Subclinical hypovitaminosis D and osteoporosis in breast cancer patients

Objective: This study was designed to detect 25-hydroxy vitamin D serum levels and bone mineral density (BMD) status in breast cancer patients, and to determine their relation to treatment and disease stages. Patients and methods: The study included 74 female patients with breast cancer and 52 healthy volunteers as the control group. Serum levels of 25-hydroxy vitamin D, calcium, phosphorus, and alkaline phosphatase were measured using ELISA kits, while dual energy x-ray absorptiometry (DXA) was performed to assess the BMD. Twelve patients received chemotherapy only; 12 received chemotherapy and hormonal therapy, 22 received chemotherapy and radiotherapy while 28 received chemotherapy, hormonal therapy and radiotherapy. Results: Serum levels of phosphorous and 25-hydroxy vitamin D were significantly lower (p =0.0001), and alkaline phosphatase was significantly increased (p =0.0001) in patients compared to the control. Hip, spine, and forearm DXA were significantly lower in patients than in controls (p =0.0001). The worst bone status was in those receiving both chemotherapy and hormonal therapy. The grade of tumor significantly correlated with the serum phosphorus level (p =0.048) and negatively with the serum 25hydroxyl vitamin D level (p =0.03) as well as with the DXA of hip (p =0.01) and spine (p =0.0001). Conclusion: Our study supports findings of increased incidence of hypovitaminosis D, osteoporosis and osteopenia in breast cancer patients. Hence, we throw light on the importance of offering calcium and vitamin D supplements to breast cancer patients. It is recommended that breast cancer patients have a DXA scan on a yearly basis.