Breast Cancer: Early detection versus prevention

From time to time I’ll hear some well-intentioned advice reminding women to “prevent breast cancer with regular screening”, usually referring to getting a mammogram.  While we would probably all agree that with any health disorder an early detection of the problem is half the cure; early detection only allows effective treatment after the fact, not prevention of the problem itself.

Which tests or the intervals of screening for breast cancer are most effective remain contentious, even among national medical experts, and I’ll address that in an upcoming blog post.  One of the simplest and most effective preventive measures is more straightforward, that of optimizing your Vitamin D3 levels.  The evidence is overwhelming.  Three out of four people with cancer have low Vitamin D levels, and the lower the level, the more likely the cancer will be diagnosed at a more advanced state.

Unfortunately, most Americans are Vitamin D deficient; 70-80% depending on the study and how deficiency is defined, and this is not surprising.  We generally work indoors, and are told to cover up and use sunscreen for every outdoor encounter.  The amount of Vitamin D3 in our diet or multivitamins is well below what we now know is needed for optimal support.  And until recently, few people had their levels checked.  I’ve found over the last 15 years of checking Vitamin D3 levels that no matter what you are doing, almost without exception, your level is lower than you think it is.  Let’s talk briefly about how you can live healthier with regards to:

-optimizing Vitamin D3 for cancer prevention

-incorporating safe sun exposure into your life

-checking your Vitamin D3 levels and finding your optimal dose

Vitamin D and Cancer Reduction

I could snow you with dozens of articles about Vitamin D and cancer prevention for women, but let’s look briefly at three well designed studies:

The Lappe Prospective Study looked at over 1100 women over 4 years.  Those taking the relatively low dose of 1100 IU of Vitamin D3 per day reduced their rate of all cancers by an impressive 60%, and for every 10 ng/ml increase in a woman’s vitamin D blood level, the relative risk of her developing cancer dropped by 35%.   It will be interesting to see the longer-term benefits as they follow this group for the next 10-15 years.

The Garland study on Vitamin D and prevention of breast cancer reviewed two studies with 1760 individuals.  They found that individuals with a D3 level of 52 had a 50% lower risk of breast cancer than those with a level of <13 (which is a very low level).  They found that to bridge this deficit required these patients about 4000 IU/day, or the combination of 2000 IU/day plus a reliable 12 minutes of bright sun per day.

The Goodwin study on the effect of Vitamin D3 levels in early breast cancer retrospectively reviewed the progress of 512 women over a period of almost 12 years. They found that women with a deficiency in vitamin D at the time of their breast cancer diagnosis were 73% more likely to die from breast cancer than those with sufficient vitamin D (which they pegged at a level of 72) at the time of diagnosis, as well as being almost twice as likely to have recurrence over that 11+ year period.

These studies tell us that there is a substantial reduction of risk for cancer for women, particularly breast cancer, with Vitamin D3 levels in the 50-70 range, and that these higher levels reduced the odds of metastasis and mortality if you do get breast cancer. The best statistics for mammogram screening show a potential to reduce breast cancer related mortality by up to 40% among women ages 50 to 69 who regularly receive mammography screening (other studies show a lower yield of benefit).  While obviously we need both prevention and early detection, the evidence shows that the simpler, less expensive and less painful (!) route of Vitamin D3 supplementation carries the greater long term health and mortality reduction benefit of the two.

Getting safe sunlight as a Vitamin D source

The Garland study mentioned above showed that 12 minutes of sunlight gave the equivalent benefit of ~2000 IU Vitamin D3 per day.  It did not say the time of year or the amount of skin exposed per session, so this will vary among individuals.  Also, unfortunately, the older we get, the less skin translates sun into systemic Vitamin D3.  So, it’s difficult to reliably say how much your sun exposure day to day will provide, but it all does add up over time.  Let’s consider three factors that maximize sun smart Vitamin D benefit:

get your sun while being active.  Going for a walk, hiking, doing yard chores or swimming all give multiple physical and mental health benefits while getting your D3.

get your sun in shorter time intervals.  Most studies show that 10-30 minutes at a time provides enough time for D3 production.  If you’re out for this time frame, don’t use sunscreen, although a hat and sunglasses may be wise.  You can’t overdose on sun induced Vitamin D, but we want to avoid excess infrared rays.

get out as often as you can.  You may experience some weather restrictions through the year, but aim to get out virtually every day you can, hopefully at least 3 times per week.  We all encounter the typical ‘life happens’ excuses; cold days, short days, too tired, working late, etc. so do what you can when you can.  You know you’re always glad you did afterwards, right?

Checking levels and individualizing your Vitamin D3 dosage

Obviously, where you go depends on where you start.  You can ask your primary physician get a Vitamin D3 level done for you.  This is also known at the lab as a serum ‘25-hydroxyvitamin D’ level.  You can also get this test done online with several competitively priced services such as:

-The Vitamin D Council

-The Grassroots Health Project

-Life Extension Foundation

If your Vitamin D3 level is in the 50-80 range, your combination of diet, sun and supplementation are in pretty good shape.   In general, we would like for anyone with a level of 90-120 to be closely monitored and have their serum calcium checked as well.  If you are less than the 30-50 range, you should consider getting outside more often, and adding some specific Vitamin D3 supplementation.  The best algorithm that I’ve seen for raising Vitamin D3 levels, based on your initial test result is found at the Vitamin D Council’s website, at  It covers specific dosing recommendations for Vitamin D3 levels from 10 to 100.  When you raise your daily dosage, you should generally retest the level within 12 weeks to assess your progress.

Vitamin D has interactions with hundreds of gene expressions in our cells, which is one reason it is such a powerfully beneficial nutrient.  This also means that you may need to correlate your levels and supplementation plans with your personal physician, especially if you have thyroid or parathyroid problems.  Someday Vitamin D3 levels will be as routine in lab testing as checking your blood sugar, your red cell count and your kidney function.  Until then, using this key tool to prevent cancer and optimize your health may require your proactive participation.  For ladies, Vitamin D could be your breast friend, so put it to work at keeping your twins healthy and cancer free.

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