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Bone mineral density and mammographic density in Mexican women

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Abstract

Background

Bone mineral density (BMD) is a putative marker for lifetime exposure to estrogen. Studies that have explored whether BMD is a determinant of mammographic density (MD) have observed inconsistent results. Therefore, we examined this potential association in a sample of women (n = 1,516) from the clinical sub-cohort in the Mexican teachers’ cohort (n = 115,315).

Methods

We used multivariable linear regression to assess the association between quartiles of BMD and percent MD, as well as total dense and non-dense area of the breast, stratified by menopausal status. We also examined the associations by body mass index (BMI) (<30 kg/m2, ≥30 kg/m2).

Results

Overall, there was no association between BMD and MD among premenopausal women. However, when we stratified by BMI, there was a modest inverse association between BMD and percent MD (difference between extreme quartiles = −2.8, 95 % CI −5.9, 0.27, p trend = 0.04) among women with BMI < 30 kg/m2, but a positive association among obese women (comparable difference = 5.1, 95 % CI 0.02, 10.1, p trend = 0.03; p interaction < 0.01). Among postmenopausal women, BMD and percent MD were positively associated after adjustment for BMI (p trend < 0.01). Postmenopausal women in the highest two quartiles of BMD had 4–5 % point higher percent MD compared to women in the lowest quartile. The association did not differ by BMI in postmenopausal women (p interaction = 0.76).

Conclusion

Among obese premenopausal women as well as postmenopausal women, BMD was positively associated with percent MD. Among leaner premenopausal women, BMD and percent MD were modestly inversely associated. These findings support the hypothesis that cumulative exposure to estrogen (as measured by BMD) may influence MD.

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References

  1. Brower V (2010) Breast density gains acceptance as breast cancer risk factor. J Natl Cancer Inst 102(6):374–375. doi:10.1093/jnci/djq080

    Article  PubMed  Google Scholar 

  2. Boyd NF, Byng JW, Jong RA, Fishell EK, Little LE, Miller AB, Lockwood GA, Tritchler DL, Yaffe MJ (1995) Quantitative classification of mammographic densities and breast cancer risk: results from the Canadian National Breast Screening Study. J Natl Cancer Inst 87(9):670–675

    Article  CAS  PubMed  Google Scholar 

  3. Boyd NF, Rommens JM, Vogt K, Lee V, Hopper JL, Yaffe MJ, Paterson AD (2005) Mammographic breast density as an intermediate phenotype for breast cancer. Lancet Oncol 6(10):798–808

    Article  PubMed  Google Scholar 

  4. Vachon CM, Brandt KR, Ghosh K, Scott CG, Maloney SD, Carston MJ, Pankratz VS, Sellers TA (2007) Mammographic breast density as a general marker of breast cancer risk. Cancer Epidemiol Biomarkers Prev 16(1):43–49

    Article  PubMed  Google Scholar 

  5. Boyd NF, Guo H, Martin LJ, Sun L, Stone J, Fishell E, Jong RA, Hislop G, Chiarelli A, Minkin S, Yaffe MJ (2007) Mammographic density and the risk and detection of breast cancer. N Engl J Med 356(3):227–236

    Article  CAS  PubMed  Google Scholar 

  6. Kawaguchi H, Pilbeam CC, Harrison JR, Raisz LG (1995) The role of prostaglandins in the regulation of bone metabolism. Clin Orthop Relat Res 313:36–46, http://www.ncbi.nlm.nih.gov/pubmed/7641496

  7. Cauley JA, Gutai JP, Kuller LH, LeDonne D, Sandler RB, Sashin D, Powell JG (1988) Endogenous estrogen levels and calcium intakes in postmenopausal women. Relationships with cortical bone measures. JAMA 260(21):3150–3155

    Article  CAS  PubMed  Google Scholar 

  8. Murphy S, Khaw KT, Sneyd MJ, Compston JE (1992) Endogenous sex hormones and bone mineral density among community-based postmenopausal women. Postgrad Med J 68(805):908–913

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Kerlikowske K, Shepherd J, Creasman J, Tice JA, Ziv E, Cummings SR (2005) Are breast density and bone mineral density independent risk factors for breast cancer? J Natl Cancer Inst 97(5):368–374

    Article  PubMed  Google Scholar 

  10. Nguyen TV, Center JR, Eisman JA (2000) Association between breast cancer and bone mineral density: the Dubbo Osteoporosis Epidemiology Study. Maturitas 36(1):27–34

    Article  CAS  PubMed  Google Scholar 

  11. Cauley JA, Lucas FL, Kuller LH, Vogt MT, Browner WS, Cummings SR (1996) Bone mineral density and risk of breast cancer in older women: the study of osteoporotic fractures. Study of Osteoporotic Fractures Research Group. JAMA 276(17):1404–1408

