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Breast Cancer survival 2X more likely if vitamin D sufficient – meta-analysis May 2013

The relationship between serum vitamin D levels and breast cancer prognosis: A meta-analysis.

Journal of Clinical Oncology, 2013 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 31, No 15_suppl (May 20 Supplement), 2013: 1521
April Ann Nicole Rose, Christine Elser and Pamela Jean Goodwin
Faculty of Medicine, McGill University, Montreal, QC, Canada; Princess Margaret Hospital, Toronto, ON, Canada; Samuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada

Background: Vitamin D (VitD) is a circulating hormone known to regulate gene transcription in breast cancer (BC) cells. The association between VitD and BC risk has been extensively studied. Until recently, however, the role of VitD in BC progression and its association with clinical outcomes among BC patients was poorly understood. To assess these new developments, a systematic review and meta-analysis was performed.

Methods: A systematic review and meta-analysis by searching MEDLINE (1982 – 2012), ASCO, and SABCS for abstracts (2009 – 2012), with the following keywords: "breast cancer" and "prognosis" or "survival", and "vitamin D" or "calcitriol." Abstracts were scrutinized for reports correlating serum VitD levels with breast cancer clinical outcomes, including: disease-free survival (DFS) and overall survival (OS). Studies were included if serum VitD samples were taken shortly after diagnosis and survival data were reported. Meta-analyses were performed using an inverse-variance weighted fixed-effects model.

Results: We identified 7 studies reporting correlative data between serum VitD levels and BC survival. These data included 4,885 patients evaluated for DFS and 3858 patients evaluated for OS.
VitD-deficiency was defined as <30ng/mL, <20ng/mL, and <14ng/mL in 3, 3, and 1 studies, respectively, and was identified in an average of 48.1% of patients (range: 17.9-87.8%).
VitD deficiency was associated with a pooled hazard ratio (HR) of 2.13 (CI: 1.64 - 2.78) and 1.76 (CI: 1.35 - 2.30) for DFS and OS, respectively.

Conclusions: To our knowledge, this is the first report of a meta-analysis of the relationship between serum VitD and BC prognosis. The prevalence of VitD-deficiency varied widely across studies and may reflect differences in geographic location, race, and rates of supplementation across patient populations. These findings support the hypothesis that VitD-deficient breast cancer patients have poorer clinical outcomes than VitD sufficient patients; but do not establish whether this relationship is causative. Further studies are warranted to investigate the possible protective effects of VitD supplementation on survival among VitD-deficient BC patients.

Abstract presentation from the 2013 ASCO Annual Meeting

Paper published Oct 2013

Note the huge variation if the definitions of vitamin D deficiency: <30 ng, <20, and < 14 ng

See also VitaminDWiki

Studies in all 3 categories: Breast Cancer, Meta-analysis and Mortality

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