Breast cancerVitamin D levels

There have been several prospective case-control and cohort studies that looked at breast cancer incidence as a function of prediagnostic serum 25(OH)D123456. In the case of breast cancer, only case-control studies, in which serum 25(OH)D level is determined at the time of diagnosis, and nested case-control studies with follow-up times less than five years have found statistically significant inverse correlations between serum 25(OH)D level and incidence7 8.

The data in these studies can be used to estimate the relationship between prediagnostic serum 25(OH)D and breast cancer incidence by combining the values for the mean serum 25(OH)D level in a preliminary meta-analysis, then trying various mathematical functions to see which has the best fit to the data.

The result is that breast cancer incidence rates fall by about 30% for serum 25(OH)D levels greater than 40 ng/mL compared to less than 20 ng/mL91011.

A case-control study suggests that vitamin D is associated with a reduced risk of breast cancer regardless of estrogen receptor/progesterone receptor status of the tumor12.

In one NCCS of breast cancer incidence, the relative risk of cancer decreased with increasing follow-up time: 0.66 (95% CI, 0.46–0.94) for follow-up periods of 0–5 years, 0.73 (95% CI, 0.53–1.01) for 5–10 years, 0.99 (95% CI, 0.74–1.32) for 10–15 years, and 1.23 (95% CI, 0.86–1.75) for more than 15 years7.

There have also been a number of studies that investigated incidence of breast cancer with respect to oral vitamin D intake from diet and supplements. A case-control study from Italy found an odds ratio of 0.79 (95% CI, 0.70-0.90) for subjects in the highest three deciles of consumption compared to those in the lowest ones combined13.

A nested case-control study with a 10-year follow-up period found significant inverse correlations with estrogen receptor positive (ER+) or progesterone receptor positive breast cancer for >548 IU/d vitamin D vs. <162 IU/d, but not for either receptor negative breasat cancer14. This study also found a statistically significant inverse correlation with oral vitamin D intake for tumors >2 mm but not for <2 mm.

Another nested case-control study with an 8.5-year follow-up period found similar results for ER+ and ER-, although the risk ratio was not statistically significant15.

A study in France found a statistically significant inverse correlation for breast cancer incidence for >113 IU/d vitamin D vs. <80 IU/d16.

A study in New York State reported:
“We found that breast cancer cases had significantly lower 25OHD concentrations than controls (adjusted mean, 22.8 versus 26.2 ng/mL, p<0.001). Among premenopausal women, 25OHD concentrations were lower in those with high- versus low-grade tumors, and ER negative versus ER positive tumors (p≤0.03). Levels were lowest among women with triple-negative cancer (17.5 ng/mL), significantly different from those with luminal A cancer (24.5 ng/mL, p = 0.002). In case-control analyses, premenopausal women with 25OHD concentrations above the median had significantly lower odds of having triple-negative cancer (OR = 0.21, 95% CI = 0.08-0.53) than those with levels below the median; and every 10 ng/mL increase in serum 25OHD concentrations was associated with a 64% lower odds of having triple-negative cancer (OR = 0.36, 95% CI = 0.22-0.56). The differential associations by tumor subtypes among premenopausal women were confirmed in case-series analyses”17.

Thus, the evidence that vitamin D reduces the risk of breast cancer is strong.

Page last edited: 22 August 2011

References

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