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European Journal of Epidemiology

, Volume 19, Issue 8, pp 785–792 | Cite as

Bone Mass Density and Risk of Breast Cancer and Survival in Older Women

  • O. Ganry
  • C. Baudoin
  • P. Fardellone
  • J. Peng
  • N. Raverdy
Article

Abstract

Study objective: Older women with high bone mineral density (BMD) have an increased risk of breast cancer but it is not well known whether this association is associated with the stage of the tumor. The objective of the study is to determine if older women with high BMD are likely to develop a more aggressive form of breast cancer, as defined by mortality. Patients: We prospectively studied 1504 women who were 75 years of age or older at the entry in the study (range, 75–90 years), between 1992 and 1994. BMD was measured by dual-photon X-ray absorptiometry at three skeletal sites (trochanter, Ward's triangle, femoral neck). The women were followed for a mean of 7 years for the occurrence of breast cancer. Cox proportional-hazards models were used to obtain estimates of the relative risk of breast cancer and relative risk of death according to the BMD. Main results: Forty-five incident breast cancer cases were identified. In multivariate analyses of the risk of breast cancer for women in the highest tertile of BMD was greater than for women in the lowest tertile. Indeed, the women with a trochanter BMD in the highest tertile were at 2.3-fold increased risk compared with women in the lowest tertile. The women with highest tertile BMD measured at the Ward's triangle and at the femoral neck were respectively at 2.2-and 3.3-fold increased risk compared with women at the lowest risk. The 7-year survival rates were markedly less favorable for women in the second and third tertile of the three skeletal sites compared with the lowest tertile. The risk of death was greater for women in the highest tertile of BMD than for women in the lowest tertile at every skeletal site. Conclusion: Elderly women with high BMD have an increased risk of breast cancer, especially advanced cancer, compared with women with low BMD.

Bone mass density (BMD) Breast cancer Elderly women Survival 

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References

  1. 1.
    Helzlsouer KJ, Alberg AJ, Bush TJ, et al. A prospective study of endogenous hormones and breast cancer. Cancer Detect Prev 1993; 18: 79–85.Google Scholar
  2. 2.
    Toniolo PG, Levitz M, Zelenuich-Jacquotte A, et al. A prospective study of endogenous estrogens and breast cancer in postmenopausal women. J Natl Cancer Inst 1995; 87: 190–197.Google Scholar
  3. 3.
    Thomas HV, Reeves GK, Key TJ, Endogenous estrogen and postmenopausal breast cancer: A quantitative review. Cancer Causes Control 1997; 8: 922–928.Google Scholar
  4. 4.
    Utz JA, Melton LJ, Kan SH, et al. Risk of osteoporotic fractures in women with breast cancer: A populationbased cohort study. J Chron Dis 1987; 2: 105–113.Google Scholar
  5. 5.
    Adami HO, Zack M, Kressner U, et al. Hip fractures in women with breast cancer. Am J Epidemiol 1990; 5: 877–883.Google Scholar
  6. 6.
    Olsson H, Hagglund G. Reduced cancer morbidity and mortality in a prospective cohort of women with distal forearm fractures. Am J Epidemiol 1992; 4: 422–427.Google Scholar
  7. 7.
    Persson I, Adami HO, Mc Laughlin JK, et al. Reduced risk of breast and endometrial women with hip fractures. Cancer Causes Control 1994; 5: 523–528.Google Scholar
  8. 8.
    Ganry O, Peng J, Dubreuil A. Is there a reduced risk of breast cancer among women with hip fractures ? Eur J Epidemiol 1999; 3: 127–131.Google Scholar
  9. 9.
    Cauley J, Lucas FL, Kuller L, et al. Bone mineral density and risk of breast cancer in older women. JAMA 1996; 276: 1404–1408.Google Scholar
  10. 10.
    Zhang YD, Kiel DP, Kreger BE, et al. Bone mass and the risk of breast cancer among postmenopausal women. N Engl J Med 1997; 336: 611–617.Google Scholar
  11. 11.
    Kuller LH, Cauley JA, Lucas L, et al. Sex steroid hormones, bone mineral density and risk of breast cancer. Environ Health Perspec 1997; 105: 593–599.Google Scholar
  12. 12.
    Lucas FL, Cauley JA, Stone Ra, et al. Bone mineral density and risk of breast cancer. Differences by family history of breast cancer. Am J Epidemiol 1998; 148: 22–29.Google Scholar
  13. 13.
    Buist DS, LaCroix AZ, Barlow WE, et al. Bone mineral density and endogenous hormones and risk of breast cancer in postmenopausal women. Cancer Causes Control 2001; 12: 213–222.Google Scholar
  14. 14.
    Buist DS, LaCroix AZ, Barlow WE, et al. Bone mineral density and breast cancer risk in postmenopausal women. J Clin Epidemiol 2001; 54: 417–422.Google Scholar
  15. 15.
    Ganry O, Sebert JL. Bone mass and breast cancer in postmenopausal women. Rev Rhum 1998; 65: 159–160.Google Scholar
  16. 16.
    Ganry O, Tramier B, Fardellone P, et al. High bone mass as a marker for breast cancer in postmenopausal women: A case-control study. Breast 2001; 10: 313–317.Google Scholar
  17. 17.
    Zmuda JM, Cauley JA, Ljung B, et al. Bone mass and breast cancer risk in older women: Differences by stage at diagnosis. JNCI 2001; 93: 930–936. 791Google Scholar
  18. 18.
    Loocker AC, Wahner HW, Dunn WL, et al. Proximal femur bone mineral levels of US adults. Osteoporos Int 1995; 5: 389–409.Google Scholar
  19. 19.
    Ganry O, Baudoin C, Fardellone P. Effect of alcohol intake on bone mineral density in elderly women. The EPIDOS Study. Am J. Epidemiol 2000; 151: 773–779.Google Scholar
  20. 20.
    Cox DR. Regression models and life tables. JR Stat Soc 1972; 34: 187–220.Google Scholar
  21. 21.
    Grampp S, Genant HK, Mathur A, et al. Comparisons of non invasive bone mineral measurments in assessing age-related loss, fracture discrimination, and diagnostic classification. J Bone Miner Res 1997; 12: 712–714.Google Scholar
  22. 22.
    Grosclaude P, Colonna M, Hedelin G, et al. Survival of women with breast cancer in France: Variation with age, stage and treatment. Breast Cancer Res Treat 2001; 70: 137–143.Google Scholar
  23. 23.
    Ganry O, Candellier V, Raverdy N, Lorriaux A, Dubreuil A. Le cancer du sein dans la Somme (1990-1996). Épidémiologie descriptive, prise en charge thérapeutique et survie. Rev Fr Gyn Obs 1997; 92: 382–388.Google Scholar
  24. 24.
    Ganry O, Baudoin C, Fardellone P. Alcohol consumption by non institutionalised elderly women: The EPIDOS Study. Public Health 2001; 115: 186–191.Google Scholar
  25. 25.
    Kerlikowske K, Salzmann P, Philipps KA, et al. Continuing screening mammography in women aged 70-79 years: Impact on life expectancy and cost-effectiveness. JAMA 1999; 282: 2156–2163.Google Scholar

Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • O. Ganry
    • 1
    • 2
  • C. Baudoin
    • 3
  • P. Fardellone
    • 4
  • J. Peng
    • 2
  • N. Raverdy
    • 2
  1. 1.Medical Information, Epidemiology and Biostatistics, Amiens University HospitalFrance
  2. 2.Cancer registry of the Somme areaAmiensFrance
  3. 3.ParisFrance
  4. 4.Department of RheumatologyAmiens University HospitalFrance

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