Study: High vitamin D levels at breast cancer diagnosis may be associated with a better prognosis
Summary
Vitamin D is most known for its role in maintaining bone health but vitamin D has additional roles in keeping us healthy. In this study, researchers found that breast cancer patients who had the highest amounts of vitamin D in their blood (slightly over the recommended levels) had better health outcomes, including overall survival, than women with lower amounts of vitamin D. This finding adds to the growing evidence for the role of vitamin D in cancer, but it does not change how breast cancer is prevented or treated. (1/10/17)
Relevance
This article is most relevant for Women at average risk for breast cancer and newly diagnosed women
Relevance: Medium-High
Strength of Science: Medium
Research Timeline: Human Research
Media Ratings
Who covered this study?
Medical News Today
Vitamin D may increase survival for breast cancer patients
This article rates 4.0 out of 5 stars
New York Times
Vitamin D linked to longer breast cancer survival
This article rates 3.5 out of 5 stars
Contents
| At a glance | Clinical trials |
| Findings | In-depth |
| Guidelines | Limitations |
| Questions for your doctor | Resources |
STUDY AT A GLANCE
This study is about:
Whether women’s vitamin D blood levels at the time of diagnosis are related to their health outcomes.
Why is this study important?
Vitamin D is important for bone health and is also implicated in other bodily processes. Some research suggests that vitamin D is involved in breast cancer, but its role is not well understood. Researchers in this study wanted to know if there is a link between the level of vitamin D in a woman’s blood at the time of her breast cancer diagnosis and her prognosis (how well she does after the diagnosis), including measurements of breast cancer and survival.
Study findings:
- Women with the highest levels of vitamin D (slightly higher than the recommended level) in their blood had better overall survival than women with lower vitamin D levels.
- Lower vitamin D levels were associated with a more advanced breast cancer at diagnosis.
What does this mean for me?
This study suggests that women who have high vitamin D levels (slightly higher than the level recommended by the National Institute of Health) have better overall survival compared to women with lower levels. These findings agree with several other studies of vitamin D levels and breast cancer survival outcomes. But much more work needs to be done before these findings can be applied to preventing breast cancer or recurrence. This study’s results do not mean that increasing vitamin D consumption after a breast cancer diagnosis will improve patient survival; it just means that patients who had better survival were seen to have higher vitamin D levels. The researchers do not know if better survival is directly related to vitamin D.
Ultimately, vitamin D is very important for all women. It helps calcium absorption in the gut, keeps bones strong, and also aids in some functions of immune function, cell growth, and reduction of inflammation. Vitamin D deficiencies result in diseases that cause weak bones and contribute to , so it is important to maintain adequate levels of vitamin D in our bodies whether or not it affects cancer risk or prognosis. Women concerned about their vitamin D levels should consult with their health care provider who can order blood tests to check their vitamin D levels and advise them if dietary changes or supplements are necessary.
Posted 1/10/17
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References
Yao S, Kwan ML, Ergas IJ, et al. “Association of Serum Level of Vitamin D at Diagnosis with Breast Cancer Survival A Case-Cohort Analysis in the Pathways Study.” JAMA Oncology. Published online first on November 10, 2016.
National Institutes of Health, Office of Dietary Supplements. “Vitamin D.”
This article is relevant for:
Women at average risk for breast cancer and newly diagnosed women
This article is also relevant for:
people with breast cancer
people with ER/PR + cancer
healthy people with average cancer risk
people with Her2-positive cancer
people with a genetic mutation linked to cancer risk
previvors
people with triple negative breast cancer
people newly diagnosed with cancer
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IN DEPTH REVIEW OF RESEARCH
Study background:
Previous studies have tried to determine whether there are potential associations between vitamin D levels in the blood and breast cancer risk, but have concluded with mixed results: some say there is an association while others say there is not. But fewer studies have looked at whether there is an association between vitamin D blood levels at the time of diagnosis and breast cancer prognosis; studies that did involve this relationship assessed overall survival, but not deaths from breast cancer. As vitamin D deficiencies have known effects beyond any role in breast cancer, lower overall survival in women with low blood levels of vitamin D may be due to causes unrelated to their breast cancer.
