Vitamin D and calcium supplementation and one-year change in mammographic density in the women's health initiative calcium and vitamin D trial

Elizabeth R. Bertone-Johnson, Anne McTiernan, Cynthia A. Thomson, Jean Wactawski-Wende, Aaron K. Aragaki, Thomas E. Rohan, Mara Z. Vitolins, Rulla M. Tamimi, Karen C. Johnson, Dorothy Lane, Kathryn M. Rexrode, Jennifer D. Peck, Rowan T. Chlebowski, Gloria Sarto, JoAnn E. Manson

Research output: Contribution to journalArticle

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Abstract

Background: Calcium and vitamin D may be inversely related to breast cancer risk, in part by affecting mammographic density. However, results from previous, mostly cross-sectional studies have been mixed, and there have been few randomized clinical trials of the effect of calcium and vitamin D supplementation on change in mammographic density. Methods: We assessed the effect of one year of supplementation on mammographic density in 330 postmenopausal women enrolled in the Women's Health Initiative hormone therapy (HT) and calcium and vitamin D (CaD) trials. Women were randomized to receive 1,000 mg/d of elemental calcium carbonate plus 400 IU/d of vitamin D 3 or placebo. Results: After approximately one year, mammographic density decreased 2% in the CaD supplementation group and increased 1% in the placebo group (ratio of means = 0.97; 95% CI = 0.81-1.17). Results suggested potential interaction by HT use (P=0.08).Among women randomized to HT placebo, the ratio of mean density comparing CaD supplementation and placebo groups was 0.82 (95% CI = 0.61-1.11) vs. 1.16 (95% CI = 0.92-1.45) in women randomized to active HT. In sensitivity analyses limited to women taking ≥80% of study supplements, ratios were 0.67 (95% CI= 0.41-1.07) in women not assigned to HT and 1.07 (95% CI= 0.79-1.47) women assigned to HT. Conclusions: We observed no overall effect of vitamin D and calcium supplementation on mammographic density after one year. Impact: Potential interaction between these nutrients and estrogen as related to mammographic density warrants further study.

Original languageEnglish (US)
Pages (from-to)462-473
Number of pages12
JournalCancer Epidemiology Biomarkers and Prevention
Volume21
Issue number3
DOIs
StatePublished - Mar 2012

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Women's Health
Vitamin D
Calcium
Hormones
Placebos
Therapeutics
Calcium Carbonate
Cholecalciferol
Breast Density
Estrogens
Randomized Controlled Trials
Cross-Sectional Studies
Breast Neoplasms
Food

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Vitamin D and calcium supplementation and one-year change in mammographic density in the women's health initiative calcium and vitamin D trial. / Bertone-Johnson, Elizabeth R.; McTiernan, Anne; Thomson, Cynthia A.; Wactawski-Wende, Jean; Aragaki, Aaron K.; Rohan, Thomas E.; Vitolins, Mara Z.; Tamimi, Rulla M.; Johnson, Karen C.; Lane, Dorothy; Rexrode, Kathryn M.; Peck, Jennifer D.; Chlebowski, Rowan T.; Sarto, Gloria; Manson, JoAnn E.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 21, No. 3, 03.2012, p. 462-473.

Research output: Contribution to journalArticle

Bertone-Johnson, ER, McTiernan, A, Thomson, CA, Wactawski-Wende, J, Aragaki, AK, Rohan, TE, Vitolins, MZ, Tamimi, RM, Johnson, KC, Lane, D, Rexrode, KM, Peck, JD, Chlebowski, RT, Sarto, G & Manson, JE 2012, 'Vitamin D and calcium supplementation and one-year change in mammographic density in the women's health initiative calcium and vitamin D trial', Cancer Epidemiology Biomarkers and Prevention, vol. 21, no. 3, pp. 462-473. https://doi.org/10.1158/1055-9965.EPI-11-1009
Bertone-Johnson, Elizabeth R. ; McTiernan, Anne ; Thomson, Cynthia A. ; Wactawski-Wende, Jean ; Aragaki, Aaron K. ; Rohan, Thomas E. ; Vitolins, Mara Z. ; Tamimi, Rulla M. ; Johnson, Karen C. ; Lane, Dorothy ; Rexrode, Kathryn M. ; Peck, Jennifer D. ; Chlebowski, Rowan T. ; Sarto, Gloria ; Manson, JoAnn E. / Vitamin D and calcium supplementation and one-year change in mammographic density in the women's health initiative calcium and vitamin D trial. In: Cancer Epidemiology Biomarkers and Prevention. 2012 ; Vol. 21, No. 3. pp. 462-473.
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T1 - Vitamin D and calcium supplementation and one-year change in mammographic density in the women's health initiative calcium and vitamin D trial

