparing incidence rates, there was an 82% lower incidence rate of breast cancer for women with 25(OH)D concentrations ≥60 vs <20 ng/ml (Rate Ratio = 0.18, P = 0.006). Second, Kaplan-Meier curves for concentrations of <20, 20–39, 40–59 and ≥60 ng/ml were significantly different (P = 0.02), with the highest proportion breast cancer-free in the ≥60 ng/ml group (99.3%) and the lowest proportion breast cancer-free in the <20 ng/ml group (96.8%). The proportion with breast cancer was 78% lower for ≥60 vs <20 ng/ml (P = 0.02). Third, multivariate Cox regression revealed that women with 25(OH)D concentrations ≥60 ng/ml had an 80% lower risk of breast cancer than women with concentrations <20 ng/ml (HR = 0.20, P = 0.03), adjusting for age, BMI, smoking status, calcium supplement intake, and study of origin. Conclusions Higher 25(OH)D concentrations were associated with a dose-response decrease in breast cancer risk with concentrations ≥60 ng/ml being most protective.
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Affiliation(s)
| | | | | | - Leo L. Baggerly
- GrassrootsHealth, Encinitas, California, United States of America
| | - Cedric F. Garland
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Edward D. Gorham
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Bruce W. Hollis
- Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Donald L. Trump
- Inova Schar Cancer Institute, Falls Church, Virginia, United States of America
| | - Joan M. Lappe
- Department of Medicine, Creighton University, Omaha, Nebraska, United States of America
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29
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Vitamin D exposure and Risk of Breast Cancer: a meta-analysis. Sci Rep 2018; 8:9039. [PMID: 29899554 PMCID: PMC5997996 DOI: 10.1038/s41598-018-27297-1] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 05/29/2018] [Indexed: 12/31/2022] Open
Abstract
The relationship between vitamin D and breast cancer is still controversial. The present meta-analysis examines the effects of the 25(OH)D, 1,25(OH)2D and vitamin D intake on breast cancer risk. For this purpose, a PubMed, Scopus and Web of Science-databases search was conducted including all papers published with the keywords “breast cancer” and “vitamin D” with at least one reported relative risk (RR) or odds ratio (OR). In total sixty eight studies published between 1998 and 2018 were analyzed. Information about type of study, hormonal receptors and menopausal status was retrieved. Pooled OR or RR were estimated by weighting individual OR/RR by the inverse of their variance Our study showed a protective effect between 25 (OH) D and breast cancer in both cohort studies (RR = 0.85, 95%CI:0.74–0.98) and case-control studies (OR = 0.65, 95%CI: 0.56–0.76). However, analyzing by menopausal status, the protective vitamin D – breast cancer association persisted only in the premenopausal group (OR = 0.67, 95%CI: 0.49–0.92) when restricting the analysis to nested case-control studies. No significant association was found for vitamin D intake or 1,25(OH)2D. Conclusion: This systematic review suggests a protective relationship between circulating vitamin D (measured as 25(OH) D) and breast cancer development in premenopausal women.
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30
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Mizrak Kaya D, Ozturk B, Kubilay P, Onur H, Utkan G, Cay Senler F, Alkan A, Yerlikaya H, Koksoy EB, Karci E, Demirkazik A, Akbulut H, Icli F. Diagnostic serum vitamin D level is not a reliable prognostic factor for resectable breast cancer. Future Oncol 2018; 14:1461-1467. [DOI: 10.2217/fon-2017-0608] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Aim: There are inconsistent results about the effects of vitamin D level on breast cancer prognosis. We aimed to investigate the effect of vitamin D levels on the prognosis of resectable breast cancer in a patient group with highly different clothing styles. Patients & methods: A total of 186 breast cancer patients were enrolled in the study. Results: Vitamin D level was sufficient, insufficient and deficient in 17.2, 52.2 and 30.6% of patients, respectively. There was a significant relationship between clothing style and serum 25 (OH) D levels. We could not establish any relation between vitamin D level and tumor characteristics or survival. Conclusion: Vitamin D supplementation can be more important than diagnostic serum vitamin D level on prognosis of breast cancer.
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Affiliation(s)
- Dilsa Mizrak Kaya
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
- MD Anderson Cancer Center, The University of Texas, Houston, Texas 77030, USA
| | - Bengi Ozturk
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - Pinar Kubilay
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - Handan Onur
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - Gungor Utkan
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - Filiz Cay Senler
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - Ali Alkan
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - Halis Yerlikaya
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - Elif B Koksoy
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - Ebru Karci
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - Ahmet Demirkazik
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - Hakan Akbulut
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
| | - Fikri Icli
- Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey
- Department of Medical Oncology, Ufuk University School of Medicine, Ankara 06830, Turkey
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31
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Hu K, Callen DF, Li J, Zheng H. Circulating Vitamin D and Overall Survival in Breast Cancer Patients: A Dose-Response Meta-Analysis of Cohort Studies. Integr Cancer Ther 2018; 17:217-225. [PMID: 28589744 PMCID: PMC6041929 DOI: 10.1177/1534735417712007] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 04/02/2017] [Accepted: 04/14/2017] [Indexed: 12/28/2022] Open
Abstract
Studies have shown that vitamin D could have a role in breast cancer survival; however, the evidence of the relationship between patients' vitamin D levels and their survival has been inconsistent. This meta-analysis explores possible dose-response relationships between vitamin D levels and overall survival by allowing for differences in vitamin D levels among populations of the various studies. Studies relating vitamin D (25-OH-D [25-hydroxyvitamin D]) levels in breast cancer patients with their survival were identified by searching PubMed and Embase. A pooled HR (hazard ratio) comparing the highest with the lowest category of circulating 25-OH-D levels were synthesized using the Mantel-Haenszel method under a fixed-effects model. A two-stage fixed-effects dose-response model including both linear (a log-linear dose-response regression) and nonlinear (a restricted cubic spline regression) models were used to further explore possible dose-response relationships. Six studies with a total number of 5984 patients were identified. A pooled HR comparing the highest with the lowest category of circulating 25-OH-D levels under a fixed-effects model was 0.67 (95% confidence interval = 0.56-0.79, P < .001). Utilizing a dose-response meta-analysis, the pooled HR for overall survival in breast cancer patients was 0.994 (per 1 nmol/L), Pfor linear trend < .001. At or above a 23.3 nmol/L threshold, for a 10 nmol/L, 20 nmol/L, or 25 nmol/L increment in circulating 25-OH-D levels, the risk of breast cancer overall mortality decreased by 6%, 12%, and 14%, respectively. There was no significant nonlinearity in the relationship between overall survival and circulating 25-OH-D levels. Our findings suggest that there is a highly significant linear dose-response relationship between circulating 25-OH-D levels and overall survival in patients with breast cancer. However, better designed prospective cohort studies and clinical trials are needed to further confirm these findings.
