Frequency of vitamin D (Vit D) deficiency at breast cancer (BC) diagnosis and association with risk of distant recurrence and death in a prospective cohort study of T1-3, N0-1, M0 BC.

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Abstracts

2008 ASCO Annual Meeting

Frequency of vitamin D (Vit D) deficiency at breast cancer (BC) diagnosis and association with risk of distant recurrence and death in a prospective cohort study of T1-3, N0-1, M0 BC.

Sub-category:

Adjuvant Therapy

Category:

Breast Cancer--Local-Regional and Adjuvant Therapy

Meeting:

2008 ASCO Annual Meeting

Abstract No:

511

Citation:

J Clin Oncol 26: 2008 (May 20 suppl; abstr 511)

Author(s):

P. J. Goodwin, M. Ennis, K. I. Pritchard, J. Koo, N. Hood

Abstract:

Background: Vit D acts through a nuclear transcription factor to regulate many aspects of cellular growth and differentiation. Low levels have been associated with increased BC risk. We examined Vit D levels and prognostic effects in an existing BC cohort. Methods: 512 consecutive women with newly diagnosed BC were enrolled at 3 U of Toronto hospitals between 1989 and 1995. A blood specimen obtained at diagnosis was stored at -80°C. The Block questionnaire was used to measure diet intake. Clinical and pathology data were obtained from medical and pathology records. 25-OH Vit D was measured by radioimmunoassay. Women were followed prospectively to 2006. Results: Mean age was 50.4±9.7 yrs. 288 women had T1 tumors, 164 T2 and 24 T3/4. 356 tumors were N0. 342 were estrogen receptor (ER) positive. 73 tumors were grade 1, 202 grade 2 and 173 grade 3. 199 women received adjuvant chemotherapy (CXT) and 200 received tamoxifen. 116 women (22.7%) had distant recurrences and 106 (20.7%) died during a median follow-up of 11.6 yrs. Mean 25-OH Vit D was 58.1±23.4 nmol/L. Vit D levels were deficient (<50 nmol/L) in 192 (37.5%), insufficient (50-72 nmol/L) in 197 (38.5%) and adequate (>72 nmol/L) in 123 (24.0%). Low Vit D levels were associated with premenopausal status, high body mass index (BMI), high insulin and high tumor grade (all p<0.03). Low Vit D levels were associated with low dietary intake of retinol, Vitamin E, grains and alcohol (all p<0.02). Vit D was marginally lower when drawn in winter (Oct-Mar) vs summer (Apr-Sept) months (56.7 vs 59.5 nmol/L, p=0.07). Distant disease-free survival (DDFS) was significantly worse in women with deficient (vs adequate) Vit D levels (HR 1.94, 95% CI 1.16-3.24, p=0.02) as was overall survival (OS) (HR 1.73, 95% CI 1.05-2.86, p=0.02). Vit D associations with DDFS were independent of age, BMI, insulin, T and N stage, ER and grade (all HR >1.55 Q1 vs Q4, all p < 0.04); they were not significantly modified by ER, adjuvant CXT or tamoxifen. Vit D associations with OS were attenuated by grade and were absent in ER negative BC. Conclusions: Vit D deficiency is common at BC diagnosis and is associated with poor prognosis. This research was funded by the Breast Cancer Research Foundation.

Abstract Disclosures

Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy and are designated with a caret symbol (^) here and in the print version.

Associated Presentation(s):

1. Vitamin D (Vit D) deficiency is common at breast cancer (BC) diagnosis and is associated with a significantly higher risk of distant recurrence and death in a prospective cohort study of T1-3, N0-1, M0 BC

Meeting: 2008 Best of ASCO Boston
Speaker: P. Goodman
Session: General Session V: Breast Cancer - Local-Regional and Adjuvant Therapy

2. Frequency of vitamin D (Vit D) deficiency at breast cancer (BC) diagnosis and association with risk of distant recurrence and death in a prospective cohort study of T1-3, N0-1, M0 BC.

Meeting: 2008 ASCO Annual Meeting
Presenter: Pamela J Goodwin, MD
Session: Breast Cancer — Local-Regional and Adjuvant Therapy (Oral Presentation)

Other Abstracts in this Sub-Category:

		1. Adjuvant ovarian suppression combined with tamoxifen or anastrozole, alone or in combination with zoledronic acid, in premenopausal women with hormone-responsive, stage I and II breast cancer: First efficacy results from ABCSG-12. Meeting: 2008 ASCO Annual Meeting Abstract No: LBA4 First Author: M. Gnant Category: Breast Cancer--Local-Regional and Adjuvant Therapy - Adjuvant Therapy
		2. Mammographically occult contralateral breast carcinoma detected by magnetic resonance imaging in the elderly. Meeting: 2008 ASCO Annual Meeting Abstract No: 500 First Author: J. R. Bernard Jr. Category: Breast Cancer--Local-Regional and Adjuvant Therapy - Adjuvant Therapy
		3. ER alpha genotypes and breast cancer recurrence. Meeting: 2008 ASCO Annual Meeting Abstract No: 501 First Author: J. L. Grabinski Category: Breast Cancer--Local-Regional and Adjuvant Therapy - Adjuvant Therapy
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Abstracts by P. J. Goodwin :

		1. Frequency of vitamin D (Vit D) deficiency at breast cancer (BC) diagnosis and association with risk of distant recurrence and death in a prospective cohort study of T1-3, N0-1, M0 BC. Meeting: 2008 ASCO Annual Meeting Abstract No: 511 First Author: P. J. Goodwin Category: Breast Cancer--Local-Regional and Adjuvant Therapy - Adjuvant Therapy
		2. Identification of cancer care and protocol characteristics associated with recruitment rate in breast cancer clinical trials in Ontario. Meeting: 2007 ASCO Annual Meeting Abstract No: 17042 First Author: J. Lemieux Category: Health Services Research
		3. The prognostic effect of lipids on early-stage breast cancer (BC) outcome. Meeting: 2005 ASCO Annual Meeting Abstract No: 710 First Author: M. Bahl Category: Breast Cancer - Other
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Presentations by P. J. Goodwin :

		1. Diet, Exercise and Supplements: Guidelines for Cancer Survivors: Vitamin D Meeting: 2009 ASCO Annual Meeting Chair: Pamela Jean Goodwin, MD Session: Diet, Exercise, and Cancer: Does the Evidence Support Lifestyle Modification as Part of Cancer Treatment? (Education Session)
		2. The Role of Vitamin D in Breast Cancer Recurrence Meeting: 2009 ASCO Annual Meeting Speaker: Pamela Jean Goodwin, MD Session: Vitamin D Supplementation: Does It Have a Role in Cancer Treatment and Prevention? (Education Session)
		3. Welcome and Introductions Meeting: 2009 ASCO Annual Meeting Chair: Pamela Jean Goodwin, MD Session: Diet, Exercise, and Cancer: Does the Evidence Support Lifestyle Modification as Part of Cancer Treatment? (Education Session)
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Educational Book Manuscripts by P. J. Goodwin :

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