{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:31:03Z","timestamp":1787841063691,"version":"build-2784847793"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T00:00:00Z","timestamp":1600387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Vitamin D is a steroid hormone that exerts its actions through ligation of the vitamin D receptor (VDR), a transcription factor of the nuclear receptor family. VDR has not only physiologic actions in calcium metabolism but also several other cellular effects through extensive binding to the DNA and modification of genome expression. In cancer, it has neoplasia-suppressive effects and various mechanisms of action mediating cancer cell inhibition have been described. Vitamin D deficiency has been linked to increased risk of breast cancer. A role of the vitamin once the disease has been diagnosed is also probable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic review and meta-analysis of studies that report on vitamin D levels (in the form of its main circulating metabolite, 25-hydroxyvitamin D [25-OHD]) in patients with newly diagnosed breast cancer was performed. Outcomes of interest included the levels of serum 25-OHD in patients with breast cancer, those of matched controlled, in studies that included controls, as well as respective percentages of patients and controls with deficient and insufficient 25-OHD levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 25 studies (10 with controls and 15 without controls) provided data on the outcomes of interest. Populations from all continents, besides Australia, were represented in the studies. The mean level of 25-OHD in patients with breast cancer was 26.88 ng\/mL (95% CI 22.8\u201330.96 ng\/mL) and the mean level of 25-OHD in control patients was 31.41 ng\/mL (95% CI 19.31\u201343.5 ng\/mL). In the patients with breast cancer group, 45.28% (95% CI 24.37%\u201353.51%) had levels of 25-OHD below 20 ng\/mL, whereas this percentage was 33.71% (95% CI 21.61%\u201345.82%) in controls. Similarly, 67.44% (95% CI 48.32%\u201386.55%) of patients with breast cancer had a baseline level of 25-OHD below 30 ng\/mL, whereas this percentage was 33.71% (95% CI 21.61%\u201345.82%) in controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A high prevalence of vitamin D insufficiency is observed in patients with newly diagnosed breast cancer and may be linked pathophysiologically with breast cancer development or progression. Therapeutic benefits may be provided by manipulation of the vitamin D pathway in breast cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.hemonc.2020.08.005","type":"journal-article","created":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T00:46:42Z","timestamp":1601081202000},"page":"16-26","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":56,"title":["Vitamin D baseline levels at diagnosis of breast cancer"],"prefix":"10.4103","volume":"14","author":[{"given":"Ioannis A.","family":"Voutsadakis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-2-20241211","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.jsbmb.2016.11.020","article-title":"The role of vitamin D and VDR in carcinogenesis: through epidemiology and basic sciences","volume":"167","author":"Bandera","year":"2017","journal-title":"J Steroid Biochem Mol Biol"},{"key":"R2-2-20241211","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1007\/s00432-016-2325-y","article-title":"Influence of vitamin D signaling on hormone receptor status and HER2 expression in breast cancer","volume":"143","author":"Zhang","year":"2017","journal-title":"J Cancer Res Clin Oncol"},{"key":"R3-2-20241211","first-page":"D87","article-title":"JASPAR 2020: update of the open-access database of transcription factor binding profiles","volume":"48","author":"Fornes","year":"2020","journal-title":"Nucleic Acids Res"},{"key":"R4-2-20241211","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1634\/theoncologist.2011-0278","article-title":"Vitamin D and breast cancer","volume":"17","author":"Shao","year":"2012","journal-title":"Oncologist"},{"key":"R5-2-20241211","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1007\/s12185-013-1354-4","article-title":"Mechanisms of action and resistance to all-trans retinoic acid (ATRA) and arsenic trioxide (As2O3) in acute promyelocytic leukemia","volume":"97","author":"Tomita","year":"2013","journal-title":"Int J Hematol"},{"key":"R6-2-20241211","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1002\/jbmr.3744","article-title":"Loss of the vitamin D receptor in human breast cancer cells promotes epithelial to mesenchymal cell transition and skeletal colonization","volume":"34","author":"Horas","year":"2019","journal-title":"J Bone Mineral Res"},{"key":"R7-2-20241211","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.nutres.2010.12.001","article-title":"Prevalence and correlates of vitamin D deficiency in US adults","volume":"359","author":"Forrest","year":"2011","journal-title":"Nutr