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Affiliation(s)
- Kejia Hu
- Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | | | - Jiayuan Li
- Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Hong Zheng
- Sichuan University, Chengdu, Sichuan, People’s Republic of China
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Tommie JL, Pinney SM, Nommsen-Rivers LA. Serum Vitamin D Status and Breast Cancer Risk by Receptor Status: A Systematic Review. Nutr Cancer 2018; 70:804-820. [PMID: 29781719 DOI: 10.1080/01635581.2018.1470653] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The association between vitamin D status and breast cancer risk is equivocal. No systematic reviews or meta-analyses have examined this association stratified by receptor status. Our objective is to conduct a systematic review to answer the question, "Is there a relationship between lower serum/plasma vitamin D levels and increased risk of triple negative breast cancer (TNBC) specifically?" METHODS We systematically searched Embase and PubMed databases for published original research studies examining the risk of a breast cancer diagnosis according to vitamin D status. We excluded studies that did not provide risk estimates stratified by receptor status. RESULTS Fourteen studies met our criteria, including case-control, nested case-control, and case-series studies, reflecting the cumulative results of 13,135 breast cancer cases. When grouped by relevancy to TNBC, the proportion of analyses across all study types showing a significant association between vitamin D status and breast cancer diagnosis was 37% for non-TNBC analyses, 48% for analyses that included some TNBC cases, and 88% for TNBC analyses. CONCLUSIONS Our results suggest that low vitamin D status may particularly increase the risk of TNBC, although more research is needed to determine if this association is causative. Women should be routinely screened for 25(OH)D deficiency.
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Affiliation(s)
- Jessica L Tommie
- a Department of Rehabilitation, Exercise, and Nutritional Sciences , College of Allied Health Sciences, University of Cincinnati , Cincinnati , Ohio , USA
| | - Susan M Pinney
- b Department of Environmental Health , College of Medicine, University of Cincinnati , Cincinnati , Ohio , USA
| | - Laurie A Nommsen-Rivers
- a Department of Rehabilitation, Exercise, and Nutritional Sciences , College of Allied Health Sciences, University of Cincinnati , Cincinnati , Ohio , USA
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Chiba A, Raman R, Thomas A, Lamy PJ, Viala M, Pouderoux S, Mott SL, Schroeder MC, Thezenas S, Jacot W. Serum Vitamin D Levels Affect Pathologic Complete Response in Patients Undergoing Neoadjuvant Systemic Therapy for Operable Breast Cancer. Clin Breast Cancer 2017; 18:144-149. [PMID: 29290565 DOI: 10.1016/j.clbc.2017.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 09/27/2017] [Accepted: 12/01/2017] [Indexed: 11/15/2022]
Abstract
INTRODUCTION There has been increasing interest in the potential benefit of vitamin D in improving breast cancer outcome. Preclinical studies suggest that vitamin D enhances chemotherapy-induced cell death. We investigated the impact of serum vitamin D levels during neoadjuvant chemotherapy (NAC) on the rates of achieving pathologic complete response (pCR) after breast cancer NAC. PATIENTS AND METHODS Patients from 1 of 2 Iowa registries who had serum vitamin D level measured before or during NAC were included. French patients enrolled onto a previous study of the impact of NAC on vitamin D and bone metabolism were also eligible for this study. Vitamin D deficiency was defined as < 20 ng/mL. pCR was defined as no residual invasive disease in breast and lymph nodes. A Firth penalized logistic regression multivariable model was used. RESULTS The study included 144 women. There was no difference between the French and Iowan cohorts with regard to age at diagnosis (P = .20), clinical stage (P = .22), receptor status (P = .32), and pCR rate (P = .34). French women had lower body mass index (mean 24.8 vs. 28.8, P < .01) and lower vitamin D levels (mean 21.5 vs. 27.5, P < .01) compared to Iowan patients. In multivariable analysis, after adjusting for the effects of cohort, clinical stage, and receptor status, vitamin D deficiency increased the odds of not attaining pCR by 2.68 times (95% confidence interval, 1.12-6.41, P = .03). CONCLUSION Low serum vitamin D levels were associated with not attaining a pCR. Prospective trials could elucidate if maintaining vitamin D levels during NAC, a highly modifiable variable, may be utilized to improve cancer outcomes.
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Affiliation(s)
- Akiko Chiba
- Division of Surgical Oncology, Department of Surgery, Wake Forest University School of Medicine, Winston-Salem, NC
| | | | - Alexandra Thomas
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Pierre-Jean Lamy
- Department of Medical Oncology, Institut Régional Du Cancer de Montpellier ICM, Montpellier, France
| | - Marie Viala
- Department of Medical Oncology, Institut Régional Du Cancer de Montpellier ICM, Montpellier, France
| | - Stephane Pouderoux
- Department of Medical Oncology, Institut Régional Du Cancer de Montpellier ICM, Montpellier, France
| | - Sarah L Mott
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA
| | | | - Simon Thezenas
- Biometry Unit, Institut Régional Du Cancer de Montpellier ICM, Montpellier, France
| | - William Jacot
- Department of Medical Oncology, Institut Régional Du Cancer de Montpellier ICM, Montpellier, France.
