The prognostic value of the 25(OH) vitamin D in breast cancer

INTRODUCTION: Breast cancer is the most frequent type of cancer in women. The most important factors that affect the prognosis are family history, bilateral involvement, Estrogen Receptor (ER), Progesterone Receptor (PR), histology, differentiation, proliferative index, age, gender, stage, axillary lymph node involvement and nutrition. In many studies, it was stated that vegetable and fruit rich dietary had reduced the risk. Particularly, the Vitamin D was determined to be effective in cancer, cardiovascular diseases, diabetes and autoimmune diseases. Besides, the colon, prostate and breast cancer incidences were proved to be lower in regions with plenty of UV rays. In the present study, it was aimed to evaluate the relationship between the Vitamin D levels and the prognostic features in patients with breast cancer and the advantages of planning the surgery after adjuvant therapy with regard to prognostic factor. MATERIAL AND METHOD: The study involved 125 female patients who were diagnosed with breast cancer and operated between the years 2013 - 2014 in Adnan Menderes University Medical Faculty General Surgery Clinic. 25 (OH) hydroxy Vitamin D values of the patients were recorded and divided into 3 (three) groups (group 1: <12.5 ng/dl [low], group 2: 12.5-25 ng/dl [normal acceptable level in our country], group 3: >25 ng/dl [high]). The postoperative pathology results of the patients were evaluated; the relationship between the Vitamin D levels and demographic data, number of axillary lymph node, tumor stage, tumor grade, distant organ metastasis presence, molecular subtypes and HER2, ER, PR states was statistically evaluated. RESULTS: While N2 (number of lymph node 4-9) was determined to be higher in the patients with Vitamin D level of <12.5, N0 (no lymph node) was determined to be higher in the patients with Vitamin D level of >25 and decreased the number of lymph node was determined with increasing level of Vitamin D (P=0.021). While the Stage 3A disease was higher in patients with Vitamin D level of <12.5, it was determined that the level of tumor decreased with increasing vitamin level and the Stage 2A disease was higher in patients with Vitamin D level of >25 (P=0.038). While the tumor size between 2-5 cm was higher in patients with Vitamin D level of < 12.5, there was no 2-5 cm size tumor in patients with Vitamin D level of >25 and the tumor diameter decreased with increasing level of Vitamin D. While the advanced stage tumors were higher in patients with Vitamin D level of <12.5, the early stage tumors were higher in patients with Vitamin D level of <25 and it was determined that the early stage tumors were seen more frequently with increasing level of Vitamin D. CONCLUSION: It was determined that the number of the held lymph node is decreased, lower stage tumors and smaller tumors were encountered with increasing level of Vitamin D. Key Words: Breast Cancer, 25(OH) Vitamin D, Estrogen Receptor(ER), Progesterone Receptor(PR), Axillary Lymph Node