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Variants in the vitamin D pathway, serum levels of vitamin D, and estrogen receptor negative breast cancer among African-American women: a case-control study

Song Yao1*, Gary Zirpoli1, Dana H Bovbjerg2, Lina Jandorf3, Chi Chen Hong1, Hua Zhao1, Lara E Sucheston1, Li Tang1, Michelle Roberts1, Gregory Ciupak1, Warren Davis1, Helena Hwang4, Candace S Johnson5, Donald L Trump6, Susan E McCann1, Foluso Ademuyiwa6, Karen S Pawlish7, Elisa V Bandera8 and Christine B Ambrosone1

Author Affiliations

1 Department of Cancer Prevention & Control, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA

2 University of Pittsburgh Cancer Institute, University of Pittsburgh, 5150 Centre Avenue, Pittsburgh, PA 15232, USA

3 Department of Oncological Sciences, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA

4 Department of Pathology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA

5 Department of Pharmacology and Therapeutics, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA

6 Department of Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA

7 New Jersey State Cancer Registry, New Jersey Department of Health & Senior Services, 369 South Warren Street, Trenton, NJ 08608, USA

8 The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, 125 Paterson Street, New Brunswick, NJ 08901, USA

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Breast Cancer Research 2012, 14:R58  doi:10.1186/bcr3162

Published: 4 April 2012



American women of African ancestry (AA) are more likely than European Americans (EA) to have estrogen receptor (ER)-negative breast cancer. 25-hydroxyvitamin D (25OHD) is low in AAs, and was associated with ER-negative tumors in EAs. We hypothesized that racial differences in 25OHD levels, as well as in inherited genetic variations, may contribute, in part, to the differences in tumor characteristics.


In a case (n = 928)-control (n = 843) study of breast cancer in AA and EA women, we measured serum 25OHD levels in controls and tested associations between risk and tag single nucleotide polymorphisms (SNPs) in VDR, CYP24A1 and CYP27B1, particularly by ER status.


More AAs had severe vitamin D deficiency (< 10 ng/ml) than EAs (34.3% vs 5.9%), with lowest levels among those with the highest African ancestry. Associations for SNPs differed by race. Among AAs, VDR SNP rs2239186, associated with higher serum levels of 25OHD, decreased risk after correction for multiple testing (OR = 0.53, 95% CI = 0.31-0.79, p by permutation = 0.03), but had no effect in EAs. The majority of associations were for ER-negative breast cancer, with seven differential associations between AA and EA women for CYP24A1 (p for interaction < 0.10). SNP rs27622941 was associated with a > twofold increased risk of ER-negative breast cancer among AAs (OR = 2.62, 95% CI = 1.38-4.98), but had no effect in EAs. rs2209314 decreased risk among EAs (OR = 0.38, 95% CI = 0.20-0.73), with no associations in AAs. The increased risk of ER-negative breast cancer in AAs compared to EAs was reduced and became non-significant (OR = 1.20, 95% CI = 0.80-1.79) after adjusting for these two CYP24A1 SNPs.


These data suggest that genetic variants in the vitamin D pathway may be related to the higher prevalence of ER-negative breast cancer in AA women.