Prognostic Effects of 25-Hydroxyvitamin D Levels in Early Breast Cancer.
Vitamin D has been linked to breast cancer risk, but prognostic effects are unknown. Such effects are biologically plausible given the presence of vitamin D receptors in breast cancer cells, which act as nuclear transcription factors to regulate gene activity.
PATIENTS AND METHODS:
The study was conducted in a prospective inception cohort of 512 women with early breast cancer diagnosed 1989 to 1996. Vitamin D levels were measured in stored blood. Clinical, pathologic, and dietary data were accessed to examine prognostic effects of vitamin D.
Mean age was 50.4 years, mean vitamin D was 58.1 +/- 23.4 nmol/L. Vitamin D levels were deficient (< 50 nmol/L) in 37.5% of patients, insufficient (50 to 72 nmol/L) in 38.5% of patients, and sufficient (> 72 nmol/L) in 24.0% of patients. There was little variation in mean vitamin D levels between summer and winter months. Mean follow-up was 11.6 years; 116 women had distant recurrences, and 106 women died. Women with deficient vitamin D levels had an increased risk of distant recurrence (hazard ratio [HR] = 1.94; 95% CI, 1.16 to 3.25) and death (HR = 1.73; 95% CI, 1.05 to 2.86) compared with those with sufficient levels. The association remained after individual adjustment for key tumor and treatment related factors but was attenuated in multivariate analyses (HR = 1.71; 95% CI, 1.02 to 2.86 for distant recurrence; HR = 1.60; 95% CI, 0.96 to 2.64 for death).
Vitamin D deficiency may be associated with poor outcomes in breast cancer.
Their idea of deficient and insufficient and even sufficient are really out of date.
We really should regard any level below 80nmol/l 32ng as deficient as under that level you can measure adverse consequences in Bone Mineral Density
under 100nmol/l 40ng should be regarded as insufficient as you need to be at 40ng 100nmol/l or above in order for calctriol to be produced optimally but to have the lowest incidence of disease and best prognosis for cancer you need at level at or above 55ng as only then does your body have an effective store of D3 to call on to fight the condition.
The deficient state is one where things get worse if you don't change matters. You haven't enough money coming in each week to pay the weekly bills, you're putting the difference on the credit card and you know you can't do that for evermore.
The insufficient state is where you can almost make the weekly income match weekly expenditure but it requires both luck and skillfull management and you have nothing in reserve to meet any exceptional circumstance.
Optimal status is where your weekly income exceeds your weekly expenditure, you have a small easily accessible reserve that you can call on as needed.