Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 1/2011

01-05-2011 | Clinical trial

The effect of various vitamin D supplementation regimens in breast cancer patients

Authors: Luke J. Peppone, Alissa J. Huston, Mary E. Reid, Randy N. Rosier, Yousef Zakharia, Donald L. Trump, Karen M. Mustian, Michelle C. Janelsins, Jason Q. Purnell, Gary R. Morrow

Published in: Breast Cancer Research and Treatment | Issue 1/2011

Login to get access

Abstract

Vitamin D deficiency in the patients treated for breast cancer is associated with numerous adverse effects (bone loss, arthralgia, and falls). The first aim of this study was to assess vitamin D status, determined by 25-OH vitamin D levels, among women diagnosed with breast cancer according to demographic/clinical variables and bone mineral density (BMD). The second aim of this study was to evaluate the effect of daily low-dose and weekly high-dose vitamin D supplementation on 25-OH vitamin D levels. This retrospective study included 224 women diagnosed with stage 0–III breast cancer who received treatment at the James P. Wilmot Cancer Center at the University of Rochester Medical Center. Total 25-OH vitamin D levels (D2 + D3) were determined at baseline for all participants. Vitamin D deficiency was defined as a 25-OH vitamin D level < 20 ng/ml, insufficiency as 20–31 ng/ml, and sufficiency as ≥32 ng/ml. BMD was assessed during the period between 3 months before and 6 months following the baseline vitamin D assessment. Based on the participants’ baseline levels, they received either no supplementation, low-dose supplementation (1,000 IU/day), or high-dose supplementation (≥50,000 IU/week), and 25-OH vitamin D was reassessed in the following 8–16 weeks. Approximately 66.5% had deficient/insufficient vitamin D levels at baseline. Deficiency/insufficiency was more common among non-Caucasians, women with later-stage disease, and those who had previously received radiation therapy (P < 0.05). Breast cancer patients with deficient/insufficient 25-OH vitamin D levels had significantly lower lumbar BMD (P = 0.03). Compared to the no-supplementation group, weekly high-dose supplementation significantly increased 25-OH vitamin D levels, while daily low-dose supplementation did not significantly increase levels. Vitamin D deficiency and insufficiency were common among women with breast cancer and associated with reduced BMD in the spine. Clinicians should carefully consider vitamin D supplementation regimens when treating vitamin D deficiency/insufficiency in breast cancer patients.
Literature
1.
Alaimo K, McDowell MA, Briefel RR, Bischof AM, Caughman CR, Loria CM, Johnson CL (1994) Dietary intake of vitamins, minerals, and fiber of persons ages 2 months and over in the United States: Third National Health and Nutrition Examination Survey, Phase 1, 1988–91. Adv Data 258:1–28
2.
Rock CL (2007) Multivitamin-multimineral supplements: who uses them? Am J Clin Nutr 85:277S–279SPubMed
3.
Looker AC, Dawson-Hughes B, Calvo MS, Gunter EW, Sahyoun NR (2002) Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone 30:771–777PubMedCrossRef
4.
Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, Vamvakas EC, Dick IM, Prince RL, Finkelstein JS (1998) Hypovitaminosis D in medical inpatients. N Engl J Med 338:777–783PubMedCrossRef
5.
Yetley EA (2008) Assessing the vitamin D status of the US population. Am J Clin Nutr 88:558S–564SPubMed
6.
Bouillon R, Van Cromphaut S, Carmeliet G (2003) Intestinal calcium absorption: molecular vitamin D mediated mechanisms. J Cell Biochem 88:332–339PubMedCrossRef
7.