    Article  CAS  PubMed  Google Scholar 

  12. Zhang Y, Kiel DP, Kreger BE, Cupples LA, Ellison RC, Dorgan JF, Schatzkin A, Levy D, Felson DT (1997) Bone mass and the risk of breast cancer among postmenopausal women. N Engl J Med 336(9):611–617

    Article  CAS  PubMed  Google Scholar 

  13. Buist DS, LaCroix AZ, Barlow WE, White E, Weiss NS (2001) Bone mineral density and breast cancer risk in postmenopausal women. J Clin Epidemiol 54(4):417–422

    Article  CAS  PubMed  Google Scholar 

  14. Crandall CJ, Zheng Y, Karlamangla A, Sternfeld B, Habel LA, Oestreicher N, Johnston J, Cauley JA, Greendale GA (2007) The association between mammographic breast density and bone mineral density in the study of women’s health across the nation. Ann Epidemiol 17(8):575–583

    Article  PubMed  Google Scholar 

  15. Chen Z, Arendell L, Aickin M, Cauley J, Lewis CE, Chlebowski R (2008) Hip bone density predicts breast cancer risk independently of Gail score: results from the Women’s Health Initiative. Cancer 113(5):907–915

    Article  PubMed  PubMed Central  Google Scholar 

  16. Grenier D, Cooke AL, Lix L, Metge C, Lu H, Leslie WD (2011) Bone mineral density and risk of postmenopausal breast cancer. Breast Cancer Res Treat 126(3):679–686

    Article  PubMed  Google Scholar 

  17. Kim BK, Choi YH, Song YM, Park JH, Noh HM, Nguyen TL, Hopper JL (2014) Bone mineral density and the risk of breast cancer: a case-control study of Korean women. Ann Epidemiol 24(3):222–227

    Article  PubMed  Google Scholar 

  18. Fraenkel M, Novack V, Liel Y, Koretz M, Siris E, Norton L, Shafat T, Shany S, Geffen DB (2013) Association between bone mineral density and incidence of breast cancer. PLoS ONE 8(8):e70980

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Boyd NF, Martin LJ, Bronskill M, Yaffe MJ, Duric N, Minkin S (2010) Breast tissue composition and susceptibility to breast cancer. J Natl Cancer Inst 102(16):1224–1237. doi:10.1093/jnci/djq239

    Article  PubMed  PubMed Central  Google Scholar 

  20. Buist DS, Anderson ML, Taplin SH, LaCroix AZ (2004) The relationship between breast density and bone mineral density in postmenopausal women. Cancer 101(9):1968–1976

    Article  PubMed  Google Scholar 

  21. Crandall C, Palla S, Reboussin BA, Ursin G, Greendale GA (2005) Positive association between mammographic breast density and bone mineral density in the Postmenopausal Estrogen/Progestin Interventions Study. Breast Cancer Res 7(6):R922–R928

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Dite GS, Wark JD, Giles GG, English DR, McCredie MR, Hopper JL (2006) Is there a positive association between mammographic density and bone mineral density? Breast Cancer Res 8(1):401

    Article  PubMed  PubMed Central  Google Scholar 

  23. Gupta R, Alhajri FA, Mohammed AM, Chavan VN, Gupta P (2008) Relationship between mammography breast density and bone mineral density. J Clin Densitom 11(3):431–436

    Article  CAS  PubMed  Google Scholar 

  24. Sung J, Song YM, Stone J, Lee K (2011) The relationship between bone mineral density and mammographic density in Korean women: the Healthy Twin study. Breast Cancer Res Treat 129(2):583–591

    Article  PubMed  Google Scholar 

  25. Yong M, Atkinson C, Newton KM, Aiello Bowles EJ, Stanczyk FZ, Westerlind KC, Holt VL, Schwartz SM, Leisenring WM, Lampe JW (2009) Associations between endogenous sex hormone levels and mammographic and bone densities in premenopausal women. Cancer Causes Control 20(7):1039–1053

    Article  PubMed  PubMed Central  Google Scholar 

  26. Chavarri-Guerra Y, Villarreal-Garza C, Liedke PE, Knaul F, Mohar A, Finkelstein DM, Goss PE (2012) Breast cancer in Mexico: a growing challenge to health and the health system. Lancet Oncol 13(8):e335–e343

    Article  PubMed  Google Scholar 

  27. Romieu I, Escamilla-Nunez MC, Sanchez-Zamorano LM, Lopez-Ridaura R, Torres-Mejia G, Yunes EM, Lajous M, Rivera-Dommarco JA, Lazcano-Ponce E (2011) The association between body shape silhouette and dietary pattern among Mexican women. Public Health Nutr. doi:10.1017/s1368980011001182:1-10

    Google Scholar 

  28. Rice MS, Bertrand KA, Lajous M, Tamimi RM, Torres-Mejia G, Biessy C, Lopez-Ridaura R, Romieu I (2013) Body size throughout the life course and mammographic density in Mexican women. Breast Cancer Res Treat 138(2):601–610. doi:10.1007/s10549-013-2463-8

