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Vitamin D and Calcium Intakes from Food or Supplements and Mammographic Breast Density

¹ Unité de recherche en santé des populations and ² Centre des maladies du sein Deschênes-Fabia, Centre hospitalier affilié universitaire de Québec; ³ Département de médecine sociale et préventive, Université Laval; ⁴ Clinique radiologique Audet, Quebec, Quebec, Canada; ⁵ Fred Hutchinson Cancer Research Center, Seattle, Washington; ⁶ Institut national de santé publique du Québec; ⁷ Departments of Medicine and Oncology, Cancer Prevention Research Unit, Lady Davis Institute of the Jewish General Hospital and McGill University, Montreal, Quebec, Canada; ⁸ Centre de recherche, Hôpital Charles LeMoyne, Greenfield Park, Quebec, Canada; ⁹ Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia; and ¹⁰ Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada

Requests for reprints: Jacques Brisson, Unité de recherche en santé des populations, Hôpital St-Sacrement du Centre hospitalier affilié universitaire de Québec, 1050 Chemin Sainte-Foy, Quebec, Quebec, Canada G1S 4L8. Phone: 418-682-7392; Fax: 418-682-7949. E-mail: jacques.brisson{at}uresp.ulaval.ca

Background: A better understanding of factors that affect breast density, one of the strongest breast cancer risk indicators, may provide important clues about breast cancer etiology and prevention. This study evaluates the association of vitamin D and calcium, from food and/or supplements, to breast density in premenopausal and postmenopausal women separately.

Methods: A total of 777 premenopausal and 783 post-menopausal women recruited at two radiology clinics in Quebec City, Canada, in 2001 to 2002, completed a food frequency questionnaire to assess vitamin D and calcium. Breast density from screening mammograms was assessed using a computer-assisted method. Associations between vitamin D or calcium and breast density were evaluated using linear regression models. Adjusted means in breast density were assessed according to the combined daily intakes of the two nutrients using generalized linear models.

Results: In premenopausal women, total intakes of vitamin D and calcium were inversely related to breast density (ß = –1.4; P = 0.004 for vitamin D; ß = –0.8; P = 0.0004 for calcium). In multivariate linear regression, simultaneous increments in daily total intakes of 400 IU vitamin D and 1,000 mg calcium were associated with an 8.5% (95% confidence interval, 1.8-15.1) lower mean breast density. The negative association between dietary vitamin D intake and breast density tended to be stronger at higher levels of calcium intake and vice versa. Among postmenopausal women, intakes of vitamin D and calcium were not associated with breast density.

Conclusion: These findings show that higher intakes of vitamin D and calcium from food and supplements are related to lower levels of breast density among premenopausal women. They suggest that increasing intakes of vitamin D and calcium may represent a safe and inexpensive strategy for breast cancer prevention.

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