VITAMIN D3 AND BREAST DENSITY
THE BENEFITS OF OPTIMAL VITAMIN D3 LEVELS
As most of you know who follow my evidence-based contributions over the years, I have long advocated assuring optimal levels of Vitamin D3, part of my evidence-based Edge-CAM anticancer regimen (under testing this should be ~66 ng/ml, the unit for measuring Vitamin D3 levels on a simple blood test), both to help reduce the risk of the development of several cancers (prostate cancer, colorectal cancer, and some hematological malignances) and including breast cancer, but also to improve survival in patients with breast cancer; that is, Vitamin D3 has both an important preventive as well as therapeutic role in multiple different cancers, besides of course increasingly documented benefits in other chronic diseases.
To take but one example Vitamin D use was associated with improved disease-free recurrence (DFS) - that is, greater freedom from recurrence - in nonmetastatic HER2+ breast cancer patients (Zeichner et al., SABCS 2013), among others.
This is especially critical because vast proportions of the population, both in the U.S. and globally, show under testing sub-optimal (inadequate or deficient,, or below the optimal threshold cited) levels, and as I have noted, evidence demonstrates that simply increasing exposure to sunlight is not a consistently reliable (or safe) method for achieving optimal status (besides increasing malignancy risk of various skin and other cancers), and that there are insufficient or inadequate levels in populations, as I have documented, even in sun-drenched Hawaii, Sicily, and Queensland Australia, putting the lie to the common perception that somehow sunlight exposure - or a deep tan - somehow assures good Vitamin D levels: it doesn't, and a deep tan almost makes the matter worse since the increased pigment (called melanin) in tanned skin serves to actually block the conversion of sunlight to Vitamin D (called photosynthesis.).
Aggravating this further is the established fact that only a minority of patients of women with breast (and other) cancer have sufficient baseline vitamin D3, and the current recommendations in the U.S. regarding daily vitamin D supplementation (no more than 2000 IUs daily) is set -against the evidence - far too low to significantly correct this deficiency in this population, and in the general population as a whole.
THE GOOD NEWS
But now we have still another reason to work hard at getting our levels of Vitamin D3 to an optimal threshold (~66 ng/ml): a just published study (Fair et al. Nutr Res. 2015 Jul) demonstrated that doing so can decrease breast density, and dense breasts are known to elevate risk of breast cancer, so optimizing Vitamin D3 levels serves to significantly decrease the risk associated with dense breasts, and this is a truly breakthrough finding!
First, a brief tutorial:
WHAT ARE DENSE BREASTS
Dense breasts have a significant proportion of connective tissue (fibrous and glandular) and less fatty tissue. This increases risk in two ways:
(1) all that connective tissue on a mammogram makes it exceedingly difficult if not impossible to spot any underlying abnormal lesion, which is hidden by the overlay of thick connective tissue that a typical mammogram can't penetrate;
(2) it is an underappreciated fact - and almost never cited in connection with breast density - that breast cancer almost never occurs in fatty tissue, but rather develops in the connective, fibrous, glandular highways and byways of the breast; therefore, in a largely fatty breast, there simply is less connective tissue to serve as a breeding ground for breast cancer, while in a dense breast with less fatty tissue, the substantial amounts of connective tissue increase breast cancer risk, with the most dense breasts - categorized extremely dense - having almost a 5 to 6 fold elevation in risk of developing breast cancer (see chart below).
BREAST SIZE AND BREAST DENSITY: A PARTIAL AND INEXACT RELATIONSHIP
And although it is true that there are more women with smaller breasts that are dense, than women with larger breasts that are dense, since most larger breasts tend also to be more fatty, this relationship is not absolute, and there can be appreciable numbers of women with smaller but still fatty breasts, and women with larger but still dense breasts, so size is not a wholly consistent indicator. In most states, new rules require the mammography facility to inform women if they have dense breasts, and that that puts them at elevated risk, and must also inform about the degree of density (see the diagram below), with increasing risk as the degree of density in the breast increases.
BEFORE: INTERLEAVED MAMMOGRAM PLUS MRI
Before, there was only one defensive measure a women with dense breasts could take: to add breast MRI to an interleaved schedule of mammography (mammogram yearly, then six months later an MRI, then six moths after that, another mammogram, repeating the alternating cycle, to assure that if a lesion in a dense breast is missed on a mammogram, the following MRI will pick it up (there is an old joke: don't ask your spouse or partner to try to determine if you have dense breasts - men lose their concentration under such a pleasurable task and so are unlikely to be a reliable testing tool!). And although most women can perform a breast self-examination (BSE) and have some rough idea of how fatty or dense their breasts are, this too is just not consistently effective, and only a radiological exam can be decisive, and measure the degree of density (and hence the degree of extra risk).
NOW: ASSURE OPTIMAL VITAMIN D3 LEVELS + ADEQUATE CALCIUM
The study cited above (Fair et al.) has now shown a significant trend of decreasing breast density with increasing vitamin D and calcium intake (~1500 mg/daily) among premenopausal (but not among postmenopausal) women. The amount needed to achieve the optimal threshold cannot be determined across the board, because every woman is different, so the only way to do this is to check your Vitamin D3 levels (a simple blood test, orderable by any physician).
Here's a rule of thumb: say you get your Vitamin D3 level tested, and it comes back as 26 ng/ml. We know that roughly every 1000 IUs of Vitamin D3 as a supplement tends to increase your level by 10 points: so adding 4000 IUs of supplemental Vitamin D3 (any brand will do) should raise you from 26 to 66 ng/ml (40 points, so 4000 IUs). Take that supplementary amount for about 10 - 12 weeks, and have your levels retest to confirm that you did indeed reach the optimal level (Vitamin D3 raises no safety issues in supplementation even up to 10,000 IUs, and even beyond if necessary).
THE MAGIC OF REDUCING THE DENSITY OF YOUR BREASTS
What's amazing is that simply ingesting an optimal amount of a critical vitamin (D3) can help change the anatomy of a breast to a more favorable form, from a dense breast to a more fatty one.
(1) Even if you don't have dense breasts, the same guidance should be followed given the well-known cancer preventive and survival-therapeutic benefits of sustaining optimal Vitamin D3 levels.
(2) Although the study on breast density found the reduction in density among premenopausal but not postmenopausal women, this may have been a study size artifact, and in any case, once again there are as I noted independent benefits accruing from optimal Vitamin D3 levels, for postmenopausal women too.
(3) If you are confirmed with dense breasts, still follow an interleaved mammogram + MRI regimen, unless your breasts become predominantly fatty.
(4) Any questions? You can always contact me.
No Surrender Breast Cancer Foundation (NSBCF)