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Predictive tumor and demographic characteristics by 25-OH vitamin D levels in breast cancers: A comparison with matched controls.

e21144 Background: Studies show that women with low vitamin D levels have an increased risk of breast cancer incidence and mortality, but there is a lack of research examining vitamin D levels and prognostic variables in breast cancer patients. The aim of this study is to examine 25-OH vitamin D levels between breast cancer cases and controls, and by tumor characteristics among breast cancer cases.


METHODS
25-OH vitamin D levels were collected from 194 women who underwent breast cancer surgery and 194 cancer-free controls (matched on age and date of visit) seen at the Univ. of Rochester Medical Center between 1/2009 and 12/2010. Mean 25-OH vitamin D levels were calculated by case/control status for the overall cohort and by tumor characteristics (invasiveness, ER status, triple-negative status, Oncotype DX score, molecular phenotype) for breast cancer cases by ANCOVA.


RESULTS
Breast cancer (BC) cases had significantly lower 25-OH vitamin D levels than cancer-free (CF) controls (BC: 32.7 ng/ml vs. CF: 37.4 ng/ml; p=0.02). A significant trend toward lower 25-OH vitamin D levels was seen in women with invasive breast cancer compared to women with in situ breast cancer (invasive: 32.0 ng/ml vs. in situ: 37.4 ng/ml; p=0.08). Lower 25-OH vitamin D levels were observed in breast cancer patients with ER- negative tumors (ER-: 28.1 ng/ml vs. ER+: 33.4 ng/ml; p=0.04) and triple-negative tumors (triple-negative: 26.2 ng/ml vs. all other BC: 33.3 ng/ml; p=0.02). Women with Oncotype scores <18 had higher mean 25-OH vitamin D levels than women with Oncotype DX scores >30 (<18: 31.5 ng/ml vs. >30: 12.3 ng/ml; p=0.05). Women with basal-like phenotype had lower 25-OH vitamin D levels than women luminal-A phenotype (basal-like: 24.2 ng/ml vs. luminal-A: 32.8 ng/ml; p=0.04).


CONCLUSIONS
Breast cancer patients with a more aggressive molecular phenotype (basal-like), worse prognostic markers (ER- and triple-negative), and high recurrence risk (Oncotype) had lower mean 25-OH vitamin D levels, lending support to previous research that found decreased survival among vitamin D deficient women. Further research is needed to elucidate the biological relationship between vitamin D and breast cancer progression.