Cranney A, Horsley T, O’Donnell S, Weiler H, Puil L, Ooi D, Atkinson S, Ward L, Moher D, Hanley D et al (2007) Effectiveness and safety of vitamin D in relation to bone health. Evid Rep Technol Assess (Full Rep) 158:1–235
8.
Lowe L, Hansen CM, Senaratne S, Colston KW (2003) Mechanisms implicated in the growth regulatory effects of vitamin D compounds in breast cancer cells. Recent Results Cancer Res 164:99–110PubMed
9.
10.
van Etten E, Stoffels K, Gysemans C, Mathieu C, Overbergh L (2008) Regulation of vitamin D homeostasis: implications for the immune system. Nutr Rev 66:S125–S134PubMedCrossRef
11.
Abbas S, Linseisen J, Slanger T, Kropp S, Mutschelknauss EJ, Flesch-Janys D, Chang-Claude J (2008) Serum 25-hydroxyvitamin D and risk of post-menopausal breast cancer—results of a large case–control study. Carcinogenesis 29:93–99PubMedCrossRef
12.
Bertone-Johnson ER, Chen WY, Holick MF, Hollis BW, Colditz GA, Willett WC, Hankinson SE (2005) Plasma 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D and risk of breast cancer. Cancer Epidemiol Biomarkers Prev 14:1991–1997PubMedCrossRef
13.
Lowe LC, Guy M, Mansi JL, Peckitt C, Bliss J, Wilson RG, Colston KW (2005) Plasma 25-hydroxy vitamin D concentrations, vitamin D receptor genotype and breast cancer risk in a UK Caucasian population. Eur J Cancer 41:1164–1169PubMedCrossRef
14.
Goodwin PJ, Ennis M, Pritchard KI, Koo J, Hood N (2009) Prognostic effects of 25-hydroxyvitamin D levels in early breast cancer. J Clin Oncol 27:3757–3763PubMedCrossRef
15.
Porojnicu AC, Dahlback A, Moan J (2008) Sun exposure and cancer survival in Norway: changes in the risk of death with season of diagnosis and latitude. Adv Exp Med Biol 624:43–54PubMedCrossRef
16.
Porojnicu AC, Lagunova Z, Robsahm TE, Berg JP, Dahlback A, Moan J (2007) Changes in risk of death from breast cancer with season and latitude: sun exposure and breast cancer survival in Norway. Breast Cancer Res Treat 102:323–328PubMedCrossRef
17.
Robsahm TE, Tretli S, Dahlback A, Moan J (2004) Vitamin D3 from sunlight may improve the prognosis of breast-, colon- and prostate cancer (Norway). Cancer Causes Control 15:149–158PubMedCrossRef
18.
Bischoff HA, Stahelin HB, Dick W, Akos R, Knecht M, Salis C, Nebiker M, Theiler R, Pfeifer M, Begerow B et al (2003) Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 18:343–351PubMedCrossRef
19.
Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, Thoma A, Kiel DP, Henschkowski J (2009) Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Arch Intern Med 169:551–561PubMedCrossRef
20.
Grados F, Brazier M, Kamel S, Duver S, Heurtebize N, Maamer M, Mathieu M, Garabedian M, Sebert JL, Fardellone P (2003) Effects on bone mineral density of calcium and vitamin D supplementation in elderly women with vitamin D deficiency. Joint Bone Spine 70:203–208PubMedCrossRef
21.
Lindsey AM, Gross G, Twiss J, Waltman N, Ott C, Moore TE (2002) Postmenopausal survivors of breast cancer at risk for osteoporosis: nutritional intake and body size. Cancer Nurs 25:50–56PubMedCrossRef
22.
Hirbe A, Morgan EA, Uluckan O, Weilbaecher K (2006) Skeletal complications of breast cancer therapies. Clin Cancer Res 12:6309s–6314sPubMedCrossRef
23.
Chen Z, Maricic M, Aragaki AK, Mouton C, Arendell L, Lopez AM, Bassford T, Chlebowski RT (2009) Fracture risk increases after diagnosis of breast or other cancers in postmenopausal women: results from the Women’s Health Initiative. Osteoporos Int 20:527–536PubMedCrossRef
24.
Chen Z, Maricic M, Bassford TL, Pettinger M, Ritenbaugh C, Lopez AM, Barad DH, Gass M, Leboff MS (2005) Fracture risk among breast cancer survivors: results from the Women’s Health Initiative Observational Study. Arch Intern Med 165:552–558PubMedCrossRef
25.