Res"},{"key":"R8-2-20241211","doi-asserted-by":"crossref","first-page":"j4952","DOI":"10.1136\/bmj.j4952","article-title":"Low vitamin D levels as a risk factor for cancer","volume":"359","author":"Manousaki","year":"2017","journal-title":"Br Med J"},{"key":"R9-2-20241211","doi-asserted-by":"crossref","first-page":"077004","DOI":"10.1289\/EHP943","article-title":"Serum vitamin D and risk of breast cancer within five years","volume":"125","author":"O\u2019Brien","year":"2017","journal-title":"Environ Health Perspect"},{"key":"R10-2-20241211","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1158\/1055-9965.EPI-14-0007","article-title":"Prospective population-based study of the association between serum 25-hydroxyvitamin-D levels and the incidence of specific types of cancer","volume":"23","author":"Skaaby","year":"2014","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"R11-2-20241211","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1093\/jnci\/djn360","article-title":"Calcium plus vitamin D supplementation and the risk of breast cancer","volume":"100","author":"Chlebowski","year":"2008","journal-title":"J Natl Cancer Inst"},{"key":"R12-2-20241211","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1007\/s10549-012-2012-x","article-title":"25-Hydroxy vitamin-D, obesity, and associated variables as predictors of breast cancer risk and tamoxifen benefit in NSABP-P1","volume":"133","author":"Amir","year":"2012","journal-title":"Breast Cancer Res Treat"},{"key":"R13-2-20241211","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1007\/s10552-013-0158-4","article-title":"Associations of serum 25\u2013hydroxyvitamin D with overall and breast cancer-specific mortality in a multiethnic cohort of breast cancer survivors","volume":"24","author":"Villase\u00f1or","year":"2013","journal-title":"Cancer Causes Control"},{"key":"R14-2-20241211","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1080\/01635581.2018.1470653","article-title":"Serum vitamin D status and breast cancer risk by receptor status: a systematic review","volume":"70","author":"Tommie","year":"2018","journal-title":"Nutr Cancer"},{"key":"R15-2-20241211","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.jsbmb.2018.04.005","article-title":"Serum 25-hydroxyvitamin D and breast cancer risk by pathological subtype (MCC-Spain)","volume":"182","author":"Lope","year":"2018","journal-title":"J Steroid Biochem Mol Biol"},{"key":"R16-2-20241211","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"Br Med J"},{"key":"R17-2-20241211","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/1756-0500-5-52","article-title":"Meta-analyses and Forest plots using a Microsoft Excel spreadsheet: step-by-step guide focusing on descriptive data analysis","volume":"5","author":"Neyeloff","year":"2012","journal-title":"BMC Res Notes"},{"key":"R18-2-20241211","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1097\/CAD.0000000000000493","article-title":"A systematic review and pooled analysis of retrospective series of eribulin in metastatic breast cancer","volume":"28","author":"Voutsadakis","year":"2017","journal-title":"Anticancer Drugs"},{"key":"R19-2-20241211","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/1471-2288-9-80","article-title":"Meta-Analyst: software for meta-analysis of binary, continuous and diagnostic data","volume":"9","author":"Wallace","year":"2009","journal-title":"BMC Med Res Methodol"},{"key":"R20-2-20241211","doi-asserted-by":"crossref","first-page":"280","DOI":"10.7326\/0003-4819-158-4-201302190-00009","article-title":"Assessing bias in studies of prognostic factors","volume":"158","author":"Hayden","year":"2013","journal-title":"Ann Intern Med"},{"key":"R21-2-20241211","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.clbc.2017.12.001","article-title":"Serum vitamin D levels affect pathologic complete response in patients undergoing neoadjuvant systemic therapy for operable breast cancer","volume":"18","author":"Chiba","year":"2018","journal-title":"Clin Breast Cancer"},{"key":"R22-2-20241211","doi-asserted-by":"crossref","first-page":"e17251","DOI":"10.1371\/journal.pone.0017251","article-title":"Pretreatment serum concentrations of 25-hydrox-yvitamin D and breast cancer prognostic characteristics: a case-control and a case-series study","volume":"6","author":"Yao","year":"2011","journal-title":"PLoS ONE"},{"key":"R23-2-20241211","doi-asserted-by":"crossref","first-page":"144","DOI":"10.3390\/cancers9100144","article-title":"Association of vitamin D3 level with breast cancer risk and prognosis in African-American and Hispanic women","volume":"9","author":"Wu","year":"2017","journal-title":"Cancers"},{"key":"R24-2-20241211","doi-asserted-by":"crossref","first-page":"2590","DOI":"10.1245\/s10434-012-2297-3","article-title":"The association between breast cancer prognostic indicators and serum 25-OH vitamin D levels","volume":"19","author":"Peppone","year":"2012","journal-title":"Ann