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de Sousa Almeida-Filho B, De Luca Vespoli H, Pessoa EC, Machado M, Nahas-Neto J, Nahas EAP. Vitamin D deficiency is associated with poor breast cancer prognostic features in postmenopausal women. J Steroid Biochem Mol Biol 2017; 174:284-289. [PMID: 29031688 DOI: 10.1016/j.jsbmb.2017.10.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 10/01/2017] [Accepted: 10/10/2017] [Indexed: 12/22/2022]
Abstract
This study aimed to evaluate the association between pretreatment vitamin D (VD) deficiency with breast cancer prognostic features in Brazilian postmenopausal women. An analytical cross sectional study was conducted with 192 women, aged 45-75 years, attended at University Hospital. Women with recent diagnosis of breast cancer, in amenorrhea >12months and age ≥45 years, without medication use or clinical conditions that interfere with VD values were included. Clinical and anthropometric data were collected. Serum level of 25 hydroxyvitamin D [25(OH)D] was measured in all patients until 20days after breast cancer diagnosis, and was classified as normal (≥30ng/mL), insufficiency (20-29ng/mL) and deficiency (<20ng/mL). Data on breast cancer (histopathological type, grade, tumor stage, lymph node status), hormone status (estrogen receptor, ER, progesterone receptor, PR), human epidermal growth factor receptor type 2 (HER2) and epithelial proliferative activity (Ki-67) were collected. For statistical analysis, the t-student test, the Gamma Distribution (asymmetric variables), the chi-square test and the logistic regression (OR-odds ratio) were used. The median 25(OH)D level was 25.8ng/mL (range 12.0-59.2ng/mL). Sufficient vitamin D levels were detected in 65 patients (33.9%), whereas insufficient levels in 92 patients (47.9%), and deficient levels in 35 patients (18.2%). Participants with insufficient and deficient 25(OH)D levels had a higher proportion of tumors with a high grade and locally advanced and metastatic disease, more positive lymph node, a lower proportion of ER, PR positives tumors and higher Ki-67(p<0.05). Patients with normal vitamin D had a higher frequency of luminal A (47.7%) and luminal B (32.2%) tumors when compared to patients with vitamin D insufficiency or deficiency. Furthermore, all cases of triple negative were detected in women with low VD levels. Multivariate analysis, after adjusting for age, time since menopause and BMI, showed that insufficient and deficient level of vitamin D were significantly associated with negative estrogen receptor (OR 3.77 CI 95% 1.76-8.09 and OR 3.99 CI 95% 1.83-8.68), high Ki-67 (OR 2.50, CI 95% 1.35-4.63, and OR 2.62, CI 95% 1.40-4.98), and positive axillary lymph node status (OR 1.59, CI 95% 1.03-2.33, and OR 1.58, CI 95% 1.02-2.92) respectively. In Brazilian postmenopausal women with breast cancer, there was an association between vitamin D insufficiency or deficiency and tumors with worse prognostic features. Low vitamin D levels were shown to be a risk factor for ER negative tumors, with positive axilla and a higher rate of cell proliferation.
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Affiliation(s)
| | - Heloisa De Luca Vespoli
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil
| | - Eduardo Carvalho Pessoa
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil
| | - Murilo Machado
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil
| | - Jorge Nahas-Neto
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil
| | - Eliana Aguiar Petri Nahas
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil.
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Wu Y, Sarkissyan M, Clayton S, Chlebowski R, Vadgama JV. Association of Vitamin D3 Level with Breast Cancer Risk and Prognosis in African-American and Hispanic Women. Cancers (Basel) 2017; 9:cancers9100144. [PMID: 29064397 PMCID: PMC5664083 DOI: 10.3390/cancers9100144] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 09/22/2017] [Accepted: 10/19/2017] [Indexed: 12/11/2022] Open
Abstract
Background: This study investigated the association of vitamin D3 levels with breast cancer risk and progression in African-Americans and Hispanics. Methods: A total of 237 African-American (Cases = 119, Control = 118) and 423 Hispanic women (Cases = 124, Control = 299) were recruited in the study. Blood samples were collected at the time of breast cancer screening and prior to cancer treatment for 4 weeks on average for the cases. The serum 25-hydroxyvitamin D (25(OH)D3) was measured at a Quest-Diagnostics facility. Results: The results showed that 69.2% of African-Americans and 37.8% of Hispanics had 25(OH)D3 levels below 20 ng/mL. The 25(OH)D3 level below 20 ng/mL was significantly associated with breast cancer in both African-Americans (OR = 2.5, 95% CI = 1.3-4.8) and Hispanics (OR = 1.9, 95% CI = 1.1-3.0). However, the predicted probabilities of breast cancer in African-Americans were significantly higher than in Hispanics (p < 0.001). The 25(OH)D3 below 20 ng/mL was significantly associated with triple negative breast cancer (TNBC) in African-Americans (OR = 5.4, p = 0.02, 95% CI = 1.4-15), but not in Hispanics in our cohort of participants. Levels of 25(OH)D3 below 26 ng/mL predicts a decrease in disease-free survival, but it was not an independent predictor. Conclusions: Our data shows an association between 25(OH)D3 levels and the risk of breast cancer. Further studies on the relationship between 25(OH)D3 level and breast cancer risk are warranted.
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Affiliation(s)
- Yanyuan Wu
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, CA 90059, USA.
- Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA.
| | - Marianna Sarkissyan
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, CA 90059, USA.
| | - Sheilah Clayton
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, CA 90059, USA.
| | - Rowan Chlebowski
- Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA.
- Harbor UCLA Medical Center, Torrance, CA 90509, USA.
| | - Jaydutt V Vadgama
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, CA 90059, USA.
- Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA.
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Phytotherapy and Nutritional Supplements on Breast Cancer. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7207983. [PMID: 28845434 PMCID: PMC5563402 DOI: 10.1155/2017/7207983] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/14/2017] [Accepted: 06/18/2017] [Indexed: 02/07/2023]
Abstract
Breast cancer is the most frequent type of nonskin malignancy among women worldwide. In general, conventional cancer treatment options (i.e., surgery, radiotherapy, chemotherapy, biological therapy, and hormone therapy) are not completely effective. Recurrence and other pathologic situations are still an issue in breast cancer patients due to side effects, toxicity of drugs in normal cells, and aggressive behaviour of the tumours. From this point of view, breast cancer therapy and adjuvant methods represent a promising and challenging field for researchers. In the last few years, the use of some types of complementary medicines by women with a history of breast cancer has significantly increased such as phytotherapeutic products and nutritional supplements. Despite this, the use of such approaches in oncologic processes may be problematic and patient's health risks can arise such as interference with the efficacy of standard cancer treatment. The present review gives an overview of the most usual phytotherapeutic products and nutritional supplements with application in breast cancer patients as adjuvant approach. Regardless of the contradictory results of scientific evidence, we demonstrated the need to perform additional investigation, mainly well-designed clinical trials in order to establish correlations and allow for further validated outcomes concerning the efficacy, safety, and clinical evidence-based recommendation of these products.
