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related:
Goodwin PJ. Vitamin D in cancer patients: above all, do no harm. J Clin Oncol 2009 May 1;27(13):2117-2119. (Editorial)
http://jco.ascopubs.org/cgi/content/full/27/13/2117
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Journal of Clinical Oncology, Vol 27, No 13 (May 1), 2009: pp. 2151-2156
© 2009 American Society of Clinical Oncology.
High Prevalence of Vitamin D Deficiency Despite Supplementation in Premenopausal Women With Breast Cancer Undergoing Adjuvant Chemotherapy
Katherine D. Crew, Elizabeth Shane, Serge Cremers, Donald J. McMahon, Dinaz Irani, Dawn L. Hershman
From the Department of Medicine, Division of Oncology, Columbia University, College of Physicians and Surgeons; Herbert Irving Comprehensive Cancer Center, Columbia University; and Department of Medicine, Division of Endocrinology, Columbia University, College of Physicians and Surgeons, New York, NY.
Corresponding author: Dawn L. Hershman, MD, MS, Columbia University, 161 Fort Washington Ave, 10-1068, New York, NY 10032; e-mail:
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Purpose Vitamin D deficiency is associated with increased breast cancer risk and decreased breast cancer survival. The purpose of this study was to determine the prevalence of vitamin D deficiency, as measured by serum 25-hydroxyvitamin D (25-OHD), in premenopausal women at initiation of adjuvant chemotherapy for breast cancer and after 1 year of vitamin D supplementation.
Patients and Methods The study included 103 premenopausal women from the northeastern United States with stages I to III breast cancer who received adjuvant chemotherapy and participated in a 1-year zoledronate intervention trial. All patients were prescribed vitamin D3 (cholecalciferol) 400 IU and calcium carbonate 1,000 mg daily. At baseline and at 6 and 12 months, bone mineral density (BMD) measurements were obtained and blood was collected and analyzed in batches for serum 25-OHD. Vitamin D deficiency was defined as serum 25-OHD less than 20 ng/mL, insufficiency as 20 to 29 ng/mL, and sufficiency as 30 ng/mL or greater.
Results At baseline, 74% of women were vitamin D deficient (median, 17 ng/mL). Vitamin D deficiency was slightly less common in white women (66%) compared with black (80%) and Hispanic (84%) women. After vitamin D supplementation for 1 year, less than 15% of white and Hispanic women, and no black women, achieved sufficient 25-OHD levels. Vitamin D levels did not correlate with baseline BMD and were not altered by chemotherapy or bisphosphonate use.
Conclusion Vitamin D deficiency is highly prevalent in women with breast cancer. The current recommended dietary allowance of vitamin D is too low to increase serum 25-OHD greater than 30 ng/mL. Optimal dosing for bone health and, possibly, improved survival has yet to be determined.
Supported in part by K07 Award No. CA95597 from the National Cancer Institute (D.L.H.); by an Advanced Clinical Research Award in Breast Cancer from the American Society of Clinical Oncology (D.L.H.); by K24 Award No. AR 052665 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (E.S.); and by Novartis Pharmaceuticals Corp.
Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.
Copyright © 2009 by the American Society of Clinical Oncology