Surg Oncol"},{"key":"R25-2-20241211","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1097\/GME.0000000000001203","article-title":"Low pretreatment serum concentration of vitamin D at breast cancer diagnosis in postmenopausal women","volume":"26","author":"Matos","year":"2019","journal-title":"Menopause"},{"key":"R26-2-20241211","doi-asserted-by":"crossref","first-page":"564","DOI":"10.15537\/smj.2018.6.21902","article-title":"A descriptive study of vitamin D and other nutritional factors in breast cancer patients in Saudi Arabia","volume":"39","author":"AlFaris","year":"2018","journal-title":"Saudi Med J"},{"key":"R27-2-20241211","doi-asserted-by":"crossref","first-page":"645","DOI":"10.12669\/pjms.333.11753","article-title":"Association between vitamin D deficiency and breast cancer","volume":"33","author":"Shaukat","year":"2017","journal-title":"Pak J Med Sci"},{"key":"R28-2-20241211","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.breast.2016.06.002","article-title":"Serum vitamin D (25OHD3) levels and the risk of different subtypes of breast cancer: a nested case-control study","volume":"28","author":"Shirazi","year":"2016","journal-title":"Breast"},{"key":"R29-2-20241211","doi-asserted-by":"crossref","first-page":"452","DOI":"10.20945\/2359-3997000000062","article-title":"Low serum 25-hydroxyvitamin D levels are associated with aggressive breast cancer variants and poor prognostic factors in patients with breast carcinoma","volume":"62","author":"Karthikayan","year":"2018","journal-title":"Arch Endocrinol Metab"},{"key":"R30-2-20241211","doi-asserted-by":"crossref","first-page":"8390","DOI":"10.4076\/1757-1626-2-8390","article-title":"Triple negative breast cancer patients presenting with low serum vitamin D levels: a case series","volume":"2","author":"Rainville","year":"2009","journal-title":"Cases J"},{"key":"R31-2-20241211","doi-asserted-by":"crossref","first-page":"e407","DOI":"10.1016\/j.clbc.2018.12.019","article-title":"Vitamin D receptor in breast cancer tissues and its relation to estrogen receptor alpha (ER-\u03b1) gene expression and serum 25-hydroxyvitamin D levels in Egyptian breast cancer patients: a case-control study","volume":"19","author":"Hemida","year":"2019","journal-title":"Clin Breast Cancer"},{"key":"R32-2-20241211","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1007\/s10549-015-3355-x","article-title":"Prognostic associations of 25 hydroxy vitamin D in NCIC CTG MA.21, a phase III adjuvant randomized clinical trial of three chemotherapy regimens in high-risk breast cancer","volume":"150","author":"Lohmann","year":"2015","journal-title":"Breast Cancer Res Treat"},{"key":"R33-2-20241211","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1093\/carcin\/bgs187","article-title":"Vitamin D status at breast cancer diagnosis: correlation with tumor characteristics, disease outcome, and genetic determinants of vitamin D insufficiency","volume":"33","author":"Hatse","year":"2012","journal-title":"Carcinogenesis"},{"key":"R34-2-20241211","doi-asserted-by":"crossref","first-page":"3757","DOI":"10.1200\/JCO.2008.20.0725","article-title":"Prognostic effects of 25-hydroxyvitamin D levels in early breast cancer","volume":"27","author":"Goodwin","year":"2009","journal-title":"J Clin Oncol"},{"key":"R35-2-20241211","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.jsbmb.2015.11.003","article-title":"Vitamin D levels and breast cancer characteristics: findings in patients from Saudi Arabia","volume":"164","author":"Abulkhair","year":"2016","journal-title":"J Steroid Biochem Mol Biol"},{"key":"R36-2-20241211","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.jsbmb.2017.10.009","article-title":"Vitamin D deficiency is associated with poor breast cancer prognostic features in postmenopausal women","volume":"174","author":"de Sousa","year":"2017","journal-title":"J Steroid Biochem Mol Biol"},{"key":"R37-2-20241211","first-page":"571","article-title":"Prognostic significance of serum vitamin D levels in Egyptian females with breast cancer","volume":"19","author":"Ismail","year":"2018","journal-title":"Asian Pac J Cancer Prev"},{"key":"R38-2-20241211","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.clbc.2017.05.007","article-title":"Pretreatment serum concentration of vitamin D and breast cancer characteristics: a prospective observational Mediterranean study","volume":"17","author":"Buono","year":"2017","journal-title":"Clin Breast Cancer"},{"key":"R39-2-20241211","doi-asserted-by":"crossref","first-page":"2151","DOI":"10.1200\/JCO.2008.19.6162","article-title":"High prevalence of vitamin D deficiency despite supplementation in premenopausal women with breast cancer undergoing adjuvant chemotherapy","volume":"27","author":"Crew","year":"2009","journal-title":"J Clin Oncol"},{"key":"R40-2-20241211","doi-asserted-by":"crossref","first-page":"1830","DOI":"10.1245\/s10434-010-1465-6","article-title":"Vitamin D