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If Vitamin D Prevents Breast Cancer, How Does It Do It, and How Much Does It Take?

From the University of Kansas Medical Center, Kansas City, KS

Author's disclosure of potential conflicts of interest are found at the end of this article.

Address reprint requests to Carol J. Fabian, MD, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS 66160; e-mail: cfabian{at}kumc.edu

Overview: Vitamin D plays a key role in breast tissue homeostasis. Breast epithelial cells have all the necessary machinery to convert 25(OH)D3, the major circulating precursor, into the active metabolite for intracellular use. Despite favorable modulatory effects on proliferation, differentiation, and survival pathways, the systemic level of 25(OH)D needed to optimize these effects has not been determined. It is also not clear whether vitamin D significantly reduces risk for breast cancer or recurrence after cancer develops. There are few prospective trials and results seemingly conflict. Prior to initiation of additional cancer incidence trials, proof of principal trials should be conducted correlating change in expression of key genes/biomarkers with targeted levels of 25(OH)D.