4
|
Chlebowski RT, Johnson KC, Kooperberg C, Hubbell A, Lane D, O’Sullivan M, Cummings S, Rohan T, Yasmeen S, Khandekar J. The Women’s Health Initiative randomized trial of calcium plus vitamin D: Effects on breast cancer and arthralgias. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.lba6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA6 Background: Calcium (Ca) and vitamin D (D) have been associated with reduced breast cancer and breast density in observational studies. Randomized trials have not evaluated Ca/D supplementation for breast cancer prevention. Methods: We randomized 36,282 postmenopausal women without prior breast cancer from 40 WHI centers to 1000 mg of elemental calcium as calcium carbonate and 400 IU of vitamin D3 (N = 18,176) daily or matching placebo (N = 18,106); 54% were also randomized one year previously to hormone therapy (HT) or placebo; conjugated equine estrogen (CEE) plus medroxyprogesterone acetate or CEE alone (the latter for those with prior hysterectomy). Ca/D effects on hip fracture and colorectal cancer have been reported (NEJM 2006). We report here pathologically confirmed invasive breast cancer as a secondary outcome of the Ca/D trial. Baseline serum 25(OH) D levels (in 1787 women) and serial joint symptoms (pain/stiffness and hand/feet swelling 0–3 scale, in a 6% sample) were also assessed. Results: Breast cancer incidence did not differ between Ca/D and placebo randomization groups (528 and 546 cases in Ca/D and placebo; hazard ratio 0.96; 95 percent confidence interval (CI), 0.85, 1.09). While SEER stage and abnormal mammogram frequency were similar between groups, breast cancers were smaller in the Ca/D group (1.54 cm (1.23), mean (SD) versus 1.71 (1.29), P = 0.05). Total vitamin D baseline intake was associated with lower breast cancer risk in the placebo group. Baseline vitamin D (nmol per liter) deficiency was common (≥30, sufficient (n = 266), 16 ≤ 30, insufficient (277), < 16, deficient (743)) but was not related to joint pain (seen in 72.2%, 74.0%, 74.6%, of sufficiency and deficiency groups, respectively). Joint symptoms were lower in women randomized to CEE alone (P < 0.01) but did not significantly differ by Ca/D group assignment and no significant interactions were seen between HT and Ca/D. Conclusion: Among healthy postmenopausal women, Ca/D supplementation did not reduce breast cancer risk but the cancers in those randomized to Ca/D were somewhat smaller. Exogenous estrogen use but not Ca/D supplementation influences arthralgias. [Table: see text]
Collapse
Affiliation(s)
- R. T. Chlebowski
- Los Angeles Biomedical Research Insitute, Torrance, CA; University of Tennessee, Germantown, TN; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California Irvine, Orange, CA; The State Univeristy of New York, Stony Brook, NY; University of Miami, Miami, FL; University of California at San Francisco, San Francisco, CA; Albert Einstein College of Medicine, Bronx, NY; University of California at Davis, Sacramento, CA; Women’s Health Initiative, Evanston, IL
| | - K. C. Johnson
- Los Angeles Biomedical Research Insitute, Torrance, CA; University of Tennessee, Germantown, TN; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California Irvine, Orange, CA; The State Univeristy of New York, Stony Brook, NY; University of Miami, Miami, FL; University of California at San Francisco, San Francisco, CA; Albert Einstein College of Medicine, Bronx, NY; University of California at Davis, Sacramento, CA; Women’s Health Initiative, Evanston, IL
| | - C. Kooperberg
- Los Angeles Biomedical Research Insitute, Torrance, CA; University of Tennessee, Germantown, TN; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California Irvine, Orange, CA; The State Univeristy of New York, Stony Brook, NY; University of Miami, Miami, FL; University of California at San Francisco, San Francisco, CA; Albert Einstein College of Medicine, Bronx, NY; University of California at Davis, Sacramento, CA; Women’s Health Initiative, Evanston, IL
| | - A. Hubbell
- Los Angeles Biomedical Research Insitute, Torrance, CA; University of Tennessee, Germantown, TN; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California Irvine, Orange, CA; The State Univeristy of New York, Stony Brook, NY; University of Miami, Miami, FL; University of California at San Francisco, San Francisco, CA; Albert Einstein College of Medicine, Bronx, NY; University of California at Davis, Sacramento, CA; Women’s Health Initiative, Evanston, IL
| | - D. Lane
- Los Angeles Biomedical Research Insitute, Torrance, CA; University of Tennessee, Germantown, TN; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California Irvine, Orange, CA; The State Univeristy of New York, Stony Brook, NY; University of Miami, Miami, FL; University of California at San Francisco, San Francisco, CA; Albert Einstein College of Medicine, Bronx, NY; University of California at Davis, Sacramento, CA; Women’s Health Initiative, Evanston, IL
| | - M. O’Sullivan
- Los Angeles Biomedical Research Insitute, Torrance, CA; University of Tennessee, Germantown, TN; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California Irvine, Orange, CA; The State Univeristy of New York, Stony Brook, NY; University of Miami, Miami, FL; University of California at San Francisco, San Francisco, CA; Albert Einstein College of Medicine, Bronx, NY; University of California at Davis, Sacramento, CA; Women’s Health Initiative, Evanston, IL
| | - S. Cummings
- Los Angeles Biomedical Research Insitute, Torrance, CA; University of Tennessee, Germantown, TN; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California Irvine, Orange, CA; The State Univeristy of New York, Stony Brook, NY; University of Miami, Miami, FL; University of California at San Francisco, San Francisco, CA; Albert Einstein College of Medicine, Bronx, NY; University of California at Davis, Sacramento, CA; Women’s Health Initiative, Evanston, IL
