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J Med Oncl Ther 2017 | Volume 2 Issue 3
Breast Cancer
November 01-02, 2017 | Toronto, Canada
7
th
World Congress on
Effects of pre-treatment 1,25-dihydroxyvitamin D levels on breast cancer patients receiving neoadjuvant
chemotherapy
Madeline Molot, Amy Tiersten, MD
1
; Meng Ru, MA
1
; Clare Whipple, MD
1
; Ira Bleiweiss, MD
2
; Anupma Nayak, MBBS, MD
2
; Shabnam Jaffer, MD
1
1
Icahn School of Medicine at Mount Sinai
2
Perelman School of Medicine, University of Pennsylvania
T
his study analyzed pre-treatment vitamin D levels of
breast cancer patients who had received neoadjuvant
chemotherapy (NACT). The primary outcome was pathological
complete response (pCR). Vitamin D levels were dichotomized
as being either adequate (>= 20 ng/ml) or inadequate/deficient
(<20ng/ml). Univariable logistic regression models were used
to assess the impact of Vitamin D levels and other prognostic
factors on pCR. Stepwise selection was used to identify factors
for a multivariable logistic regression, with interaction term
between vitaminD levels andmenopausal status included. Of the
88 patients reviewed, 51.2% (n=45) had inadequate/deficient
vitamin D levels and 48.8% (n=43) had adequate vitamin D
levels. It was found that menopausal status had a significant
interaction with vitamin D levels and pCR: pre-menopausal
women with adequate vitamin D levels were significantly
more likely than post-menopausal women to achieve pCR
(OR=17.697, 95% CI: (3.04, 102.89), p=0.0014). The interaction
between recurrence, percent tumor shrinkage, and vitamin
D levels was analyzed using a multivariable Cox regression
model. 17% (n=15) of the 88 patients recurred. Patients with
adequate vitamin D levels whose tumor decreased in size after
NACT were significantly less likely to recur than patients with
inadequate/deficient vitamin D levels whose tumor decreased
in the same amount (interaction p=0.0045). These data indicate
that adequate vitamin D levels and neoadjuvant chemotherapy
may produce an additive effect to yield a higher chance of pCR
and a lower chance of recurrence, an effect that is enhanced
for pre-menopausal women. Finally the data indicate that
vitamin D may provide a protective effect against recurrence
particularly when there is a large amount of tumor shrinkage
after treatment.
Speaker Biography
Madeline Molot is a senior at Barnard College studying Neuroscience and Behavior.
She has performed research at the Dubin Breast Center at Mount Sinai Hospital, as
well as at the Barnard Cognitive Development Center and at the NY State Psychiatric
Institute of the Columbia University Medical Center. She plans to attend medical school
in the future.
e:
mm4263@barnard.edu