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Increased breast cancer risk associated with deficient vitamin D levels in Saudi women

Increased breast cancer risk associated with deficient vitamin D levels in Saudi women

Tuesday, June 25, 2013. The July, 2013 issue of the American Journal of Clinical Nutrition published the finding of researchers from Saudi Arabia and the University of Arizona of a greater risk of breast cancer among women with deficient levels of serum vitamin D. Insufficient vitamin D levels are common in countries whose residents receive little sun exposure due to climate, clothing or other factors, or whose increased skin pigmentation reduces vitamin D production.

Fatimah M. Yousef and her associates compared 120 Saudi women with invasive breast cancer with 120 age-matched controls. Dietary questionnaires completed by the participants provided information concerning vitamin D intake. Blood samples were analyzed for serum 25-hydroxyvitamin D levels.

Dietary intake of vitamin D among the participants was low—a finding that was compounded by Saudi Arabia's lack of vitamin D food fortification. Average serum 25-hydroxyvitamin D levels were 9.4 nanograms per milliliter (ng/mL) among subjects with breast cancer in comparison with 15.4 ng/mL in the control group. While 38.3% of the control group had deficient vitamin D levels of less than 10 ng/mL, this percentage rose to 60.8% of the breast cancer group. When women whose vitamin D levels were less than 10 ng/mL were compared with those whose levels were greater than 20 ng/mL, the risk of breast cancer was more than six times higher.

"The current study is among the first, to our knowledge, to evaluate the association between serum 25-hydroxyvitamin D and breast cancer in women residing in Saudi Arabia, an area of high UV sunlight exposure, but potentially low vitamin D status related to skin type and cultural practices of dress," the authors announce. "Efforts to more routinely assess vitamin D status and possibly provide supplementation to correct depletion in this at-risk group should be evaluated. The association between vitamin D and breast cancer risk clearly requires further investigation."

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Vitamin D could help treat triple-negative breast cancer

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The January 21, 2013 issue of The Journal of Cell Biology published a report by Susana Gonzalo at Saint Louis University and her associates that indicates a possible benefit for vitamin D in triple-negative breast cancer, one of the more treatment resistant forms of the disease. Triple-negative breast cancer tumors do not express receptors for estrogen, progesterone or HER2, and are therefore unresponsive to hormone-targeted therapies.

Dr Gonzalo's research discovered a molecular pathway in women with triple negative breast cancer and mutations in a tumor suppressor gene known as BRCA1. Loss of BRCA1 function impairs the cells' ability to repair DNA double-strand breaks and halt the proliferation of damaged cells.

It was recently discovered that the loss of another DNA repair factor known as 53BP1 enables the proliferation of BRCA1-deficient cells. Dr Gonzalo's team discovered that the protease cathepsin L degrades 53BP1, and that vitamin D restores it. "It's a new pathway that explains how breast cancer cells lose 53BP1," stated Dr Gonzalo, who is an assistant professor of biochemistry and molecular biology at Saint Louis University. She added, however, that the mechanism behind the increase in cancer cells' nuclear cathepsin L has not been defined.

In further research utilizing tissue samples from breast cancer patients with BRCA1 mutations or triple-negative breast cancer, the team found high levels of nuclear cathepsin L and decreased levels of 53BP1 and vitamin D receptor. These markers identify which populations might best benefit from cathepsin inhibitors or vitamin D therapy.

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