Clinicopathological and immunohistochemical correlations of breast carcinoma with vitamin D status in Erbil Governorate, Kurdistan of Iraq
Background and objective: Vitamin D has been associated with decreased risk of several cancers, including breast cancer, and its deficiency has been associated with poor prognosis. This study evaluated vitamin D level in breast cancer patients at diagnosis and investigated its association with various breast cancer prognostic criteria, especially the intrinsic molecular subtypes.
Methods: Using a prospective population-based, case-control and case series, study in Erbil city during 1st October 2017 and 31st March 2018, we evaluated vitamin D status in 50 breast cancer patients in correlation with 100 normal healthy controls. We examined various clinicopathological and immunohistochemical features of breast cancer to determine the prognostic effect of plasma 25-hydroxyvitamin D levels at diagnosis.
Results: The mean patient’s age was 51.1±10.7 years. The mean plasma 5-hydroxyvitamin D concentration was 8.138 ±7.5 and 16.7±12.06ng/mL in the breast cancer patients and controls, respectively (P <0.001). Vitamin D deficiency was associated with positive breast cancer risk (Odds Ratio (OR), 4.1; 95% confidence interval (CI), 1.68–10). The risk was greater in premenopausal (OR=7.5; 95%CI =1.60-35.23) than postmenopausal women (OR=2.7; 95%CI =0.87- 8.49). The mean serum level of 5-hydroxyvitamin D decreased significantly with the increasing stage in premenopausal (P = 0.055) and HER2/neu +ve immunoexpression (P = 0.008), especially in postmenopausal (P = 0.035). Regarding the molecular subtypes, HER2/neu enriched type showed the lowest mean 5-hydroxyvitamin D with a significant statistical association in premenopausal (P = 0.033).
Conclusion: These results add to a growing body of evidence that vitamin D deficiency associated with breast cancer risk and prognosis. Well-designed clinical trials are highly needed to determine whether vitamin D supplementation is effective for breast cancer chemoprevention and prognosis improvement if occur.
Keywords: Breast cancer; Molecular types; Vitamin D.
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