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Table 20: Vitamin D and breast cancer risk

 

This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.

Introduction: A possible link between vitamin D and breast cancer is under study. Most of the vitamin D a person gets comes from the sun and a small amount comes from diet.

Studies measuring vitamin D through sunlight exposure and diet

Findings from studies on vitamin D exposure (through diet alone or diet plus sunlight) and breast cancer risk are mixed.  

Studying vitamin D with measures of sunlight exposure and diet presents some challenges. It is difficult to measure sunlight exposure. And, because so many foods that contain vitamin D also contain calcium, it is hard to single out the effects of vitamin D alone.

Studies measuring blood levels of vitamin D

Blood levels of vitamin D are a good marker of vitamin D exposure. By studying blood levels of vitamin D, researchers avoid the measurement issues with sunlight exposure and diet.  

At this time, only a few large studies (listed in the table below) have looked at possible links between blood levels of vitamin D and breast cancer risk and findings have been mixed.  

Learn more about vitamin D and breast cancer risk.

Learn more about vitamin D.

Learn about the strengths and weaknesses of different types of studies

See how this risk factor compares with other risk factors for breast cancer.

 

 Komen Perspectives 

Read our perspective on the vitamin D and breast cancer risk
(January 2011)*.
 

*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.  

 

Study selection criteria: For studies with measures of sunlight exposure and dietary intake of vitamin D: Randomized controlled trialsprospective cohort studies, nested case-control studies and meta-analyses with at least 800 breast cancer cases. For studies of blood levels of vitamin D: Prospective cohort studies and nested case-control studies with at least 500 breast cancer cases.

Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.

 Sunlight Exposure and Dietary Intake of Vitamin D 

 Study 

 Study Population
(number of participants)
 

Follow-up
(years)
 

 Measure(s) of
Vitamin D
 

 Relative Risk of Breast Cancer
in Women with a High Exposure
to Vitamin D Compared to
Women with Low Exposure,
RR (95% CI)
 

Randomized controlled trials 

Women’s Health Initiative [1]

36,282
(1,074 cases)

7

Supplement
intake

 Postmenopausal women:
0.96 (0.85-1.09)†

Prospective cohort studies  

EPIC [2]

319,985
(7,760 cases)

9

Dietary
intake

Premenopausal women:
1.07 (0.87-1.32)


Postmenopausal women:
1.02 (0.90-1.16)

Nurses' Health Study [3]

88,691
(3,482 cases)

16

Dietary and
supplement
intake

Premenopausal women:
0.72 (0.55-0.94)


Postmenopausal women:
0.94 (0.80-1.10) 

French E3N Cohort [4]

67,721
(2,871 cases)

10

Dietary
intake

Premenopausal women:
1.03 (0.85-1.25)


Postmenopausal women:
0.92 (0.83-1.02) 

     

Sun exposure:
High vs. low
level of sun exposure
in place of residence

 Premenopausal women:
0.85 (0.67-1.08)


Postmenopausal women:
0.92 (0.82-0.98)

Cancer Prevention Study II Nutrition Cohort [5]

68,567
(2,855 cases)

8-9

Dietary and
supplement
intake

 Postmenopausal women:
0.95 (0.81-1.13)

Iowa Women’s Health Study [6]

34,321
(2,440 cases)

18

Dietary and
supplement
intake

Postmenopausal women:
0.89 (0.77-1.03) 

Women’s Health Study [7]

31,487
(1,019 cases)

10

Dietary and
supplement
intake

Premenopausal women:
0.65 (0.42-1.00)


Postmenopausal women:
1.30 (0.97-1.73) 

Norwegian Women and Cancer Study [8]

41,811
(948 cases)

9

Dietary and
supplement
intake

 Pre- and postmenopausal women:
1.07 (0.87-1.32)

     

Sun exposure:
More than one
sunburn per year
vs. none

 Pre- and postmenopausal women:
0.95 (0.75-1.21)‡

VITAL Cohort [9]

