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The Effects of Vitamin D on Breast Cancer

Daisy Carter
Biology 101, Section 401
July 26, 2010

Vitamin D, serum 25-hydroxyvitamin D (25-OHD), is a very important substance for our

body to function properly. However, until a few decades ago, the necessity and benefits of this
vitamin were not as well known. Not only does it regulate calcium and promote bone health, it
has been discovered that vitamin D deficiency is associated with an increased risk in breast
cancer as well as a decrease in the survival rate. As more than 30% to 50% of healthy adults are
vitamin D deficient, this is a cause for concern; however, it is more so for women with breast
Modest amounts of vitamin D come from dietary sources, such as fortified dairy products,
fatty fish, and supplements, but the majority is produced naturally in the body when 7dehydrocholesterol in the skin is exposed to ultraviolet B (UVB) radiation to produce vitamin B3
(cholecalciferol). Vitamin D3 then goes through two processes: first in the liver to form 25OHD, the major circulating metabolite, and then in the kidneys to produce 1,25digydroxyvitamin (1,25-(OH)2D), the biologically active form. Not only does 1,25-(OH)2D
effect bone and mineral metabolism, it has pleiotrophic cancer effects, such as inhibition of cell
proliferation, promotion of differentiation, and induction of apoptosis in normal and malignant
cells. 1
There are several risk factors for vitamin D deficiency such as older age, darker skin
pigmentation, obesity, low dietary intake, and sun avoidance behaviors. This means that a
majority of the population, and especially the minorities (which is due to the melanin in the skin,
which is an effective filter of UVB radiation), are deficient.
A clinical trial was performed to determine the prevalence of vitamin D deficiency in
premenopausal women at the initiation of adjuvant chemotherapy for breast cancer and after one

year of vitamin D supplementation. As women who have or have had breast cancer have a 15%
higher fracture risk than women without a history of cancer, the effects are even greater. The
study hypothesized that standard doses of vitamin D and calcium would not be sufficient to
maintain bone density or to raise serum 25-OHD to sufficient levels in premenopausal women
undergoing chemotherapy.
The participants in the study were premenopausal women with early-stage breast cancer who
were undergoing adjuvant chemotherapy and were also undergoing a randomized, double-blind,
multicenter, phase III trial to compare zoledronic acid 4 mg intravenously every three months
with a placebo for one year. The patients were given one tablet of elemental calcium 500 IU
combined with vitamin D3 200 IU twice daily for one year and evaluated every 3 weeks for the
first 24 weeks and every 3 months thereafter.