Song Yao and colleagues from the Department of Cancer Prevention and Control at the Rosewell Park Cancer Institute performed a study (meaning they designed the study and collected the data themselves rather than looking back on information collected by others or relying on patients’ recollections). They looked at the association between blood vitamin D levels at the time of diagnosis and breast cancer prognosis.
Researchers of this study wanted to know:
Does a woman’s amount of vitamin D in her blood indicate how well she will do after a breast cancer diagnosis?
Population(s) looked at in the study:
This study (called the Pathways Study) included 1,666 women who were diagnosed with invasive breast cancer. This population was established at Kaiser Permanente Northern California and was designed to specifically study factors that are associated with breast cancer recurrence and survival. The women’s vitamin D levels were measured shortly after diagnosis and were then followed for up to 96 months after they were enrolled in the study in which researchers tracked participants’ health outcomes.
Vitamin D has several forms in the blood. In this study, the researchers measured a form called 25-hydroxyvitamin D, which according to the National Institutes of Health () is the best indicator of a person’s overall vitamin D status.
The states that a vitamin D level of 20 ng/mL or greater is considered adequate for bone and overall health. For this study, the researchers divided the women into three groups based on their vitamin D blood levels:
- Group 1 had low vitamin D levels: below 16.75 ng/mL
- Group 2 had vitamin D levels just over or under the recommended levels: 16.75-25.09 ng/mL
- Group 3 had high vitamin levels: 25.10 ng/mL or greater
Study findings:
- Women with the highest level of vitamin D (slightly higher than the recommended vitamin D levels) in their blood had better overall survival than women with lower vitamin D levels.
- This association was greatest in premenopausal women.
- Premenopausal women with the highest vitamin D levels were less likely to die from breast cancer within the period of the study than women with lower vitamin D levels..
- Premenopausal women with the highest vitamin D levels had greater invasive disease-free survival, which included recurrences and secondary cancer diagnoses, than women with lower vitamin D levels.
- Lower vitamin D levels were associated with a more advanced of breast cancer at diagnosis.
Limitations:
It is important to understand that the link identified in this study between high vitamin D levels in the blood and better breast cancer survival after diagnosis does not necessarily mean that vitamin D directly caused the better prognosis or that having higher levels of vitamin D in the blood prevents breast cancer diagnosis or recurrence. Other factors that were not measured by the study may have played a role in the women’s improved survival.
Conclusions:
This study suggests that women who are diagnosed with breast cancer and have high levels of vitamin D have a better prognosis than women with lower levels of vitamin D. More work needs to be done to further understand how this can help women with breast cancer in the clinic. In the meantime, women should maintain a healthy vitamin D level, which benefits their overall health.
Posted 1/10/17
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Expert Guidelines
Dietary Supplements
National Comprehensive Cancer Network (NCCN) guidelines on survivorship include the following recommendations on dietary supplement use:
- Taking dietary supplements is not recommended for most cancer survivors unless a patient has a known nutritional deficit, an inadequate diet or other indication (for example, ).
- Little data exist to support the use of vitamins or other dietary supplements for cancer prevention, control or recurrence.
- Taking vitamin supplements does not replace the need for a healthy diet. Patients should try to get nutrients from the foods they eat and the beverages they drink.
- Providers should ask about supplement use at regular intervals, about a patient’s reasons for using supplements and the ingredients in those supplements.
- Survivors of certain cancers are at risk of vitamin deficiencies based on cancer treatment (e.g., gastric cancer patients who have had a gastrectomy may be at risk of vitamin B12 and iron deficiencies).
- NCCN recommends calcium and vitamin D supplements for people who have been prescribed denosumab or a bisphosphonate to treat bone or .
- Patients taking multiple supplements and those in need of nutritional support should be referred to a registered dietitian or nutritionist, preferably one who is trained in supporting oncology patients.