35,016
(880 cases)

6

Supplement
intake

Postmenopausal women:
0.68 (0.50-0.92)

Women’s Lifestyle and Health Cohort Study [10]

41,889
(840 cases)

13

Dietary
intake

Pre- and postmenopausal women:
0.9 (0.8-1.1) 

     

Sun exposure:
2 or more
sunburns per year
vs. none

Pre- and postmenopausal women:
1.1 (0.9-1.4)§

Meta-analyses 

Chen et al. [11]

11 studies

Various

Dietary and
supplement
intake

Pre- and postmenopausal women:
0.91 (0.83-1.00)

Kim and Je [12]

10 studies

Various

Dietary and
supplement
intake

Pre- and postmenopausal women:
0.95 (0.88-1.01)

Gissel et al. [13]

6 studies

Various

Dietary and
supplement
intake

 Pre- and postmenopausal women:
0.98 (0.93-1.03)

† Breast cancer risk among women randomized to take a supplement containing vitamin D and calcium versus women randomized to a placebo.  

‡ Average number of sunburns per year. Sun exposure as measured by weeks per year spent on sunbathing vacations and tanning bed use was also not related to breast cancer risk.  

§ Sunburns from ages 10 to 19 years. Findings also showed other measures of sun exposure were not related to breast cancer risk including sunburns during other ages, weeks per year spent on sunbathing vacations and tanning bed use.  

 

 Blood Levels of Vitamin D 

 Study 

 Study Population
(number of participants)
 

 Follow-up
(years)
 

Relative Risk of Breast Cancer
in Women with Higher Blood Levels
of Vitamin D (25-hydroxyvitamin D)
Compared to Women with Lower Levels,
RR (95% CI)
 

Nested case-control studies 

 

Cases 

Controls 

   

New York University Women’s Health Study and Northern Sweden Mammary Screening Cohort [14]

1,585

2,940

Premenopausal women:
0.67 (0.48-0.92)  

Postmenopausal women:
1.21 (0.92-1.58)

EPIC [15]

1,391

1,391

 Pre- and postmenopausal women:
1.07 (0.85-1.36)

Women’s Health Initiative [1,16]

1,080

1,080

7

 Postmenopausal women:
1.06 (0.78-1.43)

Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial [17]

1,005

1,005

4-12

 Postmenopausal women:
1.04 (0.75-1.45)

Malmo Diet and Cancer Study [18]

764

764

10-15

Pre- and postmenopausal women:
0.93 (0.66-1.33) 

Nurses' Health Study [19]

701

724

6-7

Pre- and postmenopausal women:
0.73 (0.49-1.07)

French E3N Cohort [20]

636

1,272

10

 Pre- and postmenopausal women:
0.73 (0.55-0.96)

Nurses' Health Study II [21]

613

1,218

8-11

 Pre- and postmenopausal women:
1.29 (0.92-1.81)

Cancer Prevention Study-II [22]

516

516

4-7

 Postmenopausal women:
1.09 (0.70-1.68)

Meta-analyses 

Kim and Je [12]

14 nested case-control and
cohort studies

Pre- and postmenopausal women:
0.92 (0.83-1.02)

Chen et al. [23]

10 nested case-control studies and
1 retrospective study

 Pre- and postmenopausal women:
0.86 (0.75-1.00)

Mohr et al. [24]

5 nested case-control studies

 Pre- and postmenopausal women:
0.87 (0.77-0.99)

Gandini et al. [25]

 5 prospective studies

 Pre- and postmenopausal women:
0.97 (0.92-1.03)||

U.S. Preventive Services Task Force [26]

 4 nested case-control studies

 Pre- and postmenopausal women:
0.99 (0.97-1.01)

¶ Average number of years between blood collection and breast cancer diagnosis in cases.  

|| Results for a 10 ng/ml increase in blood vitamin D levels. 
 

References  

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Updated 05/06/14