Research table: Vitamin D and breast cancer risk

This summary table contains detailed information about research studies. Summary tables are a useful way to look at the science behind many breast cancer guidelines and recommendations. However, to get the most out of the tables, it’s important to understand some key concepts. Learn how to read a research table.

Introduction: Whether or not vitamin D is linked to a decreased risk of breast cancer is under study.

Most of the vitamin D a person gets comes from the sun and a small amount comes from their diet.

Vitamin D through sunlight exposure and diet

Findings from studies on vitamin D (through diet alone or diet plus sunlight exposure) and a decreased breast cancer risk are mixed.

Studying vitamin D with measures of sunlight exposure and diet has some challenges. It’s hard to measure sunlight exposure. And, because so many foods that contain vitamin D also contain calcium, it’s hard to single out the effects of vitamin D alone.

Blood levels of vitamin D

Blood levels of vitamin D are a good marker of vitamin D exposure. By studying blood levels of vitamin D, researchers avoid the measurement issues with sunlight exposure and diet.

Findings from studies on a possible link between blood levels of vitamin D and a decreased breast cancer risk are mixed. 

Learn more about vitamin D and breast cancer risk.

Learn more about vitamin D.

Learn about the strengths and weaknesses of different types of studies. 

See how this risk factor compares with other risk factors for breast cancer.

 

 

*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date.

 

Study selection criteria: For studies that measured sunlight exposure and dietary intake of vitamin D: Randomized controlled trials, prospective cohort studies and nested case-control studies with at least 800 breast cancer cases, and pooled analyses and meta-analyses.

For studies that measured blood levels of vitamin D: Prospective cohort studies and nested case-control studies with at least 500 breast cancer cases.

Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.

Sunlight Exposure and Dietary Intake of Vitamin D
Study	Study Population (number of participants)	Follow-up (years)	Measure(s) of Vitamin D	Relative Risk of Breast Cancer in Women with a High Exposure to Vitamin D Compared to Women with Low Exposure, RR (95% CI)
Randomized controlled trials
Women’s Health Initiative [1]	36,282 (1,667 cases)	11	Supplement intake	Postmenopausal women:  1.04 (0.94-1.14)†
VITAL Trial [2]	25,871 (246 cases)	5	Supplement intake	Postmenopausal women:  1.02 (0.79-1.31)
Prospective cohort studies
EPIC [3]	319,985 (7,760 cases)	9	Dietary intake	Premenopausal women: 1.07 (0.87-1.32) Postmenopausal women: 1.02 (0.90-1.16)
Nurses’ Health Study [4]	88,691 (3,482 cases)	16	Dietary and supplement intake	Premenopausal women: 0.72 (0.55-0.94) Postmenopausal women: 0.94 (0.80-1.10)
French E3N Cohort [5]	67,721 (2,871 cases)	10	Dietary intake	Premenopausal women: 1.03 (0.85-1.25) Postmenopausal women: 0.92 (0.83-1.02)
			Sun exposure: High vs. low level of sun exposure in place of residence	Premenopausal women: 0.85 (0.67-1.08) Postmenopausal women: 0.92 (0.82-0.98)
Cancer Prevention Study II Nutrition Cohort [6]	68,567 (2,855 cases)	8-9	Dietary and supplement intake	Postmenopausal women: 0.95 (0.81-1.13)
Iowa Women’s Health Study [7]	34,321 (2,440 cases)	18	Dietary and supplement intake	Postmenopausal women: 0.89 (0.77-1.03)
Sisters Study [8]	50,884 (1,642 cases)‡	5	Dietary and supplement intake	Premenopausal and postmenopausal women: 0.90 (0.78-1.05)
			Sun exposure: High vs. low level of sun exposure in place of residence	Premenopausal and postmenopausal women: 1.06 (0.91-1.23)
Women’s Health Study [9]	31,487 (1,019 cases)	10	Dietary and supplement intake	Premenopausal women: 0.65 (0.42-1.00) Postmenopausal women: 1.30 (0.97-1.73)
Norwegian Women and Cancer Study [10]	41,811 (948 cases)	9	Dietary and supplement intake	Premenopausal and postmenopausal women: 1.07 (0.87-1.32)
			Sun exposure: More than one sunburn per year vs. none	Premenopausal and postmenopausal women: 0.95 (0.75-1.21)§
VITAL Cohort [11]	35,016 (880 cases)	6	Supplement intake	Postmenopausal women: 0.68 (0.50-0.92)
Women’s Lifestyle and Health Cohort Study [12]	41,889 (840 cases)	13	Dietary intake	Premenopausal and postmenopausal women: 0.9 (0.8-1.1)
			Sun exposure: 2 or more sunburns per year vs. none	Premenopausal and postmenopausal women: 1.1 (0.9-1.4)¶
Meta-analyses
Chen et al. [13]	11 studies		Dietary and supplement intake	Premenopausal and postmenopausal women: 0.91 (0.83-1.00)
Kim and Je [14]	10 studies		Dietary and supplement intake	Premenopausal and postmenopausal women: 0.95 (0.88-1.01)
Zhou et al. [15]	6 studies		Supplement intake	Premenopausal and postmenopausal women: 1.04 (0.85-1.29)
Gissel et al. [16]	6 studies		Dietary and supplement intake	Premenopausal and postmenopausal women: 0.98 (0.93-1.03)
Sperati et al. [17]	2 studies		Supplement intake	Postmenopausal women: 1.11 (0.74-1.68)