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Moukayed M, Grant WB. The roles of UVB and vitamin D in reducing risk of cancer incidence and mortality: A review of the epidemiology, clinical trials, and mechanisms. Rev Endocr Metab Disord 2017; 18:167-182. [PMID: 28213657 DOI: 10.1007/s11154-017-9415-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Global cancer incidence and mortality rates are high and increasing. Thus, it is imperative to find novel solutions to preventing cancer incidence and treating it at an affordable yet efficacious manner. The solar UVB-vitamin D-cancer hypothesis was first proposed in 1980 based on a geographical ecological study. Since then, numerous ecological and observational studies as well as studies of mechanisms have provided support for the hypothesis. However, observational studies have not provided consistent support, in part due to using a single blood draw from any season to use for serum 25-hydroxyvitamin D [25(OH)D] concentration in prospective studies with long follow-up times. Case-controls studies, in which blood is drawn near time of diagnosis, and prospective studies in which blood is drawn in the sunnier half of the year, are more likely to find significant inverse relations between 25(OH)D and cancer incidence. Three vitamin D plus calcium clinical trials have found significant reduction in all-cancer incidence. This paper reviews the evidence for vitamin D in reducing incidence of and increasing survival from breast, colorectal, lung, ovarian, pancreatic, and prostate cancer. The epidemiological evidence provides strong support for all of these types of cancer except for non-aggressive prostate cancer. Studies of the cellular mechanisms of vitamin D action in different cancer cell types, strongly indicate that vitamin D can exert protective and anti-tumorigenic activities that would retard cellular transformation, hyperplasia and cancer progression. Based on the scientific evidence reviewed in this paper, individuals and health providers can consider increasing 25(OH)D concentrations through sensible sun exposure and/or vitamin D supplementation to reduce risk of and, in conjunction with standard care, treat cancer. Public health acceptance of vitamin D for cancer prevention and treatment requires stronger support from vitamin D clinical trials.
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Affiliation(s)
- Meis Moukayed
- School of Arts and Sciences, American University in Dubai, P.O. Box 28282, Dubai, United Arab Emirates
| | - William B Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA, 94164-1603, USA.
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Pretreatment Serum Concentration of Vitamin D and Breast Cancer Characteristics: A Prospective Observational Mediterranean Study. Clin Breast Cancer 2017; 17:559-563. [PMID: 28601383 DOI: 10.1016/j.clbc.2017.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 04/26/2017] [Accepted: 05/14/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND Recent studies of the correlation between breast cancer (BC) and vitamin D yielded contrasting results. Although preclinical and clinical evidence has implicated vitamin D in BC prevention and outcome, little is known about the link between vitamin D and specific BC histologically defined subtypes. In the attempt to clarify this association we correlated vitamin D levels with BC characteristics. PATIENTS AND METHODS We enrolled 220 pre- and postmenopausal women with early BC in this prospective observational trial. Data on the patients' clinical and specific BC pathological characteristics were collected and related to vitamin D levels, stratified in deficient (< 20 ng/mL), insufficient (20-30 ng/mL), and sufficient (> 30 ng/mL). BC subtypes were defined according to the 14th St Gallen Breast Cancer Conference. RESULTS Deficient vitamin D levels were correlated with Grade 3 (P = .015) and node-positive (P = .043) BC, and with a higher body mass index (P = .017). Insufficient vitamin D levels were associated with estrogen receptor expression in the primary tumor (P = .033). Vitamin D levels were unrelated to the histological molecular subtypes of BC. CONCLUSION Deficient vitamin D levels were correlated with more aggressive disease, namely, node-positive high grade BC, and with obesity. Should our findings be confirmed in larger prospective studies, nutritional programs designed to reduce body weight, and vitamin D supplementation might be considered a BC prevention strategy.
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Yao S, Kwan ML, Ergas IJ, Roh JM, Cheng TYD, Hong CC, McCann SE, Tang L, Davis W, Liu S, Quesenberry CP, Lee MM, Ambrosone CB, Kushi LH. Association of Serum Level of Vitamin D at Diagnosis With Breast Cancer Survival: A Case-Cohort Analysis in the Pathways Study. JAMA Oncol 2017; 3:351-357. [PMID: 27832250 DOI: 10.1001/jamaoncol.2016.4188] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Importance There are long-standing interests in the potential benefits of vitamin D for preventing breast cancer recurrence and mortality, yet data from prospective cohort studies are limited. Objective To investigate a serum biomarker of vitamin D status, 25-hydroxyvitamin D (25OHD) measured at the time of breast cancer diagnosis, to determine the association with prognosis. Design, Setting, and Participants The Pathways Study is a prospective cohort study of breast cancer survivors established in 2006. Enrollment was completed in 2013; follow-up is ongoing. The cohort was established in Kaiser Permanente Northern California, a large integrated health care delivery system in northern California. Women with a diagnosis of incident invasive breast cancer were typically consented and enrolled within 2 months of diagnosis. The overall enrollment rate was 46% (4505 of 9820). Participants are followed for health outcomes and comorbidities at 12, 24, 48, 72, and 96 months after baseline interview. A case-cohort design was used for efficiency assay of 25OHD, selecting 1666 cohort members with serum samples and ensuring representation in the subcohort of races and clinical subtypes. The data analysis was performed from January 5, 2014, to March 15, 2015. Main Outcomes and Measures Primary outcomes are breast cancer recurrence, second primary cancer, and death. Results Mean (SD) age was 58.7 (12.4) years. Serum 25OHD concentrations were lower in women with advanced-stage tumors, and the lowest in premenopausal women with triple-negative cancer. Levels were also inversely associated with hazards of disease progression and death. Compared with the lowest tertile, women with the highest tertile of 25OHD levels had superior overall survival (OS). This association remained after adjustment for clinical prognostic factors (hazard ratio [HR], 0.72; 95% CI, 0.54-0.98). Among premenopausal women, the association with OS was stronger, and there were also associations with breast cancer-specific survival and invasive disease-free survival (OS: HR, 0.45; 95% CI, 0.21-0.96; breast cancer-specific survival: HR, 0.37; 95% CI, 0.15-0.93; invasive disease-free survival: HR, 0.58; 95% CI, 0.34-1.01; all after full adjustment). Conclusions and Relevance Serum 25OHD levels were independently associated with breast cancer prognostic characteristics and patient prognosis, most prominently among premenopausal women. Our findings from a large, well-characterized prospective cohort provide compelling observational evidence on associations of vitamin D with lower risk of breast cancer morbidity and mortality.