deficiency is correlated with poor outcomes in patients with luminal-type breast cancer","volume":"18","author":"Kim","year":"2011","journal-title":"Ann Surg Oncol"},{"key":"R41-2-20241211","doi-asserted-by":"crossref","first-page":"3101","DOI":"10.31557\/APJCP.2019.20.10.3101","article-title":"Negative impact of 25-hydroxyvitamin D deficiency on breast cancer survival","volume":"20","author":"Thanasitthichai","year":"2019","journal-title":"Asian Pac J Cancer Prev"},{"key":"R42-2-20241211","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/1475-2891-9-60","article-title":"Impact of oral vitamin D supplementation on serum 25-hydroxyvitamin D levels in oncology","volume":"9","author":"Vashi","year":"2010","journal-title":"Nutr J"},{"key":"R43-2-20241211","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1186\/s12885-018-4686-x","article-title":"Impact of vitamin D on pathological complete response and survival following neoadjuvant chemotherapy for breast cancer: a retrospective study","volume":"18","author":"Viala","year":"2018","journal-title":"BMC Cancer"},{"key":"R44-2-20241211","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.breast.2015.10.005","article-title":"Vitamin D (25-OH D3) status and pathological response to neoadjuvant chemotherapy in stage II\/III breast cancer: data from the NEOZOTAC trial (BOOG 1001)","volume":"25","author":"Charehbili","year":"2016","journal-title":"Breast"},{"key":"R45-2-20241211","doi-asserted-by":"crossref","first-page":"134","DOI":"10.4048\/jbc.2018.21.2.134","article-title":"Association between changes in serum 25-hydroxyvitamin D levels and survival in patients with breast cancer receiving neoadjuvant chemotherapy","volume":"21","author":"Kim","year":"2018","journal-title":"J Breast Cancer"},{"key":"R46-2-20241211","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1002\/cam4.235","article-title":"Pretreatment vitamin D level and response to neoadjuvant chemotherapy in women with breast cancer on the I-SPY trial (CALGB 150007\/150015\/ACRIN6657)","volume":"3","author":"Clark","year":"2014","journal-title":"Cancer Med"},{"key":"R47-2-20241211","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.mce.2011.05.020","article-title":"Vitamin D metabolism in mammary gland and breast cancer","volume":"347","author":"Welsh","year":"2011","journal-title":"Mol Cell Endocrinol"},{"key":"R48-2-20241211","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1369\/0022155411429155","article-title":"The association between vitamin D receptor expression and prolonged overall survival in breast cancer","volume":"60","author":"Ditsch","year":"2012","journal-title":"J Histochem Cytochem"},{"key":"R49-2-20241211","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1001\/jamaoncol.2016.4188","article-title":"Association of serum level of vitamin D at diagnosis with breast cancer survival. A case-cohort analysis in the Pathways Study","volume":"3","author":"Yao","year":"2017","journal-title":"JAMA. Oncol"},{"key":"R50-2-20241211","doi-asserted-by":"crossref","first-page":"R74","DOI":"10.1186\/bcr2920","article-title":"Serum 25-hydroxyvitamin D and postmenopausal breast cancer survival: a prospective patient cohort study","volume":"13","author":"Vrieling","year":"2011","journal-title":"Breast Cancer Res"},{"key":"R51-2-20241211","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1093\/aje\/kwy285","article-title":"The association of a breast cancer diagnosis with serum 25-hydroxyvitamin D concentration over time","volume":"188","author":"O\u2019Brien","year":"2019","journal-title":"Am J Epidemiol"},{"key":"R52-2-20241211","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.3390\/cancers5041439","article-title":"The inverse relationship between 25-hydroxyvitamin D and cancer survival: discussion of causation","volume":"5","author":"Robsahm","year":"2013","journal-title":"Cancers"},{"key":"R53-2-20241211","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1007\/s10549-019-05486-4","article-title":"25-hydroxyvitamin D at time of breast cancer diagnosis and breast cancer survival","volume":"179","author":"Kanstrup","year":"2020","journal-title":"Breast Cancer Res Treat"}],"container-title":["Hematology\/Oncology and Stem Cell Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1658387620301473?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1658387620301473?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ovid.com\/10.1016\/j.hemonc.2020.08.005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:40:38Z","timestamp":1787838038000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1016\/j.hemonc.2020.08.005"}},"subtitle":["A systematic review and meta-analysis"],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":53,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1016\/j.hemonc.2020.08.005","relation":{},"ISSN":["1658-3876"],"issn-type":[{"value":"1658-3876","type":"print"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}