† Breast cancer risk among women randomized to take a supplement containing vitamin D and calcium compared to women randomized to a placebo for 7 years (with continued follow-up).  

‡ All women in the study have a sister who has been diagnosed with breast cancer.

§ Average number of sunburns per year. Findings also showed other measures of sun exposure were not related to breast cancer risk including weeks per year spent on sunbathing vacations and tanning bed use. 

¶ Sunburns from ages 10-19. Findings also showed other measures of sun exposure were not related to breast cancer risk including sunburns at other ages, weeks per year spent on sunbathing vacations and tanning bed use. 

 

Blood Levels of Vitamin D
Study	Study Population (number of participants)		Follow-up (years)	Relative Risk of Breast Cancer in Women with Higher Blood Levels of Vitamin D (25-hydroxyvitamin D) Compared to Women with Lower Levels, RR (95% CI)
Nested case-control studies
	Cases	Controls
Sisters Study [8]	1,600‡	1,822‡	5	Premenopausal women: 1.06 (0.67-1.68) Postmenopausal women: 0.72 (0.56-0.92)
New York University Women’s Health Study and Northern Sweden Mammary Screening Cohort [18]	1,585	2,940	9||	Premenopausal women: 0.67 (0.48-0.92) Postmenopausal women: 1.21 (0.92-1.58)
Nurses’ Health Study [19]	1,502	1,502	20	Premenopausal and postmenopausal women: 0.87 (0.67-1.13)**
EPIC [20]	1,391	1,391	4||	Premenopausal and postmenopausal women: 1.07 (0.85-1.36)
Women’s Health Initiative [1,21]	1,080	1,080	7	Postmenopausal women: 1.06 (0.78-1.43)
Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial [22]	1,005	1,005	4-12	Postmenopausal women: 1.04 (0.75-1.45)
Malmo Diet and Cancer Study [23]	764	764	10-15	Premenopausal and postmenopausal women: 0.93 (0.66-1.33)
French E3N Cohort [24]	636	1,272	10	Premenopausal and postmenopausal women: 0.73 (0.55-0.96)
Melbourne Collaborative Cohort Study [25]	634	1,332	14	Premenopausal and postmenopausal women: 0.95 (0.79-1.15)
Nurses’ Health Study II [26]	613	1,218	8-11	Premenopausal and postmenopausal women: 1.29 (0.92-1.81)
Cancer Prevention Study-II [27]	516	516	4-7	Postmenopausal women: 1.09 (0.70-1.68)
Pooled and meta-analyses
Visvanathan et al. [28]	23,437 (10,484 cases)			Premenopausal and postmenopausal women: 1.05 (0.94-1.21)††
Kim and Je [14]	14 nested case-control and cohort studies			Premenopausal and postmenopausal women: 0.92 (0.83-1.02)
Chen et al. [29]	10 nested case-control studies and 1 retrospective study			Premenopausal and postmenopausal women: 0.86 (0.75-1.00)
Mohr et al. [30]	5 nested case-control studies			Premenopausal and postmenopausal women: 0.87 (0.77-0.99)
U.S. Preventive Services Task Force [31]	4 nested case-control studies			Premenopausal and postmenopausal women: 0.99 (0.97-1.01)

‡ All women in the study have a sister who has been diagnosed with breast cancer.

|| Average number of years between blood collection and breast cancer diagnosis in cases.

** Among women with blood collection during the winter, results were similar, relative risk of 1.10 (0.75-1.60). Among women with blood collection during the summer, those with higher blood levels of vitamin D had a lower risk of breast cancer compared to those with lower blood levels of vitamin D, relative risk of 0.66 (0.46-0.94). 

†† Results were also not statistically significant among women with blood collection in the winter or among women with blood collection in the summer.

References

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Updated 06/06/24