A randomized controlled trial of calcium plus vitamin D supplementation and risk of benign proliferative breast disease |
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Authors: | Thomas E Rohan Abdissa Negassa Rowan T Chlebowski Clementina D Ceria-Ulep Barbara B Cochrane Dorothy S Lane Mindy Ginsberg Sylvia Wassertheil-Smoller David L Page |
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Institution: | (1) Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA;(2) Harbor-UCLA Medical Center, Torrance, CA, USA;(3) School of Nursing and Dental Hygiene, University of Hawaii, Honolulu, HI, USA;(4) School of Nursing, University of Washington, Seattle, WA, USA;(5) Department of Preventive Medicine, School of Medicine, SUNY at Stony Brook, Stony Brook, NY, USA;(6) Vanderbilt University Medical School, Nashville, TN, USA |
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Abstract: | Experimental evidence provides strong support for anti-carcinogenic effects of calcium and vitamin D with respect to breast
cancer. Observational epidemiologic data also provide some support for inverse associations with risk. We tested the effect
of calcium plus vitamin D supplementation on risk of benign proliferative breast disease, a condition which is associated
with increased risk of breast cancer. We used the Women’s Health Initiative randomized controlled trial. The 36,282 participants
were randomized either to 500 mg of elemental calcium as calcium carbonate plus 200 IU of vitamin D3 (GlaxoSmithKline) twice daily (n = 18,176) or to placebo (n = 18,106). Regular mammograms and clinical breast exams were performed. We identified women who had had a biopsy for benign
breast disease and subjected histologic sections from the biopsies to standardized review. After an average follow-up period
of 6.8 years, 915 incident cases of benign proliferative breast disease had been ascertained, with 450 in the intervention
group and 465 in the placebo group. Calcium plus vitamin D supplementation was not associated with altered risk of benign
proliferative breast disease overall (hazard ratio = 0.99, 95% confidence interval = 0.86–1.13), or by histologic subtype.
Risk varied significantly by levels of age at baseline, but not by levels of other variables. Daily use of 1,000 mg of elemental
calcium as calcium carbonate plus 400 IU of vitamin D3 for almost 7 years by postmenopausal women did not alter the overall risk of benign proliferative breast disease. |
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Keywords: | Calcium Vitamin D Benign proliferative breast disease |
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