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Vitamin D, Tissue Resistance, Bone Mineral Density and Breast Cancer Risk

Albano, Jessica (2009) Vitamin D, Tissue Resistance, Bone Mineral Density and Breast Cancer Risk. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Etiologic factors such as vitamin D and estrogen are potentially related to breast cancer development, although details of their mechanisms are not completely understood. We prospectively investigated correlates of breast cancer risk among postmenopausal women in the Study of Osteoporotic Fractures (SOF). First, we undertook a case-cohort study to test the hypothesis that low serum 25-hydroxyvitamin D [25(OH)D] will be associated with an increased risk of ER+ breast cancer (N=502). Low 25(OH)D levels were not associated with an increased risk of breast cancer and do not support an association between 25(OH)D and ER+ breast cancer development. Second, we utilized fractional calcium absorption (FCA) as a marker of tissue resistance to vitamin D to test the hypothesis that low FCA will be associated with an increased risk of breast cancer (N=5035). To the contrary, over a mean 9.6 years, increasing rates of FCA were associated with a higher risk of invasive breast cancer. A stronger positive relationship was noted among women with low dietary calcium intake. The findings support a modestly increased risk of breast cancer with higher FCA rates particularly among those who have low calcium intake. Finally, we examined the long-term association of an initial bone mineral density (BMD) measure and change in BMD (annual percent change assessed 3.5 years later) on breast cancer risk (N=5385). Furthermore, we tested the hypothesis that the risk associated with an initial BMD measure would be strengthened by the addition of the change variable. Over a mean 9.5 years, there was no association between increasing levels of BMD, change in BMD, or a combined model and breast cancer. The effect of BMD was found to be dependent upon family history of breast cancer. Among women with a positive family history, high BMD was associated with a 3-fold higher risk of breast cancer compared to low BMD. Through our investigations of two etiologic factors and their association with breast cancer development, we have enhanced our knowledge regarding the interdependence of vitamin D, calcium, and estrogen. These findings may lead to improved opportunities for prevention and early detection and are of significant public health relevance.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairCauley, Jane AJCauley@edc.pitt.eduJCAULEY
Committee MemberBodnar, Lisabodnar@edc.pitt.eduLBODNAR
Committee MemberEvans, Rhobert WEvansR@edc.pitt.eduRWE2
Committee MemberStone, Roslyn Aroslyn@pitt.eduROSLYN
Date: 29 June 2009
Date Type: Completion
Defense Date: 6 March 2009
Approval Date: 29 June 2009
Submission Date: 5 April 2009
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: bone mineral density; breast cancer; estrogen receptor; fractional calcium absorption; postmenopausal; vitamin D
Other ID:, etd-04052009-225910
Date Deposited: 10 Nov 2011 19:34
Last Modified: 15 Nov 2016 13:38


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