Serum levels of vitamin D, PTH and calcium and breast cancer risk—a prospective nested case–control study

Previous studies indicate that calcium and its regulating hormones, i.e., parathyroid hormone (PTH) and vitamin D, might affect breast cancer risk. Evidence also suggests that this relationship could be influenced by menopausal status and BMI. We examined breast cancer risk related to prediagnostic serum levels of vitamin D (25OHD₂ and 25OHD₃), PTH and calcium using a nested case–control design within the Malmö Diet and Cancer Study. There were 764 incident breast cancer cases, and 764 controls were selected by incidence density matching, using age as the underlying time scale, matching on calendar time at inclusion, menopausal status and age at inclusion. Using logistic regression analysis, odds ratios (OR) with 95% confidence intervals were calculated for breast cancer risk in different quartiles of the analyzed factors. All analyses were adjusted for risk factors for breast cancer, and for levels of albumin, creatinine and phosphate. Analyses were repeated stratified for BMI and menopausal status, and for low vs. high levels of 25OHD₃, PTH and calcium. There was a weak, nonsignificant inverse association between breast cancer risk and 25OHD₃, and the OR for the 2nd, 3rd and 4th quartiles, as compared to the first, were 0.84 (0.60–1.15), 0.84 (0.60–1.17) and 0.93 (0.66–1.33). Serum calcium was positively associated with breast cancer in premenopausal women (OR for the 4th quartile = 3.10:1.33–7.22 and p for quartile trend = 0.04), and in women with BMI > 25 (OR for the 4th quartile = 1.94:1.12–3.37 and p for trend < 0.01). There was no association between baseline serum PTH and breast cancer risk.