AU - Bertone-Johnson, Elizabeth R.

AU - McTiernan, Anne

AU - Thomson, Cynthia A.

AU - Wactawski-Wende, Jean

AU - Aragaki, Aaron K.

AU - Rohan, Thomas E.

AU - Vitolins, Mara Z.

AU - Tamimi, Rulla M.

AU - Johnson, Karen C.

AU - Lane, Dorothy

AU - Rexrode, Kathryn M.

AU - Peck, Jennifer D.

AU - Chlebowski, Rowan T.

AU - Sarto, Gloria

AU - Manson, JoAnn E.

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N2 - Background: Calcium and vitamin D may be inversely related to breast cancer risk, in part by affecting mammographic density. However, results from previous, mostly cross-sectional studies have been mixed, and there have been few randomized clinical trials of the effect of calcium and vitamin D supplementation on change in mammographic density. Methods: We assessed the effect of one year of supplementation on mammographic density in 330 postmenopausal women enrolled in the Women's Health Initiative hormone therapy (HT) and calcium and vitamin D (CaD) trials. Women were randomized to receive 1,000 mg/d of elemental calcium carbonate plus 400 IU/d of vitamin D 3 or placebo. Results: After approximately one year, mammographic density decreased 2% in the CaD supplementation group and increased 1% in the placebo group (ratio of means = 0.97; 95% CI = 0.81-1.17). Results suggested potential interaction by HT use (P=0.08).Among women randomized to HT placebo, the ratio of mean density comparing CaD supplementation and placebo groups was 0.82 (95% CI = 0.61-1.11) vs. 1.16 (95% CI = 0.92-1.45) in women randomized to active HT. In sensitivity analyses limited to women taking ≥80% of study supplements, ratios were 0.67 (95% CI= 0.41-1.07) in women not assigned to HT and 1.07 (95% CI= 0.79-1.47) women assigned to HT. Conclusions: We observed no overall effect of vitamin D and calcium supplementation on mammographic density after one year. Impact: Potential interaction between these nutrients and estrogen as related to mammographic density warrants further study.

AB - Background: Calcium and vitamin D may be inversely related to breast cancer risk, in part by affecting mammographic density. However, results from previous, mostly cross-sectional studies have been mixed, and there have been few randomized clinical trials of the effect of calcium and vitamin D supplementation on change in mammographic density. Methods: We assessed the effect of one year of supplementation on mammographic density in 330 postmenopausal women enrolled in the Women's Health Initiative hormone therapy (HT) and calcium and vitamin D (CaD) trials. Women were randomized to receive 1,000 mg/d of elemental calcium carbonate plus 400 IU/d of vitamin D 3 or placebo. Results: After approximately one year, mammographic density decreased 2% in the CaD supplementation group and increased 1% in the placebo group (ratio of means = 0.97; 95% CI = 0.81-1.17). Results suggested potential interaction by HT use (P=0.08).Among women randomized to HT placebo, the ratio of mean density comparing CaD supplementation and placebo groups was 0.82 (95% CI = 0.61-1.11) vs. 1.16 (95% CI = 0.92-1.45) in women randomized to active HT. In sensitivity analyses limited to women taking ≥80% of study supplements, ratios were 0.67 (95% CI= 0.41-1.07) in women not assigned to HT and 1.07 (95% CI= 0.79-1.47) women assigned to HT. Conclusions: We observed no overall effect of vitamin D and calcium supplementation on mammographic density after one year. Impact: Potential interaction between these nutrients and estrogen as related to mammographic density warrants further study.

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