Abstract
Background. Breast cancer is the second most common cancer in the world and the most frequent cancer among women. Advancement in medical sciences has provided us with a multimodality approach in treatment of breast cancer thus increasing the overall survival. The choice depends on the stage of the disease, the tumor type and the general health of the patient. Among the different approaches, chemotherapy is defined as the treatment to destroy the tumor cell. In the oncology research field, vitamin D has emerged as the most fruitful issue in the previous decade with effort connecting it with risk reduction and progression in various epithelial cancers especially in breast cancer. Patients with early-stage (EBC) or locally advanced breast cancer are often treated with chemotherapy and anti-hormonal therapy. Aims and objective; To evaluate an association between vitamin D levels at baseline, levels at the end of neoadjuvant chemotherapy and changes in these levels during chemotherapy on quality of life scores. To evaluate the effect of Vitamin D supplementation during chemotherapy in breast cancer patients on ,Skeletal Health, Chemotherapy related fatigue ,Chemotherapy related toxicities Materials and methods; Group I (n=55) –Chemotherapy with Vitamin D (Calcitriol 60,000 IU weekly) + Elemental Calcium (200 mg) daily. Group II (n=55) – Chemotherapy alone*Sample size calculated using formula n =[(σ12+ σ22) X(zα+zβ)2]/d2.Results; from the above result we conclude that most of the patient with carcinoma breast has insufficient to deficient levels of vitamin D. In our present study post neoadjuvant chemotherapy vitamin D of all patients of group 1 achieved normal value and almost all patients in group 2 without supplementation turning out to be deficient .There was no significant difference in calcium at chemotherapy between the groups. Calcium level was found to be significantly higher in Group I than group II after neoadjuvant chemotherapy. There was significant increase in calcium level from before to after in Group I and decrease in Group II .Conclusions .In present study it was found that vitamin D supplementation can achieve vitamin D normalization without significant side-effects. All parameters of quality of life and bone mineral density were seen to decrease due to neoadjuvant chemotherapy adding to the morbidity of disease. In relation to quality of life parameter only physical was found to have a significant association with change in vitamin D levels. Further fatigue and pain were seen to reduce in patient supplemented with vitamin D. No effect was seen on emotional, functional and social parameters of quality of life despite vitamin D supplementation.