title: Increased vitamin D and calcium intake associated with reduced mammographic breast density among premenopausal women.
abstract: Vitamin D has been identified as a weak protective factor for postmenopausal breast cancer (relative risk, ~0.9), whereas high breast density has been identified as a strong risk factor (relative risk, ~4-6). To test the hypothesis that there is an association between vitamin D intake, but not circulating vitamin D levels, and mammographic breast density among women in our study, we conducted a cross-sectional study of 165 screening mammography patients at Nashville General Hospital's Breast Health Center, a public facility serving medically indigent and underserved women. Dietary and total (dietary plus supplements) vitamin D and calcium intakes were estimated by the Harvard African American Food Frequency Questionnaire, and blood samples were analyzed for 25-hydroxyvitamin D. Average percent breast density for the left and right breasts combined was estimated from digitized films using an interactive thresholding method available through Cumulus software. After statistical adjustment for age, race, and body mass index, the results revealed that there were significant trends of decreasing breast density with increasing vitamin D and calcium intake among premenopausal but not among postmenopausal women. There was no association between serum vitamin D and breast density in premenopausal or postmenopausal women. Confirmation of our findings in larger studies may assist in clarifying the role of vitamin D in breast density.
authors: Vanderbilt Institute for Clinical Translational Research, Vanderbilt University Medical Center, Nashville, TN 37203, USA. Electronic address: alecia.fair@vanderbilt.edu.
authors: Alecia Malin
authors: AM
authors: Fair
authors: GeneDx, Inc, Gaithersburg, MD 20877, USA. Electronic address: tolewis@genedx.com.
authors: Toni J
authors: TJ
authors: Lewis
authors: Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA. Electronic address: msanderson@mmc.edu.
authors: Maureen
authors: M
authors: Sanderson
authors: Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37203, USA. Electronic address: William.dupont@vanderbilt.edu.
authors: William D
authors: WD
authors: Dupont
authors: Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37203, USA. Electronic address: sarah.fletcher@vanderbilt.edu.
authors: Sarah
authors: S
authors: Fletcher
authors: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA. Electronic address: kathleen.egan@moffitt.org.
authors: Kathleen M
authors: KM
authors: Egan
authors: Department of Radiology, Meharry Medical College, Nashville, TN 37208, USA. Electronic address: adisher@mmc.edu.
authors: Anthony C
authors: AC
authors: Disher
mesh_terms: D000328:Adult; D000071060:Breast Density; D001943:Breast Neoplasms / Q000517:prevention & control*; D002136:Calcium, Dietary / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D004032:Diet; D015930:Diet Records; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D042361:Mammary Glands, Human / Q000002:abnormalities*; D008875:Middle Aged; D017698:Postmenopause; D017697:Premenopause; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D002136:Calcium, Dietary; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Cross-sectional studies; Mammography; Medically underserved; Vitamin D