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Affiliation(s)
- Song Yao
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Marilyn L Kwan
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Isaac J Ergas
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Janise M Roh
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Ting-Yuan David Cheng
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Chi-Chen Hong
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Susan E McCann
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Li Tang
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Warren Davis
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Song Liu
- Department of Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, New York
| | | | - Marion M Lee
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland
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Zhang X, Harbeck N, Jeschke U, Doisneau-Sixou S. Influence of vitamin D signaling on hormone receptor status and HER2 expression in breast cancer. J Cancer Res Clin Oncol 2016; 143:1107-1122. [PMID: 28025696 DOI: 10.1007/s00432-016-2325-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 12/16/2016] [Indexed: 12/14/2022]
Abstract
PURPOSE Breast cancer is a significant global public health issue. It is the leading cause of death among women around the world, with an incidence increasing annually. In recent years, there has been more and more information in the literature regarding a protective role of vitamin D in cancer. Increasingly preclinical and clinical studies suggest that vitamin D optimal levels can reduce the risk of breast cancer development and regulate cancer-related pathways. METHOD In this review, we focus on the importance of vitamin D in breast cancers, discussing especially the influence of vitamin D signaling on estrogen receptor and human epidermal growth factor receptor 2 (HER2), two major biomarkers of breast cancer today. CONCLUSION We discuss the possibility of actual and future targeted therapeutic approaches for vitamin D signaling in breast cancer.
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Affiliation(s)
- Xi Zhang
- Brustzentrum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Campus Innenstadt, Klinikum der Ludwig-Maximilians-Universität, Maistraße 11, 80337, Munich, Germany
| | - Nadia Harbeck
- Brustzentrum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Campus Innenstadt, Klinikum der Ludwig-Maximilians-Universität, Maistraße 11, 80337, Munich, Germany
| | - Udo Jeschke
- Brustzentrum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Campus Innenstadt, Klinikum der Ludwig-Maximilians-Universität, Maistraße 11, 80337, Munich, Germany
| | - Sophie Doisneau-Sixou
- Brustzentrum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Campus Innenstadt, Klinikum der Ludwig-Maximilians-Universität, Maistraße 11, 80337, Munich, Germany. .,Faculté des Sciences Pharmaceutiques, Université Paul Sabatier Toulouse III, 31062, Toulouse Cedex 09, France.
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Abulkhair O, Saadeddin A, Makram O, Gasmelseed A, Pasha T, Shehata H, Fakhoury HM. Vitamin D levels and breast cancer characteristics: Findings in patients from Saudi Arabia. J Steroid Biochem Mol Biol 2016; 164:106-109. [PMID: 26554935 DOI: 10.1016/j.jsbmb.2015.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 10/14/2015] [Accepted: 11/05/2015] [Indexed: 12/31/2022]
Abstract
Inverse relationship between vitamin D status and risk of breast cancer has been previously reported in the literature. We conducted this study to determine the association between vitamin D levels and breast cancer characteristics in patients from Saudi Arabia. Newly diagnosed breast cancer patients (N=406) were recruited. Serum levels of 25-hydroxyvitamin D [25 (OH) D] were measured at baseline. A significantly higher percentage of patients with triple negative status (18%) had 25 (OH) D levels ≤25nmol/L, compared to only 8% with 25 (OH) D levels >25nmol/L (p=0.009). Patients with 25 (OH) D levels ≤25nmol/L were 2.54 times more likely to present with triple negative status compared to those with 25 (OH) D levels >25nmol/L (p=0.02). Our findings suggest an association between low 25 (OH) D levels and increased risk of triple negative breast cancer.
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Affiliation(s)
- Omalkhair Abulkhair
- Department of Oncology, King Abdulaziz Medical City, National Guard Health Affairs, PO Box 22490, Riyadh 11426, Saudi Arabia
| | - Ahmed Saadeddin
- Department of Oncology, King Abdulaziz Medical City, National Guard Health Affairs, PO Box 22490, Riyadh 11426, Saudi Arabia
| | - Olaa Makram
- Department of Oncology, King Abdulaziz Medical City, National Guard Health Affairs, PO Box 22490, Riyadh 11426, Saudi Arabia
| | - Ahmed Gasmelseed
- Department of Oncology, King Abdulaziz Medical City, National Guard Health Affairs, PO Box 22490, Riyadh 11426, Saudi Arabia
| | - Tabrez Pasha
- Department of Oncology, King Abdulaziz Medical City, National Guard Health Affairs, PO Box 22490, Riyadh 11426, Saudi Arabia
| | - Hussam Shehata
- Department of Oncology, King Abdulaziz Medical City, National Guard Health Affairs, PO Box 22490, Riyadh 11426, Saudi Arabia
| | - Hana M Fakhoury
- Basic Sciences Department, College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, P.O.box 3660, Mail code 3127, Riyadh 11481, Saudi Arabia,.
