Reproductive factors, nutritional status and serum 25(OH)D levels in women with breast cancer: A case control study.

The study was conducted with an objective to investigate the association between reproductive factors, nutritional status and serum 25(OH)D levels among women diagnosed with breast cancer (BC). A total of 200 women with BC attending a tertiary healthcare institute of Delhi, India matched with 200 healthy women for age (±2years) and socio economic status were included in the study. Data was collected on socio-demographic profile, reproductive factors, physical activity and dietary intake (24h dietary recall and food frequency questionnaire) using interviewer administered structured questionnaires and standard tools. Non fasting blood samples (5ml) were collected for the biochemical estimation of serum 25(OH)D and calcium levels by chemiluminescent immunoassay and colorimetric assay technique. Data was analyzed by univariable conditional logistic regression and significant variables with (p<0.05), were analyzed in final model by conditional multivariable logistic regression analysis. The mean age of patients at diagnosis of BC was 45±10years. Results of multivariable conditional logistic regression analysis revealed significantly higher odds of BC for reproductive factors like age at marriage (more than 23 years), number of abortions, history or current use of oral contraceptive pills (OCP), with [OR (95% CI)] of [2.4 (1.2-4.9)], [4.0 (1.6-12.6)], [2.4 (1.2-5.0)]. Women with physically light activities and occasional consumption of eggs were found to have higher odds of BC [4.6 (1.6-13.0)] and [3.2 (1.6-6.3)]. Women with serum 25(OH)D levels less than 20ng/ml and calcium levels less than 10.5mg/dl had higher odds of having BC [2.4 (1.2-5.1)] and [3.7 (1.5-8.8)]. A protective effect of urban areas as place of residence and energy intake greater than 50% of Recommended Dietary Allowance (RDA) per day against BC was observed (p<0.05). The findings of the present study revealed a significant association of reproductive and dietary factors in addition to sedentary physical activity and low serum 25(OH)D levels in women diagnosed with BC.