Swarnkar Manish, Kumar Krishna, Prasad Pankaj, Singhal Kritika
General Surgery, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Cureus. 2024 Jun 13;16(6):e62296. doi: 10.7759/cureus.62296. eCollection 2024 Jun.
Introduction Breast cancer is the most frequent cancer among women worldwide, but there is little literature regarding the effects of vitamin D on breast cancer patients in the Indian population. Hence, this study was planned to determine the correlation between vitamin D deficiency and tumor characteristics in breast cancer patients. Methods This was a cross-sectional study conducted in a tertiary healthcare facility in central India among all newly diagnosed patients with breast carcinoma who had received primary surgery and pathological confirmation. We performed universal sampling and included 50 patients in the study. We excluded patients with insufficient histopathological reports, those unfit for surgery, and those with hepatic or renal failure, metabolic bone disease, malabsorption, or recent consumption of vitamin D (patients who had received oral vitamin D in the preceding two weeks, or vitamin D injection in the preceding six months). Results Among the 50 patients, 86% were vitamin D deficient, with a mean deficiency of 23.54. Vitamin D deficiency is most common in the age groups 41-50 years and >60 years, with the mean age group of 51.49 years. The left side is more involved than the right in vitamin D-deficient patients. Most patients were moderately and poorly differentiated, suggesting a significant association between vitamin D deficiency and tumor differentiation. Almost half the patients were estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (Her-2/neu) status negative with vitamin D deficiency. Vitamin D deficiency was highest in Her-2/neu amplified, luminal A, and B patients. The mean lymph node-positive participants was 4.04, and the mean number of lymph nodes extracted was 15.58 in vitamin D-deficient breast cancer patients. Conclusion The prevalence of low vitamin D status was high among breast cancer patients. There is an association between vitamin D deficiency and tumors with poor prognostic features. Low vitamin D levels were considered a risk factor for ER, PR, and Her-2/neu-negative tumors along with positive lymph node status in breast cancer patients. Vitamin D status is a modifiable risk factor for breast cancer. Thus, it is concluded from this study that vitamin D has a potential role in the prevention of breast cancer, it may reduce its aggressiveness, and its deficiency is associated with an increased risk of breast cancer.
引言
乳腺癌是全球女性中最常见的癌症，但关于维生素D对印度人群乳腺癌患者影响的文献很少。因此，本研究旨在确定乳腺癌患者维生素D缺乏与肿瘤特征之间的相关性。
方法
这是一项在印度中部一家三级医疗机构对所有接受了初次手术和病理确诊的新诊断乳腺癌患者进行的横断面研究。我们进行了普查，研究纳入了50例患者。我们排除了组织病理学报告不充分的患者、不适合手术的患者以及患有肝或肾功能衰竭、代谢性骨病、吸收不良或近期服用过维生素D的患者（前两周内口服过维生素D或前六个月内注射过维生素D的患者）。
结果
在这50例患者中，86%存在维生素D缺乏，平均缺乏程度为23.54。维生素D缺乏在41 - 50岁和60岁以上年龄组最为常见，平均年龄组为51.49岁。维生素D缺乏患者左侧受累比右侧更多。大多数患者为中分化和低分化，提示维生素D缺乏与肿瘤分化之间存在显著关联。几乎一半的患者雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（Her-2/neu）状态为维生素D缺乏阴性。Her-2/neu扩增、管腔A型和B型患者中维生素D缺乏最为严重。维生素D缺乏的乳腺癌患者平均淋巴结阳性数为4.04，平均提取的淋巴结数为15.58。
结论
乳腺癌患者中维生素D水平低的患病率很高。维生素D缺乏与预后不良特征的肿瘤之间存在关联。低维生素D水平被认为是乳腺癌患者ER、PR和Her-2/neu阴性肿瘤以及淋巴结阳性状态的危险因素。维生素D状态是乳腺癌的一个可改变的危险因素。因此，本研究得出结论，维生素D在预防乳腺癌方面具有潜在作用，它可能降低乳腺癌的侵袭性，其缺乏与乳腺癌风险增加有关。
