Vitamin D, Breast Cancer, and Bone Health

6621 Background: Results from the ATAC trial comparing Tamoxifen to the Aromatase inhibitors (AIs) anastrozole in PM women with early stage breast cancer were initially presented in San Antonio, Texas, in December 2001. ASCO issued guidelines for the adjuvant use of AIs in 2002, updated in 2003. We compared patterns of usage of adjuvant hormonal agents and bone health management before and after availability of the ATAC data in community versus academic centers. Methods: We conducted a retrospective analysis of 432 patients between 1999–2005 from group practices affiliated with two large community hospitals and one academic center. Data were collected from tumor registries regarding demographics, first-line hormonal agent choice, and use of bone density studies, vitamin D/calcium supplements and bisphosphonates. Results: Demographics were identical in both groups before and after January 2002. Before 2002, 96% of the patients were prescribed Tamoxifen in both community and academic centers. After the initial presentation of the ATAC data, 55.08% (65/118) of patients from the community centers versus only 17.11% (19/111) from the academic center were prescribed AIs (p=0.0001). Of the 84 patients who received an AI after January 2002, similar proportions of patients had baseline bone density scans (38.5% community vs. 36.8% academic; p=0.89) and follow up annual/biannual scans (33 % vs. 32%; p=0.85). In addition, similar proportions of patients on AIs were prescribed calcium/vitamin D supplements (47.4% vs. 52.6%; p=0.69) and bisphosphonates (36.8% vs. 21.05%; p=0.20) in community and academic centers, respectively. Conclusions: Community oncologists adopted AIs into clinical practice sooner than academic physicians on the basis of unpublished clinical trial results, even before ASCO published guidelines. Although patients on AIs are deemed to be at higher risk for bone fractures, fewer than 40% were evaluated with baseline or surveillance bone density scans in both community and academic practices. Similar proportions of patients received calcium/vitamin D supplements or bisphosphonates among centers. No significant financial relationships to disclose.

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Vitamin D, Breast Cancer and Bone Health

10.21236/ada518878 ◽

2009 ◽

Author(s):

Eva Balint

Keyword(s):

Breast Cancer ◽

Vitamin D ◽

Bone Health

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Breast cancer and vitamin D in postmenopausal minorities.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.27_suppl.17 ◽

2012 ◽

Vol 30 (27_suppl) ◽

pp. 17-17

Author(s):

Demet Gokalp Yasar ◽

Pam Khosla

Keyword(s):

Breast Cancer ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Cancer Patients ◽

Bone Health ◽

Postmenopausal Breast Cancer ◽

Cancer Information ◽

Minority Population ◽

Breast Cancer Patients ◽

Significant Difference

17 Background: Bone health is a particular concern for breast cancer survivors, because these women have 15% higher fracture risk than women without a history of breast cancer. Many studies have suggested that vitamin D deficiency may be involved in breast cancer initiation, progression, and prognosis. This study examines the prevalence of vitamin D deficiency among postmenopausal breast cancer patients in minority population. Methods: This retrospective study reviewed the electronic records of 200 postmenopausal breast cancer patients from ethnic groups of blacks, Hispanics and Asians. Results: Of the 200 patients, 84 (42%) had their 25-OHD levels checked at least once. Of patients, 42.7% found body mass index (BMI)>30kg/m2. There was significant difference between race and BMI (p<0.05). Black Vitamin D deficiency (level< 20ng/mL) found in 35 (41.7%), vitamin D insufficiency (level range 20-30ng/mL) found in 30 (35.7%) of the patients. The median serum 25-OHD level was 21 (range 4-65ng/ml). The serum 25-OHD levels did not have significant difference among blacks and Hispanics. Tumor stages found negatively correlated with 25-OHD levels r=-0.227 and p=0.04. Conclusions: This study revealed that vitamin D deficiency has a high prevalence among postmenopausal breast cancer minority population. Data from Third National Health and Nutrition Examination survey showed that mean serum 25-OHD levels among white, Hispanic and black women were 76ng/ml, 56.7ng/ml and 45.3ng/ml, respectively. Also, prevalence rate of vitamin D deficiency is reported in the studies among breast cancer patients are approximately 30%. Our data compared with this general population’s numbers is low; our median 25-OHD level was 21ng/ml. Our study found negative correlation with Vitamin D levels and stages of the breast cancer. Information is lacking on direct prognostic effect of vitamin D in breast cancer but this findings including our study support the hypothesis that vitamin D has a role in the pathogenesis of breast cancer. In the setting of breast cancer diagnosis either for bone health, or for breast cancer prognosis in postmenopausal women, we advocate routine 25-OHD levels screening for the vitamin D deficiency especially in minority populations would be beneficial.