Updated: 05/20/2022
Questions To Ask Your Doctor
- Should I have my vitamin D levels monitored?
- If I am vitamin D deficient, what can I do?
- What are measures I can take to reduce my breast cancer risk?
- Should I be taking any other supplements?
- Can you refer me to a nutritionist?
Open Clinical Trials
- clinicaltrials.gov/show/NCT03596073. Calcipotriene is a form of vitamin D. It works by slowing down the growth of skin cells and has been approved for treating a skin condition called psoriasis. Researchers want to find out how topical calcipotriene ointment affects people who have breast cancer, and what impact that may have on those who are at risk of developing breast cancer in the future.
Open Clinical Trials
The following are studies focused on nutrition for people diagnosed with breast cancer.
- NCT05056077: Tools To Be Fit: Tools to Improve Nutrition and Physical Activity for Cancer Survivors. This study looks at which tools work best for helping cancer survivors improve their diet and exercise.
- NCT05259410: Time-Restricted Eating During Chemotherapy for Breast Cancer. This study looks at whether intermittent fasting during treatment improves treatment-related outcomes, patient-related outcomes and limit treatment-related weight gain.
- NCT04365569 Evaluating the Effectiveness of an Individualized Nutrition and Physical Activity Counseling Program. This pilot study looks at whether a tailored in-person and telephone-based nutrition and exercise counseling program help breast cancer patients improve weight and fitness and thus improve cancer outcomes.
- NCT03824145: Every Day Counts: A Lifestyle Program for Women With Breast Cancer (EDC). This study examines the diet and activity, body composition, blood and quality of life in breast cancer patients from Milwaukee and Chicago.
- NCT05984888: Pilot Study of a MIND Diet Intervention in Women Undergoing Active Treatment for Breast Cancer. The MIND diet is high in anti-inflammatory nutrients and limits the intake of brain-unhealthy foods (i.e., foods high in fat, red meat, and sweets), which may help reduce the negative effects of cancer treatments on memory and thinking. This study will investigate whether the MIND diet is protective of function in women with invasive breast cancer starting systemic therapies.
Visit our Featured Research Page and Research Search and Enroll Tool to find additional studies enrolling people with or at high risk for cancer.
Updated: 05/31/2024
Related Resources
The following resources focus on nutrition and cancer.
- FORCE nutrition resources:
- Information: Nutrition, Exercise and Weight
- XRAY: Reviews on Diet and Exercise
- Video: Diet and Nutrition
- Video: Nutrition and Supplements
- Video playlist: Nutrition and Exercise
- FORCE partners with Savor Health® to provide free, personalized and evidence-based nutrition support 24/7 and “on-demand" nutritional guidance through their text-based Intelligent Nutrition Assistant (Ina®). You can subscribe here for the free service.
- United States Office of Disease Prevention and Health Promotion has links to national guidelines on nutrition and resources.
- The American Institute for Cancer Research (AICR) is an organization that translates research on diet and cancer risk into practical information for the public. Their tools can help people maintain a healthy diet, weight and exercise routine.
- The Academy of Nutrition and Dietetics has a user-friendly, plain-language website with tools for maintaining good nutrition and an active lifestyle.
- Nutrition.gov provides information about healthy eating, physical activity, food safety and healthy recipes. The site was developed by the U.S. Department of Agriculture.
The following resources focus on nutritional safety.
- Alerts, Advisories and Recalls from the and the FTC.
- The National Center for Complementary and Integrative Health (NCCIH) is part of the National Institutes of Health that researches practices and products that are not part of conventional medicine.
- How Safe is this Product or Practice? is a resource from NCCIH with results from research on complementary and integrative therapies.
Updated: 11/20/2023
Who covered this study?
Medical News Today
Vitamin D may increase survival for breast cancer patients
This article rates 4.0 out of 5 stars
New York Times
Vitamin D linked to longer breast cancer survival
This article rates 3.5 out of 5 stars
Medical Daily
Breast cancer treatment: High levels of vitamin D linked to better prognosis
This article rates 3.0 out of 5 stars