| | - T. Rohan
- Los Angeles Biomedical Research Insitute, Torrance, CA; University of Tennessee, Germantown, TN; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California Irvine, Orange, CA; The State Univeristy of New York, Stony Brook, NY; University of Miami, Miami, FL; University of California at San Francisco, San Francisco, CA; Albert Einstein College of Medicine, Bronx, NY; University of California at Davis, Sacramento, CA; Women’s Health Initiative, Evanston, IL
| | - S. Yasmeen
- Los Angeles Biomedical Research Insitute, Torrance, CA; University of Tennessee, Germantown, TN; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California Irvine, Orange, CA; The State Univeristy of New York, Stony Brook, NY; University of Miami, Miami, FL; University of California at San Francisco, San Francisco, CA; Albert Einstein College of Medicine, Bronx, NY; University of California at Davis, Sacramento, CA; Women’s Health Initiative, Evanston, IL
| | - J. Khandekar
- Los Angeles Biomedical Research Insitute, Torrance, CA; University of Tennessee, Germantown, TN; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California Irvine, Orange, CA; The State Univeristy of New York, Stony Brook, NY; University of Miami, Miami, FL; University of California at San Francisco, San Francisco, CA; Albert Einstein College of Medicine, Bronx, NY; University of California at Davis, Sacramento, CA; Women’s Health Initiative, Evanston, IL
| |
Collapse
|
5
|
Chlebowski RT, Chen Z, Rohan T, Aragaki A, Lane D, Dolan N, Paskett E, Patterson R, Hubbell A, Prentice R. Ethnicity and breast cancer in the Women's Health Initiative: A unifying concept for unfavorable outcome in African American women. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.1008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- R. T. Chlebowski
- Harbor-UCLA Research & Education Institute, Torrance, CA; University of Arizona, Tucson, AZ; Albert Einstein College of Medicine, Bronx, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; School of Medicine, SUNY, Stony Brook, NY; Northwestern University, Chicago, IL; Ohio State University, Columbus, OH; University of Calfornia, Irvine, Irvine, CA; , Seattle, WA
| | - Z. Chen
- Harbor-UCLA Research & Education Institute, Torrance, CA; University of Arizona, Tucson, AZ; Albert Einstein College of Medicine, Bronx, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; School of Medicine, SUNY, Stony Brook, NY; Northwestern University, Chicago, IL; Ohio State University, Columbus, OH; University of Calfornia, Irvine, Irvine, CA; , Seattle, WA
| | - T. Rohan
- Harbor-UCLA Research & Education Institute, Torrance, CA; University of Arizona, Tucson, AZ; Albert Einstein College of Medicine, Bronx, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; School of Medicine, SUNY, Stony Brook, NY; Northwestern University, Chicago, IL; Ohio State University, Columbus, OH; University of Calfornia, Irvine, Irvine, CA; , Seattle, WA
| | - A. Aragaki
- Harbor-UCLA Research & Education Institute, Torrance, CA; University of Arizona, Tucson, AZ; Albert Einstein College of Medicine, Bronx, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; School of Medicine, SUNY, Stony Brook, NY; Northwestern University, Chicago, IL; Ohio State University, Columbus, OH; University of Calfornia, Irvine, Irvine, CA; , Seattle, WA
| | - D. Lane
- Harbor-UCLA Research & Education Institute, Torrance, CA; University of Arizona, Tucson, AZ; Albert Einstein College of Medicine, Bronx, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; School of Medicine, SUNY, Stony Brook, NY; Northwestern University, Chicago, IL; Ohio State University, Columbus, OH; University of Calfornia, Irvine, Irvine, CA; , Seattle, WA
| | - N. Dolan
- Harbor-UCLA Research & Education Institute, Torrance, CA; University of Arizona, Tucson, AZ; Albert Einstein College of Medicine, Bronx, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; School of Medicine, SUNY, Stony Brook, NY; Northwestern University, Chicago, IL; Ohio State University, Columbus, OH; University of Calfornia, Irvine, Irvine, CA; , Seattle, WA
| | - E. Paskett
- Harbor-UCLA Research & Education Institute, Torrance, CA; University of Arizona, Tucson, AZ; Albert Einstein College of Medicine, Bronx, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; School of Medicine, SUNY, Stony Brook, NY; Northwestern University, Chicago, IL; Ohio State University, Columbus, OH; University of Calfornia, Irvine, Irvine, CA; , Seattle, WA
| | - R. Patterson
- Harbor-UCLA Research & Education Institute, Torrance, CA; University of Arizona, Tucson, AZ; Albert Einstein College of Medicine, Bronx, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; School of Medicine, SUNY, Stony Brook, NY; Northwestern University, Chicago, IL; Ohio State University, Columbus, OH; University of Calfornia, Irvine, Irvine, CA; , Seattle, WA
| | - A. Hubbell
- Harbor-UCLA Research & Education Institute, Torrance, CA; University of Arizona, Tucson, AZ; Albert Einstein College of Medicine, Bronx, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; School of Medicine, SUNY, Stony Brook, NY; Northwestern University, Chicago, IL; Ohio State University, Columbus, OH; University of Calfornia, Irvine, Irvine, CA; , Seattle, WA
| | - R. Prentice
- Harbor-UCLA Research & Education Institute, Torrance, CA; University of Arizona, Tucson, AZ; Albert Einstein College of Medicine, Bronx, NY; Fred Hutchinson Cancer Research Center, Seattle, WA; School of Medicine, SUNY, Stony Brook, NY; Northwestern University, Chicago, IL; Ohio State University, Columbus, OH; University of Calfornia, Irvine, Irvine, CA; , Seattle, WA
| |
Collapse
|