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Kongress Medizin und Gesellschaft 2007

17. bis 21.09.2007, Augsburg

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Serum 25-hydroxyvitamin D and risk of postmenopausal breast cancer in a German case-control study: Effect modification by hormone therapy

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  • Sascha Abbas - Deutsches Krebsforschungszentrum Heidelberg, Abteilung Epidemiologie von Krebserkrankungen, Heidelberg
  • Jakob Linseisen - Deutsches Krebsforschungszentrum Heidelberg, Abteilung Epidemiologie von Krebserkrankungen, Heidelberg
  • Tracy Slanger - Deutsches Krebsforschungszentrum Heidelberg, Abteilung Epidemiologie von Krebserkrankungen, Heidelberg
  • Silke Kropp - Deutsches Krebsforschungszentrum Heidelberg, Abteilung Epidemiologie von Krebserkrankungen, Heidelberg
  • Elke Mutschelknauss - Institut für Medizinische Biometrie und Epidemiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
  • Dieter Flesch-Janys - Institut für Medizinische Biometrie und Epidemiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
  • Jenny Chang-Claude - Deutsches Krebsforschungszentrum Heidelberg, Abteilung Epidemiologie von Krebserkrankungen, Heidelberg

Kongress Medizin und Gesellschaft 2007. Augsburg, 17.-21.09.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07gmds001

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/gmds2007/07gmds001.shtml

Published: September 6, 2007

© 2007 Abbas et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Introduction: Numerous studies have suggested that vitamin D may reduce the risk of breast cancer. However, only few studies have assessed the association of breast cancer and serum 25-hydroxyvitamin D [25(OH)D], a medium-term biomarker of vitamin D supply. We therefore analyzed the association of serum 25(OH)D concentrations with the risk of postmenopausal breast cancer. Because estrogens are known to influence vitamin D metabolism we investigated effect modification by hormone therapy (HT).

Material and Methods: We used 1398 breast cancer cases and 1394 matched controls (age 50 to 74 years) from the Rhine-Neckar-Region of the population based, two centre case-control study MARIE (Mammary Carcinoma Risk Evaluation). Information on breast cancer risk factors was collected by a personal interview and data on lifetime HT using a pictogram of preparations. 25(OH)D concentration was measured in serum samples with an enzyme immunoassay. We used conditional logistic regression models with adjustment for potential confounders to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for breast cancer.

Results: Serum 25(OH)D concentration was significantly inversely associated with the risk of postmenopausal breast cancer. Compared with the lowest category (< 30 nM), the OR (95% CI) for the highest category of 25(OH)D (≥ 75 nM) was 0.32 (0.24, 0.43), (ptrend < .0001). The inverse association with increasing levels of 25(OH)D was stronger in women who never used menopausal hormone therapy than that in past and in current users, with ORs per 10 nM increment in 25(OH)D of 0.77 (0.72, 0.83), 0.87 (0.80, 0.95) and 0.96 (0.91, 1.02), respectively (p Interaction < .0001).

Conclusions: These results strongly support the hypothesis of a protective effect for postmenopausal breast cancer through a better vitamin D supply. In addition, this association may be modified by use of hormone therapy, the attenuation in current users being stronger than that in past users.