title: Vitamin D deficiency is correlated with poor outcomes in patients with luminal-type breast cancer.
abstract: OBJECTIVE
  Vitamin D deficiency may be an indicator of poor prognosis in patients with breast cancer before surgery. We investigated the association between serum vitamin D concentration and breast cancer prognosis according to intrinsic cancer subtypes.
  
  
  METHODS
  From June to December 2006, serum 25-OHD was measured in 310 Korean women with breast cancer who were treated at the Asan Medical Center, Korea. Clinicopathologic data were examined to determine the prognostic effects of serum 25-OHD. Expression of estrogen receptor (ER), progesterone receptor (PR), and epidermal growth factor receptor 2 (Her2) were measured using tissue microarrays. Patients were classified with luminal A, luminal B, Her2-enriched, or basal-like subtypes of breast cancer.
  
  
  RESULTS
  Mean patient age was 48.7 years, and mean serum 25-OHD concentration was 31.4 ± 16.1 ng/ml. The 25-OHD levels were deficient (< 20 ng/ml) in 75 patients (24.2%), insufficient (20-29 ng/ml) in 95 (30.6%), and sufficient (30-150 ng/ml) in 140 (45.2%). Women with deficient 25-OHD levels were at increased risk of recurrence compared with those with sufficient vitamin D levels (P = 0.002). The 25-OHD concentration was inversely associated with prognosis of patients with cancer of the luminal A (P = 0.012) and luminal B subtypes (P =0.023), but not with the prognosis of patients with Her2/neu-enriched (P = 0.245) or triple-negative (P = 0.879) cancer subtypes. This association remained valid after adjustment for age, tumor size, nodal status, and estrogen receptor status (hazards ratio = 3.97; 95% confidence interval = 1.77-9.61).
  
  
  CONCLUSIONS
  Vitamin D deficiency may be associated with poor outcomes in patients with luminal-type breast cancer.
authors.affiliation: Department of Surgery, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: Hee Jeong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Yu Mi
authors.initials: YM
authors.lastname: Lee
authors.forename: Beon Seok
authors.initials: BS
authors.lastname: Ko
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Jong Han
authors.initials: JH
authors.lastname: Yu
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Son
authors.forename: Gyung-Yub
authors.initials: GY
authors.lastname: Gong
authors.forename: Sung Bae
authors.initials: SB
authors.lastname: Kim
authors.forename: Sei Hyun
authors.initials: SH
authors.lastname: Ahn
mesh_terms: D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*; D012189:Retrospective Studies; D015996:Survival Rate; D014807:Vitamin D / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*
chemical_list: D050071:Bone Density Conservation Agents; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D014807:Vitamin D