RT Journal Article
SR Electronic
T1 Increased Incidence of Breast Cancer in Multiple Sclerosis: The Influence of Vitamin D and Estrogen in MS-Breast Cancer Concordance (P6.176)
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP P6.176
VO 82
IS 10 Supplement
A1 Laplant, Jacquelyn
A1 Knobler, Robert
YR 2014
UL http://n.neurology.org/content/82/10_Supplement/P6.176.abstract
AB OBJECTIVE: To determine if breast cancer (BC) is more common in MS than expected in the general population and if this is influenced by a vitamin D-estrogen interaction. BACKGROUND: MS is more frequent in women and BC is the most common malignancy in women. Vitamin D improves both MS and BC, whereas estrogens improve MS but exacerbate BC. We investigated whether BC was more or less frequent in MS since estrogens typically increase the active form of vitamin D (enhancing synthesis and inhibiting breakdown), while vitamin D can either enhance or diminish estrogen activity through an estrogen-vitamin D loop. DESIGN/METHODS: Meta-analysis of the concordance of MS and BC, regarding incidence, tumor characteristics and MS treatment was compared to lung, colon, prostate cancer and melanoma in MS, reflecting their high frequency in the general population. We also assessed the actions of vitamin D and estrogens in MS and BC. RESULTS: Available data on lung, colon, prostate cancer and melanoma indicated a decreased incidence in MS. In contrast, increased BC frequency was noted in MS, despite interstudy variation, with larger tumor size at diagnosis than non-MS patients. Data on MS severity and influence on cancer risk of cytotoxic therapies for treating MS was inadequate. In BC cells, vitamin D suppressed estrogen synthesis and estrogen receptor (ER) expression. Selective estrogen receptor modulators (SERMs) function in BC treatment as ER antagonists, but suppress the MS model, EAE, presumably acting as ER agonists. CONCLUSIONS: We identified an increased frequency of BC in MS compared to other common malignancies, warranting further study. Tissue-specific suppression of estrogen by vitamin D occurs within the breast. Identifying local influences reflecting the complex interactions of vitamin D and estrogen within MS tissues or BC cells may provide greater insight into the etiology, prevention and treatment of these diseases. Study Support: None.Disclosure: Dr. Laplant has nothing to disclose.Thursday, May 1 2014, 7:30 am-11:00 am