    Article  PubMed  PubMed Central  Google Scholar 

  29. Lajous M, Ortiz-Panozo E, Monge A, Santoyo-Vistrain R, García-Anaya A, Yunes-Díaz E, Rice MS, Blanco M, Hernández-Ávila M, Willett WC, Romieu I, López-Ridaura R (2015) Cohort Profile: The Mexican Teachers' Cohort (MTC). Int J Epidemiol (Accepted)

  30. Baim S, Binkley N, Bilezikian JP, Kendler DL, Hans DB, Lewiecki EM, Silverman S (2008) Official Positions of the International Society for Clinical Densitometry and executive summary of the 2007 ISCD position development conference. J Clin Densitom 11(1):75–91. doi:10.1016/j.jocd.2007.12.007

    Article  PubMed  Google Scholar 

  31. Hernandez-Prado B, Lazcano-Ponce E, Cruz-Valdez A, Diaz R, Tamayo J, Hernandez-Avila M (2002) Validity of bone mineral density measurements in distal sites as an indicator of total bone mineral density in a group of pre-adolescent and adolescent women. Arch Med Res 33(1):33–39

    Article  PubMed  Google Scholar 

  32. Byng JW, Boyd NF, Fishell E, Jong RA, Yaffe MJ (1994) The quantitative analysis of mammographic densities. Phys Med Biol 39(10):1629–1638

    Article  CAS  PubMed  Google Scholar 

  33. Ursin G, Astrahan MA, Salane M, Parisky YR, Pearce JG, Daniels JR, Pike MC, Spicer DV (1998) The detection of changes in mammographic densities. Cancer Epidemiol Biomarkers Prev 7(1):43–47

    CAS  PubMed  Google Scholar 

  34. Torres-Mejia G, De Stavola B, Allen DS, Perez-Gavilan JJ, Ferreira JM, Fentiman IS, Dos Santos Silva I (2005) Mammographic features and subsequent risk of breast cancer: a comparison of qualitative and quantitative evaluations in the Guernsey prospective studies. Cancer Epidemiol Biomarkers Prev 14(5):1052–1059

    Article  PubMed  Google Scholar 

  35. Byng JW, Boyd NF, Little L, Lockwood G, Fishell E, Jong RA, Yaffe MJ (1996) Symmetry of projection in the quantitative analysis of mammographic images. Eur J Cancer Prev 5(5):319–327

    Article  CAS  PubMed  Google Scholar 

  36. van der Klift M, de Laet CE, Coebergh JW, Hofman A, Pols HA (2003) Bone mineral density and the risk of breast cancer: the Rotterdam Study. Bone 32(3):211–216

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We are grateful first and foremost to all MTC participants for their time and commitment. We would like to thank educational authorities, with special thanks to Victor Sastré, Director de Regulación for their continued support. We thank ISSSTE’s Medical Directorate staff and regional offices in Jalisco and Veracruz for their technical and administrative support. This work was supported by the American Institute for Cancer Research (05B047, 10A035), CONACYT (14429), Ministry of Health Mexico, Avon Cosmetics, Fundación Banorte, Fundación Gruma, Bicentennial Fund Traveling Fellowship, Harvard School of Public Health Department of Epidemiology, and National Institutes of Health, National Cancer Institute (T32 CA09001). K.A.B. was supported by the Simeon J. Fortin Charitable Foundation, Bank of America, N.A., Co-Trustee. H.M. was supported by the National Institute of General Medical Sciences Initiative for Maximizing Student Development (R25 GM56847).

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA

    Heidi Moseson

  2. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Martin Lajous

  3. Channing Division of Network Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Megan S. Rice & Kimberly A. Bertrand

  4. Center for Research on Population Health, National Institute of Public Health, 7ª Cerrada Fray Pedro de Gante #50, Mexico City, 14000, Mexico

    Ruy López-Ridaura, Gabriela Torres & Martin Lajous

  5. Medical Direction, Social Security and Services Institute for the Employees of the State, Mexico City, Mexico

    Margarita Blanco

  6. Mexican Committee for the Prevention of Osteoporosis, Mexico City, Mexico

    Juan Alfredo Tamayo-Orozco

  7. Center for Research in Epidemiology and Population Health (CESP), Inserm (Institut National de la Santé et de la Recherche Médicale), U1018, Villejuif, France

    Martin Lajous

  8. International Agency for Research on Cancer, Lyon, France

    Isabelle Romieu

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  1. Heidi Moseson
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Correspondence to Martin Lajous.

Additional information

Heidi Moseson and Megan S. Rice are the co-first authors.

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Moseson, H., Rice, M.S., López-Ridaura, R. et al. Bone mineral density and mammographic density in Mexican women. Cancer Causes Control 27, 39–46 (2016). https://doi.org/10.1007/s10552-015-0680-7

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  • DOI: https://doi.org/10.1007/s10552-015-0680-7

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