The Who, What, Where, When and Sometimes, Why.

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 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 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.

 

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Komen Perspectives

Read our perspective on the vitamin D and breast cancer risk.*

 

*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 Therefore, some information may be out of date.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 trialsprospective cohort studies and nested case-control studies with at least 800 breast cancer cases, and pooled and meta-analyses.

For studies of 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. Sun exposure as measured by weeks per year spent on sunbathing vacations and tanning bed use were also not related to breast cancer risk. 

¶ 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 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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  2. Manson JE, Cook NR, Lee IM, et al. for the VITAL Research Group. Vitamin D supplements and prevention of cancer and cardiovascular disease. N Engl J Med. 380(1):33-44, 2019.
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Updated 11/08/23

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