Beth Israel Medical Center, 325 West 15th Street, New York, New York 10011, USA.
Oncologist. 2012;17(1):36-45. doi: 10.1634/theoncologist.2011-0278. Epub 2012 Jan 10.
In addition to its role in calcium homeostasis and bone health, vitamin D has also been reported to have anticancer activities against many cancer types, including breast cancer. The discovery that breast epithelial cells possess the same enzymatic system as the kidney, allowing local manufacture of active vitamin D from circulating precursors, makes the effect of vitamin D in breast cancer biologically plausible. Preclinical and ecologic studies have suggested a role for vitamin D in breast cancer prevention. Inverse associations have also been shown between serum 25-hydroxyvitamin D level (25(OH)D) and breast cancer development, risk for breast cancer recurrence, and mortality in women with early-stage breast cancer. Clinical trials of vitamin D supplementation, however, have yielded inconsistent results. Regardless of whether or not vitamin D helps prevent breast cancer or its recurrence, vitamin D deficiency in the U.S. population is very common, and the adverse impact on bone health, a particular concern for breast cancer survivors, makes it important to understand vitamin D physiology and to recognize and treat vitamin D deficiency. In this review, we discuss vitamin D metabolism and its mechanism of action. We summarize the current evidence of the relationship between vitamin D and breast cancer, highlight ongoing research in this area, and discuss optimal dosing of vitamin D for breast cancer prevention.
除了在钙平衡和骨骼健康中的作用外,维生素 D 还被报道具有多种抗癌作用,包括乳腺癌。发现乳腺上皮细胞具有与肾脏相同的酶系统,允许从循环前体中局部制造活性维生素 D,这使得维生素 D 在乳腺癌中的作用具有生物学合理性。临床前和生态学研究表明维生素 D 在乳腺癌预防中的作用。血清 25-羟维生素 D 水平(25(OH)D)与乳腺癌的发生、乳腺癌复发的风险以及早期乳腺癌女性的死亡率之间也存在反比关系。然而,维生素 D 补充的临床试验结果并不一致。无论维生素 D 是否有助于预防乳腺癌或其复发,美国人群中维生素 D 缺乏非常普遍,对骨骼健康的不利影响,特别是对乳腺癌幸存者,这使得了解维生素 D 生理学以及识别和治疗维生素 D 缺乏症变得非常重要。在这篇综述中,我们讨论了维生素 D 的代谢及其作用机制。我们总结了目前维生素 D 与乳腺癌之间关系的证据,突出了该领域正在进行的研究,并讨论了预防乳腺癌的最佳维生素 D 剂量。