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42
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Acevedo F, Pérez V, Pérez-Sepúlveda A, Florenzano P, Artigas R, Medina L, Sánchez C. High prevalence of vitamin D deficiency in women with breast cancer: The first Chilean study. Breast 2016; 29:39-43. [DOI: 10.1016/j.breast.2016.06.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 06/21/2016] [Accepted: 06/22/2016] [Indexed: 02/01/2023] Open
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Palmer JR, Gerlovin H, Bethea TN, Bertrand KA, Holick MF, Ruiz-Narvaez EN, Wise LA, Haddad SA, Adams-Campbell LL, Kaufman HW, Rosenberg L, Cozier YC. Predicted 25-hydroxyvitamin D in relation to incidence of breast cancer in a large cohort of African American women. Breast Cancer Res 2016; 18:86. [PMID: 27520657 PMCID: PMC4983060 DOI: 10.1186/s13058-016-0745-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 07/29/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Vitamin D deficiency, which has been linked to an increased risk of colorectal cancer, is particularly common among African Americans. Previous studies of vitamin D status and breast cancer risk, mostly conducted in white women, have had conflicting results. We examined the relationship between predicted vitamin D status and incidence of breast cancer in a cohort of 59,000 African American women. METHODS Participants in the Black Women's Health Study have been followed by biennial mail questionnaires since 1995, with self-reported diagnoses of cancer confirmed by hospital and cancer registry records. Repeated five-fold cross-validation with linear regression was used to derive the best 25-hydroxyvitamin D (25(OH)D) prediction model based on measured 25(OH)D in plasma specimens obtained from 2856 participants in 2013-2015 and questionnaire-based variables from the same time frame. In the full cohort, including 1454 cases of incident invasive breast cancer, Cox proportional hazards models were used to compute the incidence rate ratio (IRR) for each quartile of predicted vitamin D score relative to the highest quartile. Predicted vitamin D score for each two-year exposure period was a cumulative average of predicted scores from all exposure periods up to that time. RESULTS Twenty-two percent of women with measured 25(OH)D were categorized as "deficient" (<20 ng/mL) and another 25 % as "insufficient" (20-29 ng/mL). The prediction model explained 25 % of variation in measured 25(OH)D and the correlation coefficient for predicted versus observed 25(OH)D averaged across all cross-validation runs was 0.49 (SD 0.026). Breast cancer risk increased with decreasing quartile of predicted 25(OH)D, p for trend 0.015; the IRR for the lowest versus highest quartile was 1.23 (95 % confidence interval 1.04, 1.46). CONCLUSIONS In prospective data, African American women in the lowest quartile of cumulative predicted 25(OH)D were estimated to have a 23 % increased risk of breast cancer relative to those with relatively high levels. Preventing vitamin D deficiency may be an effective means of reducing breast cancer incidence in African American women.
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Affiliation(s)
- Julie R Palmer
- Slone Epidemiology Center at Boston University, 1010 Commonwealth Avenue, 4th floor, Boston, MA, 02215, USA.
| | - Hanna Gerlovin
- Slone Epidemiology Center at Boston University, 1010 Commonwealth Avenue, 4th floor, Boston, MA, 02215, USA.,Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Traci N Bethea
- Slone Epidemiology Center at Boston University, 1010 Commonwealth Avenue, 4th floor, Boston, MA, 02215, USA
| | - Kimberly A Bertrand
- Slone Epidemiology Center at Boston University, 1010 Commonwealth Avenue, 4th floor, Boston, MA, 02215, USA
| | - Michael F Holick
- Department of Medicine, Physiology and Biophysics, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Edward N Ruiz-Narvaez
- Slone Epidemiology Center at Boston University, 1010 Commonwealth Avenue, 4th floor, Boston, MA, 02215, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Stephen A Haddad
- Slone Epidemiology Center at Boston University, 1010 Commonwealth Avenue, 4th floor, Boston, MA, 02215, USA
| | | | | | - Lynn Rosenberg
- Slone Epidemiology Center at Boston University, 1010 Commonwealth Avenue, 4th floor, Boston, MA, 02215, USA
| | - Yvette C Cozier
- Slone Epidemiology Center at Boston University, 1010 Commonwealth Avenue, 4th floor, Boston, MA, 02215, USA
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Shirazi L, Almquist M, Borgquist S, Malm J, Manjer J. Serum vitamin D (25OHD3) levels and the risk of different subtypes of breast cancer: A nested case–control study. Breast 2016; 28:184-90. [DOI: 10.1016/j.breast.2016.06.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 05/21/2016] [Accepted: 06/01/2016] [Indexed: 11/16/2022] Open
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45
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Al-Azhri J, Zhang Y, Bshara W, Zirpoli G, McCann SE, Khoury T, Morrison CD, Edge SB, Ambrosone CB, Yao S. Tumor Expression of Vitamin D Receptor and Breast Cancer Histopathological Characteristics and Prognosis. Clin Cancer Res 2016; 23:97-103. [PMID: 27407090 DOI: 10.1158/1078-0432.ccr-16-0075] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 06/27/2016] [Accepted: 07/03/2016] [Indexed: 11/16/2022]
Abstract
PURPOSE Our previous work has shown low serum 25-hydroxyvitamin D concentrations in association with aggressive breast cancer subtypes. Vitamin D receptor (VDR) is central for vitamin D-mediated transcription regulation. Few studies have examined breast VDR expression with tumor characteristics or patient survival. EXPERIMENTAL DESIGN VDR expression in breast tumor tissue microarrays was determined by immunohistochemistry in 1,114 female patients as low, moderate, and strong expression based on an immunoreactive score, and examined with histopathologic tumor characteristics and survival outcomes including progression-free survival, breast cancer-specific survival, and overall survival. RESULTS A majority (58%) of breast tumors showed moderate or strong VDR expression. VDR expression was inversely related to aggressive tumor characteristics, including large tumor size, hormonal receptor (HR) negativity, and triple-negative subtype (P < 0.05). In addition, VDR expression was also inversely related to Ki-67 expression among patients older than 50 years. Nevertheless, VDR expression was not associated with any patient survival outcomes examined. CONCLUSIONS In a large patient population, VDR expression is inversely associated with more aggressive breast cancer, but not with breast cancer survival outcomes. The present findings of VDR expression are consistent with our previous results of circulating vitamin D biomarkers, which provide two converging lines of evidence supporting the putative benefits of vitamin D against aggressive breast cancer. Because of the observational nature of our analyses, future studies are warranted to establish the causality of the reported associations. Clin Cancer Res; 23(1); 97-103. ©2016 AACR.