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Bone health and adherence to vitamin D and calcium therapy in early breast cancer patients on endocrine therapy with aromatase inhibitors

The Breast ◽

10.1016/j.breast.2016.10.018 ◽

2017 ◽

Vol 31 ◽

pp. 16-19 ◽

Cited By ~ 3

Author(s):

Lidija Bošković ◽

Maja Gašparić ◽

Marija Petković ◽

Damir Gugić ◽

Ingrid Belac Lovasić ◽

...

Keyword(s):

Breast Cancer ◽

Vitamin D ◽

Cancer Patients ◽

Endocrine Therapy ◽

Early Breast Cancer ◽

Aromatase Inhibitors ◽

Bone Health ◽

Breast Cancer Patients

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Vitamin D, Breast Cancer and Bone Health

10.21236/ada499634 ◽

2008 ◽

Author(s):

Eva Balint

Keyword(s):

Breast Cancer ◽

Vitamin D ◽

Bone Health

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Vitamin D (vD) deficiency (def) in breast cancer (BC) patients (pts)

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.11082 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 11082-11082

Author(s):

C. A. Presant ◽

L. Bosserman

Keyword(s):

Breast Cancer ◽

Vitamin D ◽

Bone Disease ◽

Bone Health ◽

Individual Study ◽

Vitamin D Metabolism ◽

D 20 ◽

Study Participants ◽

Asco 2006 ◽

Confirmatory Trials

11082 Background: Vitamin D metabolism is important for maintaining bone health and perhaps cancer prevention. Prior studies have reported vD def in 88% of brca pts (Lonning et al ASCO 2006 abst 554), and 79% of women (Chlebowski et al ASCO 2006 abst 6) . Methods: In order to determine the frequency of vD def, we studied 41 consecutive brca pts. Levels of vD were correlated with clinical features. Pts were classified as vD def if 25OH D <20, 1.25 diOH D <14, or D3 <20. Insufficiency (ins) of vD was 25OH D 20–29. Results: 8 pts had vD def (19.5%). This was more common in young pts <60 (37.5%) compared to older pts (8%) (p4) in 5/6 pts <60 and 5/7 older pts. vD def did not correlate with bone disease: 25% def in pts without bone disease, 17% in pts with osteopenia, and 17% in pts with osteoporosis. In older pts, vD was normal in 12/14 pts on anastrazole, and in 7/11 pts not on anastrazole, indicating no relation of anastrazole to vD def. Bisphosphonate (bis) usage was slightly higher in older pts (60%) versus younger pts (38%) but not significantly (p<0.2). While only 19% of pts on bis had vD ins or def, 50% of pts not on bis had ins or def vD (p<0.05). Although only 5% of pts on bis had vD def, 30% of pts not taking bis had vD def (p<0.05). Conclusions: In brca pts, vD def is less than reported, but still frequent. All brca pts should be tested for vD periodically. VD def may be less frequent in pts on bis, and confirmatory trials should be performed. VD levels should also be monitored even if pts report taking vD. VD def or ins should be treated and monitored by oncologists. Since vD may be related to cancer incidence, and to bone disease, all brca trials collecting data on bone events, bone density, and second cancers should also report relationship to vD levels in individual study participants. No significant financial relationships to disclose.

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