Geburtshilfe Frauenheilkd 2016; 76(05): 570-578
DOI: 10.1055/s-0042-106208
Original Article
GebFra Science
Georg Thieme Verlag KG Stuttgart · New York

Vitamin D and Mammographic Findings

Vitamin D und Mammografiebefunde
J. Riedel
1   Frauen- und Poliklinik der TU München, Munich
,
L. Straub
1   Frauen- und Poliklinik der TU München, Munich
,
J. Wissing
1   Frauen- und Poliklinik der TU München, Munich
,
A. Artmann
2   Praxis für Brustgesundheit, Munich
,
M. Schmidmayr
1   Frauen- und Poliklinik der TU München, Munich
,
M. Kiechle
1   Frauen- und Poliklinik der TU München, Munich
,
V. R. Seifert-Klauss
1   Frauen- und Poliklinik der TU München, Munich
› Author Affiliations
Further Information

Publication History

received 20 November 2015
revised 07 April 2016

accepted 07 April 2016

Publication Date:
19 May 2016 (online)

Abstract

Introduction: Pleiotropic immune-modulatory and anti-proliferative effects of vitamin D and hopes to stop cancerogenesis have led to an increased interest in possible reduction of breast cancer with higher vitamin D levels. Mammographic density is an established risk factor for breast cancer risk, and its association with serum vitamin D is complex, as recent studies have shown. Patients and Methods: In this cross-sectional study, 1103 participants were recruited in the breast diagnostic unit of the Klinikum rechts der Isar, TU Munich. A standardised questionnaire and blood samples for 25-OH-vitamin D were taken on the day of mammography. Histologic results of biopsies in suspicious mammographies were documented. Results: In the 1090 data-sets analysed, vitamin D-deficiency was common among women under 40. Highest vitamin D values were observed in participants aged 60–69 years, but average values for all age cohorts were below 20 ng/ml of vitamin D. 15.6 % of all participants had very low vitamin D values (< 10 ng/ml), 51.3 % were vitamin D-deficient (10–19 ng/ml) and only 5.7 % were above 30 ng/ml, i.e. showed sufficient vitamin D. Patients with malignant results had vitamin D < 10 ng/ml more often (16.9 %; p = 0.61), and only 3.4 % in this group had sufficient vitamin D supply (> 30 ng/ml). There were no significant differences in vitamin D-levels between density groups according to the American College of Radiology (ACR) criteria. Conclusion: Vitamin D values were lower than in comparable US women. Up to now, there is no direct clinical evidence for a relationship between the risk for breast cancer and a specific vitamin D value.

Zusammenfassung

Einleitung: Vitamin D hat bekanntlich eine pleiotrope, immunmodulierende und antiproliferative Wirkung. Die Suche nach Präventivmaßnahmen, welche die Entstehung von Brustkrebs verhindern könnten, hat das Interesse an potenziellen Zusammenhängen zwischen Brustkrebsrisiko und Höhe des Vitamin-D-Spiegels gesteigert. Hohe Brustdichte ist ein etablierter Risikofaktor für Brustkrebs, aber neuere Studien haben gezeigt, dass die Zusammenhänge zwischen Brustdichte und Vitamin-D-Spiegel im Blut komplex sind. Patientinnen und Methoden: Für diese Querschnittsstudie wurden in der Abteilung für Mammadiagnostik des Klinikums rechts der Isar der TU München 1103 Teilnehmerinnen rekrutiert. Alle Teilnehmerinnen wurden anhand eines standardisierten Fragebogens am Tag der Mammografie befragt, und bei allen wurden Blutproben zur Bestimmung des 25-OH-Vitamin-D-Spiegels entnommen. Die histologischen Biopsiebefunde nach auffälliger Mammografie wurden dokumentiert. Ergebnisse: Nach Analyse der 1090 Datensätze stellte sich heraus, dass Frauen unter 40 Jahren häufig unter Vitamin-D-Mangel litten. Die höchsten Vitamin-D-Werte fanden sich bei Frauen im Alter von 60–69 Jahren, aber der Mittelwert für alle Altersgruppen lag unter 20 ng/ml Vitamin D. Bei 15,6 % der Teilnehmerinnen war der Vitamin-D-Serumspiegel sehr niedrig (< 10 ng/ml); 51,3 % der Teilnehmerinnen hatten einen Vitamin-D-Mangel (10–19 ng/ml), und nur 5,7 % hatten einen Vitamin-D-Wert von mehr als 30 ng/ml bzw. hatten einen ausreichend hohen Vitamin-D-Spiegel im Blut. Patientinnen mit malignen Befunden hatten häufiger (16,9 %; p = 0,61) einen Vitamin-D-Serumspiegel von < 10 ng/ml; nur bei 3,4 % der Frauen in dieser Gruppe war die Versorgung mit Vitamin D (> 30 ng/ml) ausreichend. Es gab keine signifikanten Unterschiede in der Höhe des Vitamin-D-Spiegels zwischen den Gruppen mit verschiedener Brustdichte entsprechend den Kriterien des American College of Radiology (ACR). Schlussfolgerung: Es gibt bis dato keinen direkten klinischen Nachweis für einen Zusammenhang zwischen dem Risiko, an Brustkrebs zu erkranken, und einer bestimmten Höhe des Vitamin-D-Serumspiegels.

 
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