© 2005 Oxford University Press
ARTICLE |
Are Breast Density and Bone Mineral Density Independent Risk Factors for Breast Cancer?
Affiliations of authors: Department of Epidemiology and Biostatistics, University of California, San Francisco, CA (KK, SRC); General Internal Medicine Section, Department of Veterans Affairs, University of California, San Francisco, CA (KK); Department of Medicine, University of California, San Francisco, CA (KK, JC, JAT, EZ); Department of Radiology, University of California, San Francisco, CA (JS); San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco (SRC)
Correspondence and reprint requests to: Karla Kerlikowske, MD, San Francisco Veterans Affairs Medical Center, General Internal Medicine Section, 111A1, 4150 Clement Street, San Francisco, CA 94121 (e-mail: kerliko{at}itsa.ucsf.edu).
Background: Mammographic breast density and bone mineral density (BMD) are markers of cumulative exposure to estrogen. Previous studies have suggested that women with high mammographic breast density or high BMD are at increased risk of breast cancer. We determined whether mammographic breast density and BMD of the hip and spine are correlated and independently associated with breast cancer risk. Methods: We conducted a cross-sectional study (N = 15 254) and a nested case–control study (of 208 women with breast cancer and 436 control subjects) among women aged 28 years or older who had a screening mammography examination and hip BMD measurement within 2 years. Breast density for 3105 of the women was classified using the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) categories, and percentage mammographic breast density among the case patients and control subjects was quantified with a computer-based threshold method. Spearman rank partial correlation coefficient and Pearson's correlation coefficient were used to examine correlations between BI-RADS breast density and BMD and between percentage mammographic breast density and BMD, respectively, in women without breast cancer. Logistic regression was used to examine the association of breast cancer with percentage mammographic breast density and BMD. All statistical tests were two-sided. Results: Neither BI-RADS breast density nor percentage breast density was correlated with hip or spine BMD (correlation coefficient = –.02 and –.01 for BI-RADS, respectively, and –.06 and .01 for percentage breast density, respectively). Neither hip BMD nor spine BMD had a statistically significant relationship with breast cancer risk. Women with breast density in the highest sextile had an approximately threefold increased risk of breast cancer compared with women in the lowest sextile (odds ratio = 2.7, 95% confidence interval = 1.4 to 5.4); adjusting for hip or spine BMD did not change the association between breast density and breast cancer risk. Conclusion: Breast density is strongly associated with increased risk of breast cancer, even after taking into account reproductive and hormonal risk factors, whereas BMD, although a possible marker of lifetime exposure to estrogen, is not. Thus, a component of breast density that is independent of estrogen-mediated effects may contribute to breast cancer risk.
CiteULike 
Connotea 
Del.icio.us What's this?
Correspondence about this Article
- Re: Are Breast Density and Bone Mineral Density Independent Risk Factors for Breast Cancer?
- Jennifer A. Harvey
J Natl Cancer Inst 2005 97: 778.[Extract] [Full Text] [PDF]
This article has been cited by other articles:
|
|
 |
|
  C. Nagata, T. Matsubara, T. Hara, H. Fujita, Y. Nagao, S. Yamamoto, C. Shibuya, Y. Kashiki, and H. Shimizu Urinary 6-Sulfatoxymelatonin and Mammographic Density in Japanese Women Cancer Epidemiol. Biomarkers Prev., November 1, 2007; 16(11): 2509 - 2512. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Tamimi, C. Byrne, G. A. Colditz, and S. E. Hankinson Endogenous Hormone Levels, Mammographic Density, and Subsequent Risk of Breast Cancer in Postmenopausal Women J Natl Cancer Inst, August 1, 2007; 99(15): 1178 - 1187. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J Santen, N. F Boyd, R. T Chlebowski, S. Cummings, J. Cuzick, M. Dowsett, D. Easton, J. F Forbes, T. Key, S. E Hankinson, et al. Critical assessment of new risk factors for breast cancer: considerations for development of an improved risk prediction model Endocr. Relat. Cancer, June 1, 2007; 14(2): 169 - 187. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Eastell Breast Cancer and the Risk of Osteoporotic Fracture: A Paradox J. Clin. Endocrinol. Metab., January 1, 2007; 92(1): 42 - 43. [Full Text] [PDF]
|
|
|
|
|
|
N. F. Boyd, L. J. Martin, L. Sun, H. Guo, A. Chiarelli, G. Hislop, M. Yaffe, and S. Minkin Body Size, Mammographic Density, and Breast Cancer Risk. Cancer Epidemiol. Biomarkers Prev., November 1, 2006; 15(11): 2086 - 2092. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. E. Barlow, E. White, R. Ballard-Barbash, P. M. Vacek, L. Titus-Ernstoff, P. A. Carney, J. A. Tice, D. S. M. Buist, B. M. Geller, R. Rosenberg, et al. Prospective breast cancer risk prediction model for women undergoing screening mammography. J Natl Cancer Inst, September 6, 2006; 98(17): 1204 - 1214. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. J. Crandall, A. Karlamangla, M.-H. Huang, G. Ursin, M. Guan, and G. A. Greendale Association of New-Onset Breast Discomfort With an Increase in Mammographic Density During Hormone Therapy Arch Intern Med, August 14, 2006; 166(15): 1578 - 1584. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. A. McCormack and I. dos Santos Silva Breast Density and Parenchymal Patterns as Markers of Breast Cancer Risk: A Meta-analysis. Cancer Epidemiol. Biomarkers Prev., June 1, 2006; 15(6): 1159 - 1169. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Boudreau, C. M. Rutter, and D. S.M. Buist The influence of statin use on breast density. Cancer Epidemiol. Biomarkers Prev., May 1, 2006; 15(5): 1026 - 1029. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. M. Tamimi, S. E. Hankinson, G. A. Colditz, and C. Byrne Endogenous Sex Hormone Levels and Mammographic Density among Postmenopausal Women Cancer Epidemiol. Biomarkers Prev., November 1, 2005; 14(11): 2641 - 2647. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kerlikowske, J. Creasman, J. W. T. Leung, R. Smith-Bindman, and V. L. Ernster Differences in Screening Mammography Outcomes Among White, Chinese, and Filipino Women Arch Intern Med, September 12, 2005; 165(16): 1862 - 1868. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. S. Dite, J. D. Wark, G. G. Giles, D. R. English, M. R.E. McCredie, and J. L. Hopper Is There Overlap Between the Genetic Determinants of Mammographic Density and Bone Mineral Density? Cancer Epidemiol. Biomarkers Prev., September 1, 2005; 14(9): 2266 - 2268. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Harvey Re: Are Breast Density and Bone Mineral Density Independent Risk Factors for Breast Cancer? J Natl Cancer Inst, May 18, 2005; 97(10): 778 - 778. [Full Text] [PDF]
|
|