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American Journal of Epidemiology Advance Access originally published online on August 27, 2008
American Journal of Epidemiology 2008 168(8):915-924; doi:10.1093/aje/kwn198
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American Journal of Epidemiology © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Vitamin D From Dietary Intake and Sunlight Exposure and the Risk of Hormone-Receptor-Defined Breast Cancer

Kristina M. Blackmore, Maia Lesosky, Heidi Barnett, Janet M. Raboud, Reinhold Vieth and Julia A. Knight

Correspondence to Kristina M. Blackmore, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, 60 Murray Street, Box 18, Toronto, Ontario, Canada M5T 3L9 (e-mail: blackmore{at}mshri.on.ca).

Received for publication November 28, 2007. Accepted for publication June 9, 2008.

Evidence has emerged for a role of vitamin D in the development of breast cancer, and there is some suggestion that its antiproliferative effect is greater in hormone-receptor-positive cells. Few epidemiologic studies have considered the association between vitamin D and hormone-receptor-defined breast cancer, and the results are conflicting. Considering 759 cases and 1,135 controls from a case-control study (Ontario, Canada, 2003–2005), the authors examined the association between vitamin D intake at specific ages and combined estrogen-receptor- (ER) and progesterone-receptor- (PR) defined breast cancer. While increased intake of vitamin D (from the sun and diet) was most consistently associated with a significantly reduced risk of ER+/PR+ tumors (e.g., odds ratio = 0.76, 95% confidence interval: 0.59, 0.97 for use of cod liver oil during adolescence), comparable nonsignificant associations were found for receptor-negative (ER–/PR–) (odds ratio = 0.74, 95% confidence interval: 0.53, 1.04) and mixed (ER+/PR–) (odds ratio = 0.79, 95% confidence interval: 0.51, 1.22) tumors. This study suggests that vitamin D is associated with a reduced risk of breast cancer regardless of ER/PR status of the tumor. Future studies with a larger number of receptor-negative and mixed tumors are required.

breast neoplasms; case-control studies; diet; receptors, estrogen; receptors, progesterone; sunlight; vitamin D

Abbreviations: ER, estrogen receptor; PR, progesterone receptor; 1,25(OH)2D, 1,25-dihydroxyvitamin D (calcitriol); 25(OH)D, 25-hydroxyvitamin D (calcidiol)


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