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Bone mineral density and risk of postmenopausal breast cancer

  • Epidemiology
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Abstract

To determine if higher bone mineral density (BMD) is a risk factor for breast cancer in women age 50 years and older. 37,860 women ≥50-year old with no previous breast cancer diagnosis had baseline BMD assessment between January 1999 and December 2007. Cox proportional hazards models were created for time to a new breast cancer as a function of lumbar spine or femoral neck BMD quartile (1st = lowest as reference) with adjustment for relevant covariates. A secondary analysis was performed to look for an association with estrogen receptor-positive (ER-positive) breast cancers. 794 invasive and in situ breast cancers (484 ER-positive) occurred with a median follow up of 5.4 years. Increased breast cancer risk was seen for the 3rd and 4th quartiles of lumbar spine BMD with hazard ratios (HRs) of 1.26 (95% CI, 1.01–1.58) and 1.45 (95% CI, 1.16–1.81), respectively and for the 3rd quartile of femoral neck BMD with a HR of 1.33 (95% CI, 1.07–1.64). A test for linear trend showed that lumbar spine BMD (P < 0.001) and femoral neck BMD (P = 0.04) were associated with increased risk. Higher lumbar spine BMD was also associated with increased risk of ER-positive breast cancer with HR of 1.45 (95% CI, 1.08–1.94), and 1.68 (95% CI, 1.24–2.27) for women in the 2nd and 4th quartiles, respectively. A test for linear trend showed lumbar spine BMD was associated with increasing risk of ER-positive breast cancer (P = 0.003). Increased ER-positive breast cancer risk was seen for the 3rd quartile of femoral neck BMD with a HR of 1.43 (95% CI, 1.08–1.89). Higher lumbar spine and femoral neck BMD are associated with higher risk of breast cancer in women ≥50-year old. Lumbar spine and femoral neck BMD are associated with increased risk of ER-positive breast cancer.

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Acknowledgments

We are indebted to Katherine Fradette for her invaluable assistance and to Manitoba Health for providing data (HIPC No. 2007-8 56). This article has been reviewed and approved by the members of the Manitoba Bone Density Program Committee.

Disclaimers

The results and conclusions are those of the authors and no official endorsement by Manitoba Health is intended or should be inferred.

Funding

Supported by a research grant from the CancerCare Manitoba Foundation.

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Authors and Affiliations

  1. CancerCare Manitoba, 675 McDermot, Avenue, Winnipeg, MB, R3E 0V9, Canada

    Debjani Grenier, Andrew L. Cooke & Huimin Lu

  2. Department of Radiology, University of Manitoba, Winnipeg, MB, Canada

    Andrew L. Cooke & William D. Leslie

  3. Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada

    Debjani Grenier & William D. Leslie

  4. School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada

    Lisa Lix

  5. Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada

    Colleen Metge

Authors
  1. Debjani Grenier
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  2. Andrew L. Cooke
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  3. Lisa Lix
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  4. Colleen Metge
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  5. Huimin Lu
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  6. William D. Leslie
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Correspondence to Andrew L. Cooke.

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Grenier, D., Cooke, A.L., Lix, L. et al. Bone mineral density and risk of postmenopausal breast cancer. Breast Cancer Res Treat 126, 679–686 (2011). https://doi.org/10.1007/s10549-010-1138-y

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  • DOI: https://doi.org/10.1007/s10549-010-1138-y

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