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Affiliation(s)
- Jamila Al-Azhri
- Department of Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia.,Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Yali Zhang
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Wiam Bshara
- Department of Pathology, Roswell Park Cancer Institute, Buffalo, New York
| | - Gary Zirpoli
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Susan E McCann
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Thaer Khoury
- Department of Pathology, Roswell Park Cancer Institute, Buffalo, New York
| | - Carl D Morrison
- Department of Pathology, Roswell Park Cancer Institute, Buffalo, New York
| | - Stephen B Edge
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York
| | - Song Yao
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York.
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46
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McDonnell SL, Baggerly C, French CB, Baggerly LL, Garland CF, Gorham ED, Lappe JM, Heaney RP. Serum 25-Hydroxyvitamin D Concentrations ≥40 ng/ml Are Associated with >65% Lower Cancer Risk: Pooled Analysis of Randomized Trial and Prospective Cohort Study. PLoS One 2016; 11:e0152441. [PMID: 27049526 PMCID: PMC4822815 DOI: 10.1371/journal.pone.0152441] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 03/14/2016] [Indexed: 12/31/2022] Open
Abstract
Background Higher serum 25-hydroxyvitamin D [25(OH)D] concentrations have been associated with a lower risk of multiple cancer types across a range of 25(OH)D concentrations. Objectives To investigate whether the previously reported inverse association between 25(OH)D and cancer risk could be replicated, and if a 25(OH)D response region could be identified among women aged 55 years and older across a broad range of 25(OH)D concentrations. Methods Data from two cohorts representing different median 25(OH)D concentrations were pooled to afford a broader range of 25(OH)D concentrations than either cohort alone: the Lappe cohort (N = 1,169), a randomized clinical trial cohort (median 25(OH)D = 30 ng/ml) and the GrassrootsHealth cohort (N = 1,135), a prospective cohort (median 25(OH)D = 48 ng/ml). Cancer incidence over a multi-year period (median: 3.9 years) was compared according to 25(OH)D concentration. Kaplan-Meier plots were developed and the association between 25(OH)D and cancer risk was examined with multivariate Cox regression using multiple 25(OH)D measurements and spline functions. The study included all invasive cancers excluding skin cancer. Results Age-adjusted cancer incidence across the combined cohort (N = 2,304) was 840 cases per 100,000 person-years (1,020 per 100,000 person-years in the Lappe cohort and 722 per 100,000 person-years in the GrassrootsHealth cohort). Incidence was lower at higher concentrations of 25(OH)D. Women with 25(OH)D concentrations ≥40 ng/ml had a 67% lower risk of cancer than women with concentrations <20 ng/ml (HR = 0.33, 95% CI = 0.12–0.90). Conclusions 25(OH)D concentrations ≥40 ng/ml were associated with substantial reduction in risk of all invasive cancers combined.
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Affiliation(s)
| | - Carole Baggerly
- GrassrootsHealth, Encinitas, California, United States of America
| | | | - Leo L. Baggerly
- GrassrootsHealth, Encinitas, California, United States of America
| | - Cedric F. Garland
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Edward D. Gorham
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Joan M. Lappe
- Department of Medicine, Creighton University, Omaha, Nebraska, United States of America
| | - Robert P. Heaney
- Department of Medicine, Creighton University, Omaha, Nebraska, United States of America
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Brenner DR, Brockton NT, Kotsopoulos J, Cotterchio M, Boucher BA, Courneya KS, Knight JA, Olivotto IA, Quan ML, Friedenreich CM. Breast cancer survival among young women: a review of the role of modifiable lifestyle factors. Cancer Causes Control 2016; 27:459-72. [PMID: 26970739 PMCID: PMC4796361 DOI: 10.1007/s10552-016-0726-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 02/06/2016] [Indexed: 02/06/2023]
Abstract
Almost 7 % of breast cancers are diagnosed among women age 40 years and younger in Western populations. Clinical outcomes among young women are worse. Early age-of-onset increases the risk of contralateral breast cancer, local and distant recurrence, and subsequent mortality. Breast cancers in young women (BCYW) are more likely to present with triple-negative (TNBC), TP53-positive, and HER-2 over-expressing tumors than among older women. However, despite these known differences in breast cancer outcomes and tumor subtypes, there is limited understanding of the basic biology, epidemiology, and optimal therapeutic strategies for BCYW. Several modifiable lifestyle factors associated with reduced risk of developing breast cancer have also been implicated in improved prognosis among breast cancer survivors of all ages. Given the treatment-related toxicities and the extended window for late effects, long-term lifestyle modifications potentially offer significant benefits to BCYW. In this review, we propose a model identifying three main areas of lifestyle factors (energy imbalance, inflammation, and dietary nutrient adequacy) that may influence survival in BCYW. In addition, we provide a summary of mechanisms of action and a synthesis of previous research on each of these topics.
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Affiliation(s)
- Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Room 513, Holy Cross Centre, Box ACB, 2210-2nd St. SW, Calgary, AB, T2S 3C3, Canada. .,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Nigel T Brockton
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Room 513, Holy Cross Centre, Box ACB, 2210-2nd St. SW, Calgary, AB, T2S 3C3, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Joanne Kotsopoulos
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Michelle Cotterchio
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada
| | - Beatrice A Boucher
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada
| | - Kerry S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Julia A Knight
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - Ivo A Olivotto
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - May Lynn Quan
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Room 513, Holy Cross Centre, Box ACB, 2210-2nd St. SW, Calgary, AB, T2S 3C3, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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48
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Sahin S, Karatas F, Sever AR, Altundag K. Serum vitamin D levels and response to molecular subtypes in breast cancer. Breast 2016; 27:185-6. [PMID: 26952539 DOI: 10.1016/j.breast.2016.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 02/04/2016] [Indexed: 10/22/2022] Open
Affiliation(s)
- Suleyman Sahin
- Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Fatih Karatas
- Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Ali R Sever
- Hacettepe Univesity School of Medicine, Department of Radiology, Ankara, Turkey
| | - Kadri Altundag
- Hacettepe University Cancer Institute, Department of Medical Oncology, 06100 Ankara, Turkey.
