This week from Dr. Cerami and Utah Sports and Wellness
The authors of this study, analyzed data from three studies involving a total of 5,038 subjects to investigate the relationship between Vitamin D concentration and breast cancer risk among women aged 55 years and older. The current vitamin D recommendation of 20 ng/ml (50 nmol/L) is “based solely on bone health, yet it is widely used as the target level for all health conditions.” Studies with respect to cancer treatment have demonstrated vitamin D’s ability to degrade neoplasm and detailed genomics have shown the profound effects vitamin D has on established neoplastic tissue. In this study, there was an 82% lower incidence rate of breast cancer for women with [vitamin D] concentrations >60 vs <20 ng/ml. Women with [vitamin D] concentrations >60 ng/ml had an 80% lower risk of breast cancer than women with concentrations <20 ng/ml, adjusting for age, BMI, smoking status, calcium supplement intake, and study of origin. Higher [vitamin D] concentrations were associated with a dose-response decrease in breast cancer risk with concentrations >60 ng/ml being most protective. There was a consistent decrease in breast cancer risk as [vitamin D] concentrations increased. The findings from this study suggest that breast cancer incidence could be substantially reduced by increasing [vitamin D] concentrations well above 20 ng/ml (50 nmol/L).
To investigate the relationship between 25(OH)D concentration and breast cancer risk across a broad range of 25(OH)D concentrations among women aged 55 years and older.Analyses used pooled data from two randomized clinical trials (N = 1129, N = 2196) and a prospective cohort (N = 1713) to examine a broad range of 25(OH)D concentrations. The outcome was diagnosis of breast cancer during the observation periods (median: 4.0 years). Three analyses were conducted: 1) Incidence rates were compared according to 25(OH)D concentration from <20 to ≥60 ng/ml (<50 to ≥150 nmol/L), 2) Kaplan-Meier plots were developed and 3) multivariate Cox regression was used to examine the association between 25(OH)D and breast cancer risk using multiple 25(OH)D measurements. Within the pooled cohort (N = 5038), 77 women were diagnosed with breast cancer (age-adjusted incidence: 512 cases per 100,000 person-years). Results were similar for the three analyses. First, comparing incidence rates, there was an 82% lower incidence rate of breast cancer for women with 25(OH)D concentrations ≥60 vs <20 ng/ml (Rate Ratio = 0.18, P = 0.006). Second, Kaplan-Meier curves for concentrations of <20, 20–39, 40–59 and ≥60 ng/ml were significantly different (P = 0.02), with the highest proportion breast cancer-free in the ≥60 ng/ml group (99.3%) and the lowest proportion breast cancer-free in the <20 ng/ml group (96.8%). The proportion with breast cancer was 78% lower for ≥60 vs <20 ng/ml (P = 0.02). Third, multivariate Cox regression revealed that women with 25(OH)D concentrations ≥60 ng/ml had an 80% lower risk of breast cancer than women with concentrations <20 ng/ml (HR = 0.20, P = 0.03), adjusting for age, BMI, smoking status, calcium supplement intake, and study of origin.Higher 25(OH)D concentrations were associated with a dose-response decrease in breast cancer risk with concentrations ≥60 ng/ml being most protective.
These authors also note:
- “Breast cancer is the most common non-skin cancer in women.”
- “More than 252,000 new cases of female breast cancer and 40,600 deaths were projected to occur in 2017 in the United States.”
- “While more early detection and improvements in treatment have reduced the mortality rate, there has been no reduction in the incidence of breast cancer in the past 20 years.”
- “The national cost of female breast cancer in 2010 was estimated to be $16.5 billion.”
- Numerous epidemiological studies have found an association between higher serum Vitamin D concentrations and lower breast cancer risk.
- “Vitamin D plays a number of roles in the prevention of breast cancer development and progression”
- “The biologically active form of vitamin D, 1,25(OH)2D3, binds to the vitamin D receptor (VDR) in normal breast epithelium and this complex regulates the cell cycle, promotes differentiation, increases cell-to-cell adhesion, protects cells from DNA damage, regulates cytokines, activates immune cells, and suppresses inflammation, all of which may act to reduce malignant transformations.”
- In this patient population of 5,083 subjects, “there was only one case of breast cancer diagnosed after one year among those with [vitamin D]
concentrations >60 ng/ml.”
- “Vitamin D status is a modifiable risk factor for breast cancer, and increasing [vitamin D] concentrations via supplementation at the population level is safe and affordable.”