Kanis JA, McCloskey EV, Powles T, Paterson AH, Ashley S, Spector T (1999) A high incidence of vertebral fracture in women with breast cancer. Br J Cancer 79:1179–1181PubMedCrossRef
26.
Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB (2009) Incidence and mortality of hip fractures in the United States. JAMA 302:1573–1579PubMedCrossRef
27.
Cooper C (1997) The crippling consequences of fractures and their impact on quality of life. Am J Med 103:12S–17S discussion 17S–19SPubMedCrossRef
28.
Rapp K, Becker C, Lamb SE, Icks A, Klenk J (2008) Hip fractures in institutionalized elderly people: incidence rates and excess mortality. J Bone Miner Res 23:1825–1831PubMedCrossRef
29.
Hanley DA, Davison KS (2005) Vitamin D insufficiency in North America. J Nutr 135:332–337PubMed
30.
Malabanan A, Veronikis IE, Holick MF (1998) Redefining vitamin D insufficiency. Lancet 351:805–806PubMedCrossRef
31.
Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R (2005) Estimates of optimal vitamin D status. Osteoporos Int 16:713–716PubMedCrossRef
32.
Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food, Nutrition Board, Institute of Medicine (1997) Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D and fluoride. Washington, DC, National Academy Press
33.
Hiremath GS, Cettomai D, Baynes M, Ratchford JN, Newsome S, Harrison D, Kerr D, Greenberg BM, Calabresi PA (2009) Vitamin D status and effect of low-dose cholecalciferol and high-dose ergocalciferol supplementation in multiple sclerosis. Mult Scler 15:735–740PubMedCrossRef
34.
Lips P, Graafmans WC, Ooms ME, Bezemer PD, Bouter LM (1996) Vitamin D supplementation and fracture incidence in elderly persons. A randomized, placebo-controlled clinical trial. Ann Intern Med 124:400–406PubMed
35.
Meyer HE, Smedshaug GB, Kvaavik E, Falch JA, Tverdal A, Pedersen JI (2002) Can vitamin D supplementation reduce the risk of fracture in the elderly? A randomized controlled trial. J Bone Miner Res 17:709–715PubMedCrossRef
36.
Crew KD, Shane E, Cremers S, McMahon DJ, Irani D, Hershman DL (2009) High prevalence of vitamin D deficiency despite supplementation in premenopausal women with breast cancer undergoing adjuvant chemotherapy. J Clin Oncol 27:2151–2156PubMedCrossRef
37.
Prieto-Alhambra D, Javaid MK, Servitja S, Arden NK, Martinez-Garcia M, Diez-Perez A, Albanell J, Tusquets I, Nogues X (2011) Vitamin D threshold to prevent aromatase inhibitor-induced arthralgia: a prospective cohort study. Breast Cancer Res Treat 125:869–878PubMedCrossRef
38.
Cannell JJ, Hollis BW, Zasloff M, Heaney RP (2008) Diagnosis and treatment of vitamin D deficiency. Expert Opin Pharmacother 9:107–118PubMedCrossRef
39.
Amir E, Simmons CE, Freedman OC, Dranitsaris G, Cole DE, Vieth R, Ooi WS, Clemons M (2010) A phase 2 trial exploring the effects of high-dose (10, 000 IU/day) vitamin D(3) in breast cancer patients with bone metastases. Cancer 116:284–291PubMedCrossRef
40.
Bacon CJ, Gamble GD, Horne AM, Scott MA, Reid IR (2009) High-dose oral vitamin D3 supplementation in the elderly. Osteoporos Int 20:1407–1415PubMedCrossRef
41.
Burton JM, Kimball S, Vieth R, Bar-Or A, Dosch HM, Cheung R, Gagne D, D’Souza C, Ursell M, O’Connor P (2010) A phase I/II dose-escalation trial of vitamin D3 and calcium in multiple sclerosis. Neurology 74:1852–1859PubMedCrossRef
42.
Jorde R, Sneve M, Torjesen PA, Figenschau Y, Hansen JB, Grimnes G (2010) No significant effect on bone mineral density by high doses of vitamin D3 given to overweight subjects for one year. Nutr J 9:1PubMedCrossRef
43.
Hind K, Oldroyd B, Truscott JG (2010) In vivo precision of the GE Lunar iDXA densitometer for the measurement of total-body, lumbar spine, and femoral bone mineral density in adults. J Clin Densitom 13:413–417PubMedCrossRef
