Association between Epstein-Barr virus infection and risk for development of pregnancy-associated breast cancer: Joint effect with vitamin D?

Calypse B. Agborsangaya, Tuula Lehtinen, Adetunji T. Toriola, Eero Pukkala, Helja Marja Surcel, Rosamaria Tedeschi, Matti Lehtinen

Research output: Contribution to journalArticle


Background: Few studies have evaluated the role of the ubiquitous Epstein-Barr virus (EBV) infection, together with levels of the immunomodulator, vitamin D, in different breast cancer entities. We studied, prospectively, the association of EBV and vitamin D status with the risk of pregnancy-associated breast cancer (PABC), breast cancer diagnosed during pregnancy or 1 year post-partum, using a nested case-control study. Methods: Serum vitamin D and antibodies to EBV were measured for 108 PABC cases of the Finnish Maternity Cohort, and 208 controls matched for date of birth, date of sampling and parity. The joint effect of vitamin D and EBV on the risk of PABC was evaluated. Results: EBV seropositivity was generally not associated with the risk of PABC. Among individuals with sufficient (≥75 nmol/l) levels of vitamin D, we, however, found similar increased risk estimates for PABC associated with serum immunoglobulin G (IgG) antibodies to EBV early antigens [odds ratio (OR) = 7.7, 95% (confidence interval) CI 1.4-42.3] and the viral reactivator protein, ZEBRA (OR = 7.8, 95% CI 1.1-61.2). Conclusion: Immunological markers of EBV reactivation status among individuals with sufficient vitamin D levels were consistently associated with increased risk of the disease. This suggests that EBV reactivation may be an indicator of the progression of breast cancer occurring soon after pregnancy, while the virus probably is not the aetiological agent.

Original languageEnglish
Pages (from-to)116-120
Number of pages5
JournalEuropean Journal of Cancer
Issue number1
Publication statusPublished - Jan 2011



  • Breast cancer
  • Epstein-Barr virus
  • Nested case-control study
  • Pregnancy-associated breast cancer
  • Vitamin D

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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