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49
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Jacobs ET, Kohler LN, Kunihiro AG, Jurutka PW. Vitamin D and Colorectal, Breast, and Prostate Cancers: A Review of the Epidemiological Evidence. J Cancer 2016; 7:232-40. [PMID: 26918035 PMCID: PMC4747876 DOI: 10.7150/jca.13403] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 12/03/2015] [Indexed: 02/07/2023] Open
Abstract
Over the past two decades, the question of whether vitamin D has a role in cancer incidence, progression, and mortality has been studied in detail. Colorectal, breast, and prostate cancers have been a particular area of focus; together, these three malignancies account for approximately 35% of cancer cases and 20% of cancer deaths in the United States, and as such are a major public health concern. Herein, we review and synthesize the epidemiological research regarding vitamin D, as measured by the biomarker 25-hydroxycholecalciferol [25(OH)D], and the incidence, progression, and mortality of these cancers. Overall, the results of observational studies of the relationship between 25(OH)D and colorectal cancer have revealed a consistent inverse association for incidence and mortality; while for breast cancer, results have generally demonstrated a relationship between higher 25(OH)D and lower risk for progression and mortality. In contrast, randomized, double-blind clinical trials conducted to date have generally failed to support these findings. For prostate cancer, there is no convincing evidence of an association between 25(OH)D and incidence, and inconsistent data for progression and mortality, though results of one open label clinical trial suggest that supplementation with 4000 IU/d of vitamin D3 may inhibit progression of the disease. Nonetheless, until the results of additional ongoing randomized, double-blind clinical trials are reported, it will be difficult to ascertain if vitamin D itself is related to a reduction in risk for some cancer endpoints, or whether high concentrations of the vitamin D biomarker 25(OH)D may instead serve as a marker for an overall beneficial risk factor profile.
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Affiliation(s)
- Elizabeth T Jacobs
- University of Arizona Cancer Center, Tucson, Arizona (ETJ); Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona (ETJ, LNK); Department of Nutritional Sciences, University of Arizona, Tucson, Arizona (ETJ, AGK); School of Mathematical and Natural Sciences, Arizona State University, Phoenix, Arizona (PWJ); Department of Basic Medical Sciences, The University of Arizona, College of Medicine, Phoenix, AZ (PWJ)
| | - Lindsay N Kohler
- University of Arizona Cancer Center, Tucson, Arizona (ETJ); Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona (ETJ, LNK); Department of Nutritional Sciences, University of Arizona, Tucson, Arizona (ETJ, AGK); School of Mathematical and Natural Sciences, Arizona State University, Phoenix, Arizona (PWJ); Department of Basic Medical Sciences, The University of Arizona, College of Medicine, Phoenix, AZ (PWJ)
| | - Andrew G Kunihiro
- University of Arizona Cancer Center, Tucson, Arizona (ETJ); Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona (ETJ, LNK); Department of Nutritional Sciences, University of Arizona, Tucson, Arizona (ETJ, AGK); School of Mathematical and Natural Sciences, Arizona State University, Phoenix, Arizona (PWJ); Department of Basic Medical Sciences, The University of Arizona, College of Medicine, Phoenix, AZ (PWJ)
| | - Peter W Jurutka
- University of Arizona Cancer Center, Tucson, Arizona (ETJ); Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona (ETJ, LNK); Department of Nutritional Sciences, University of Arizona, Tucson, Arizona (ETJ, AGK); School of Mathematical and Natural Sciences, Arizona State University, Phoenix, Arizona (PWJ); Department of Basic Medical Sciences, The University of Arizona, College of Medicine, Phoenix, AZ (PWJ)
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50
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Yao S, Haddad SA, Hu Q, Liu S, Lunetta KL, Ruiz-Narvaez EA, Hong CC, Zhu Q, Sucheston-Campbell L, Cheng TYD, Bensen JT, Johnson CS, Trump DL, Haiman CA, Olshan AF, Palmer JR, Ambrosone CB. Genetic variations in vitamin D-related pathways and breast cancer risk in African American women in the AMBER consortium. Int J Cancer 2015; 138:2118-26. [PMID: 26650177 DOI: 10.1002/ijc.29954] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 11/19/2015] [Accepted: 11/20/2015] [Indexed: 01/08/2023]
Abstract
Studies of genetic variations in vitamin D-related pathways and breast cancer risk have been conducted mostly in populations of European ancestry, and only sparsely in African Americans (AA), who are known for a high prevalence of vitamin D deficiency. We analyzed 24,445 germline variants in 63 genes from vitamin D-related pathways in the African American Breast Cancer Epidemiology and Risk (AMBER) consortium, including 3,663 breast cancer cases and 4,687 controls. Odds ratios (OR) were derived from logistic regression models for overall breast cancer, by estrogen receptor (ER) status (1,983 ER positive and 1,098 ER negative), and for case-only analyses of ER status. None of the three vitamin D-related pathways were associated with breast cancer risk overall or by ER status. Gene-level analyses identified associations with risk for several genes at a nominal p ≤ 0.05, particularly for ER- breast cancer, including rs4647707 in DDB2. In case-only analyses, vitamin D metabolism and signaling pathways were associated with ER- cancer (pathway-level p = 0.02), driven by a single gene CASR (gene-level p = 0.001). The top SNP in CASR was rs112594756 (p = 7 × 10(-5), gene-wide corrected p = 0.01), followed by a second signal from a nearby SNP rs6799828 (p = 1 × 10(-4), corrected p = 0.03). In summary, several variants in vitamin D pathways were associated with breast cancer risk in AA women. In addition, CASR may be related to tumor ER status, supporting a role of vitamin D or calcium in modifying breast cancer phenotypes.
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Affiliation(s)
- Song Yao
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY
| | | | - Qiang Hu
- Department of Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY
| | - Song Liu
- Department of Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY
| | - Kathryn L Lunetta
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | | | - Chi-Chen Hong
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY
| | - Qianqian Zhu
- Department of Biostatistics and Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY
| | | | - Ting-Yuan David Cheng
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY
| | - Jeannette T Bensen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Candace S Johnson
- Department of Pharmacology and Therapeutics, Roswell Park Cancer Institute, Buffalo, NY
| | | | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Julie R Palmer
- Slone Epidemiology Center at Boston University, Boston, MA
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY
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