44.
Hans D, Downs RW Jr, Duboeuf F, Greenspan S, Jankowski LG, Kiebzak GM, Petak SM (2006) Skeletal sites for osteoporosis diagnosis: the 2005 ISCD Official Positions. J Clin Densitom 9:15–21PubMedCrossRef
45.
Khan QJ, Reddy PS, Kimler BF, Sharma P, Baxa SE, O’Dea AP, Klemp JR, Fabian CJ (2010) Effect of vitamin D supplementation on serum 25-hydroxy vitamin D levels, joint pain, and fatigue in women starting adjuvant letrozole treatment for breast cancer. Breast Cancer Res Treat 119:111–118PubMedCrossRef
46.
Neuhouser ML, Sorensen B, Hollis BW, Ambs A, Ulrich CM, McTiernan A, Bernstein L, Wayne S, Gilliland F, Baumgartner K et al (2008) Vitamin D insufficiency in a multiethnic cohort of breast cancer survivors. Am J Clin Nutr 88:133–139PubMed
47.
Fakih MG, Trump DL, Johnson CS, Tian L, Muindi J, Sunga AY (2009) Chemotherapy is linked to severe vitamin D deficiency in patients with colorectal cancer. Int J Colorectal Dis 24:219–224PubMedCrossRef
48.
Trump DL, Chadha MK, Sunga AY, Fakih MG, Ashraf U, Silliman CG, Hollis BW, Nesline MK, Tian L, Tan W et al (2009) Vitamin D deficiency and insufficiency among patients with prostate cancer. BJU Int 104:909–914PubMedCrossRef
49.
Clemens TL, Adams JS, Henderson SL, Holick MF (1982) Increased skin pigment reduces the capacity of skin to synthesise vitamin D3. Lancet 1:74–76PubMedCrossRef
50.
51.
52.
53.
Granacher U, Muehlbauer T, Gollhofer A, Kressig RW, Zahner L (2010) An intergenerational approach in the promotion of balance and strength for fall prevention—a mini-review. Gerontology. doi:10.​1159/​000320250
54.
Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, Orav JE, Stuck AE, Theiler R, Wong JB, Egli A, Kiel DP, Henschkowski J (2009) Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ 339:b3692PubMedCrossRef
55.
Wicherts IS, van Schoor NM, Boeke AJ, Visser M, Deeg DJ, Smit J, Knol DL, Lips P (2007) Vitamin D status predicts physical performance and its decline in older persons. J Clin Endocrinol Metab 92:2058–2065PubMedCrossRef
56.
Zerwekh JE (2008) Blood biomarkers of vitamin D status. Am J Clin Nutr 87:1087S–1091SPubMed
Metadata
Title
The effect of various vitamin D supplementation regimens in breast cancer patients
Authors
Luke J. Peppone
Alissa J. Huston
Mary E. Reid
Randy N. Rosier
Yousef Zakharia
Donald L. Trump
Karen M. Mustian
Michelle C. Janelsins
Jason Q. Purnell
Gary R. Morrow
Publication date
01-05-2011
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2011
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-011-1415-4

Other articles of this Issue 1/2011

Breast Cancer Research and Treatment 1/2011 Go to the issue

Preclinical study

DEAD box 1: a novel and independent prognostic marker for early recurrence in breast cancer

Preclinical study

S-adenosylhomocysteine hydrolase inhibition by 3-deazaneplanocin A analogues induces anti-cancer effects in breast cancer cell lines and synergy with both histone deacetylase and HER2 inhibition

Epidemiology

Sentinel node micrometastases in breast cancer do not affect prognosis: a population-based study

Epidemiology

Are breast conservation and mastectomy equally effective in the treatment of young women with early breast cancer? Long-term results of a population-based cohort of 1,451 patients aged ≤40 years

Brief Report

Genome-wide copy number alterations in subtypes of invasive breast cancers in young white and African American women

Invited Commentary

Dead-box or black-box: is DDX1 a potential biomarker in breast cancer?
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits