Association between plasma 25-hydroxyvitamin D and breast cancer risk.
Vitamin D has been associated with decreased risk of several cancers. In experimental studies, vitamin D has been shown to inhibit cell proliferation and induce differentiation and apoptosis in normal and malignant breast cells. Using a population-based case-control study on Long Island, New York, we examined the association of breast cancer with plasma 25-hydroxyvitamin D (25-OHD) levels, a measure of vitamin D body stores. In-person interviews and blood specimens were obtained from 1,026 incident breast cancer cases diagnosed in 1996 to 1997 and 1,075 population-based controls. Plasma 25-OHD was measured in batched, archived specimens by Diasorin RIA. The mean (SD) plasma 25-OHD concentration was 27.1 (13.0) and 29.7 (15.1) ng/mL in the cases and controls, respectively (P < 0.0001). Plasma 25-OHD was inversely associated with breast cancer risk in a concentration-dependent fashion (P(trend) = 0.002). Compared with women with vitamin D deficiency (25-OHD, <20 ng/mL), levels above 40 ng/mL were associated with decreased breast cancer risk (odds ratio, 0.56; 95% confidence interval, 0.41-0.78). The reduction in risk was greater among postmenopausal women (odds ratio, 0.46; 95% confidence interval, 0.09-0.83), and the effect did not vary according to tumor hormone receptor status. In summary, these results add to a growing body of evidence that adequate vitamin D stores may prevent breast cancer development. Whereas circulating 25-OHD levels of >32 ng/mL are associated with normal bone mineral metabolism, our data suggest that the optimal level for breast cancer prevention is >or=40 ng/mL. Well-designed clinical trials are urgently needed to determine whether vitamin D supplementation is effective for breast cancer chemoprevention.
Crew
Katherine D
KD
Department of Medicine, Division of Hematology/Oncology, Columbia University, New York, New York 10032, USA. kd59@columbia.edu
Gammon
Marilie D
MD
Steck
Susan E
SE
Hershman
Dawn L
DL
Cremers
Serge
S
Dworakowski
Elzbieta
E
Shane
Elizabeth
E
Terry
Mary Beth
MB
Desai
Manisha
M
Teitelbaum
Susan L
SL
Neugut
Alfred I
AI
Santella
Regina M
RM
D000368:Aged; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000097:blood / Q000737:chemistry / Q000453:epidemiology* / Q000517:prevention & control; D002278:Carcinoma in Situ / Q000097:blood / Q000737:chemistry / Q000453:epidemiology* / Q000517:prevention & control; D018270:Carcinoma, Ductal, Breast / Q000097:blood / Q000737:chemistry / Q000453:epidemiology* / Q000517:prevention & control; D016022:Case-Control Studies; D004967:Estrogens; D005006:Ethnicity; D005260:Female; D006801:Humans; D008875:Middle Aged; D009376:Neoplasms, Hormone-Dependent / Q000097:blood / Q000453:epidemiology; D009518:New York / Q000453:epidemiology; D017698:Postmenopause; D011374:Progesterone; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012306:Risk; D012621:Seasons; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood
D004967:Estrogens; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D014807:Vitamin D; D011374:Progesterone; C104450:25-hydroxyvitamin D