J Breast Cancer.  2006 Dec;9(4):330-336. 10.4048/jbc.2006.9.4.330.

Relationship of Bone mineral density and the risk of breast cancer in Korean postmenopausal women

• Kim HJ
• Nam-Gung J
• Koh JM
• Lee JS
• Hong SJ
• Kwak BS
• Gu BK
• Jang MA
• Son BH
• Ahn SH

• KMID: 2286605
• DOI: http://doi.org/10.4048/jbc.2006.9.4.330

Abstract

PURPOSE: Bone mass has been proposed as a marker of cumulative exposure to estrogen in women. We have studied the association between bone mass and the risk of breast cancer in postmenopausal women.
METHODS
We investigated the association between bone mineral density (BMD), as measured at the lumbar spine and femoral neck, and the risk of breast cancer in women age 50 or older who had received an initial diagnosis of stage 0III breast cancer confirmed by pathologic assessment of breast tissue. We recruited 218 women with newly diagnosed breast cancer at Asan Medical Center from January 1, 2003 to December 31, 2004 and 963 women whose BMD was measured at the Health Promotion Center of Asan Medical Center as controls. Groups were divided by age: 5059 years old (Group A), 6069 years old (Group B), and over 70 years old (Group C). We compared BMD and prevalence of osteoporosis between groups. BMD was measured by lunar EXPERT-XL for breast cancer patients and Hologic QDR 4500-A for control group. A cross-calibration equation was used to compare BMD by different dual X-ray absorptiometry systems.
RESULTS
BMD was significantly higher among breast cancer patients than controls at lumbar spine (p= 0.04); femur neck BMD was higher but not statistically significant (p=0.47). After adjustment for age, the estimated odds ratio was 4.46 (p=0.02). In Group A, BMD for spine and femur neck was significantly higher in breast cancer patients (p<0.05). In Group B, spine BMD spine was significantly higher in breast cancer patients (p=0.005); femur neck BMD was higher but not statistically significant (p=0.24). In Group C, BMD for spine and femur neck was higher in breast cancer patients but not statistically significant (p>0.05). Prevalence of osteoporosis of the spine and femur neck was 14.9 and 4.6% for breast cancer patients and 19.6 and 8.3% for controls.
CONCLUSION
These results show that high bone mineral density has a strong relationship among breast cancer patients in postmenopausal women. In patients 70 years old or over, the age effect for bone mineral density decreased the effect of estrogen on bone.

Keyword

bone mineral density; breast cancer

MeSH Terms

Absorptiometry, Photon
Aged
Bone Density*
Breast Neoplasms*
Breast*
Chungcheongnam-do
Diagnosis
Estrogens
Female
Femur Neck
Health Promotion
Humans
Odds Ratio
Osteoporosis
Prevalence
Spine
Estrogens

Reference

1. Van de Klift M, de Laet CE, Coebergh JW, Hofman A, Pols HA. Bone mineral density and the risk of breast cancer: the Rotterdam Study. Bone. 2003. 32:211–216.

2. Bernstein L, Ross RK. Endogenous hormones and breast cancer risk. Epidemiol Rev. 1993. 15:48–65.

3. Dorgan JF, Longcope C, Stephenson HE, Falk RT, Miller R, Franz C, et al. Serum sex hormone levels are related to breast cancer risk in postmenopausal women. Environ Health Perspect. 997. 105:583–585.

4. Thomas HV, Reeves GK, Key TJ. Endogenous estrogen and postmenopausal breast cancer: a quantitative review. Cancer Causes Control. 1997. 8:922–928.

5. Cauley JA, Gutai JP, Sandler RB, LaPorte RE, Kuller LH, Sashin D. The relationship of endogenous estrogen to bone density and bone area in normal postmenopausal women. Am J Epidemiol. 1986. 124:752–761.

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

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

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

9. Zhang Y, Kiel DP, Kreger BE, Cupples LA, Ellison RC, Dorgan JF, et al. Bone mass and the risk of breast cancer among postmenopausal women. N Engl J Med. 1997. 336:611–617.

10. Jo JM, Kim JS, Kim GS, Kim SW, Shin JW, Moon DH. Cross-calibration of Bone mineral density between two different dual X-ray absorptiometry systems: Hologic QDR 4500-A and Lunar EXPERT-XL. Korean J Nucl Med. 1999. 33:282–288.

11. Helzlsouer KJ, Alberg AJ, Bush TL, Longcope C, Gordon GB, Comstosck GW. A prospective study of endogenous hormones and breast cancer. Cancer Detect Prev. 1994. 18:79–85.

12. Toniolo PG, Levitz M, Zelenuich-Jacquotte A, Banerjee S, Koenig SL, Shore RE. A prospective study of endogenous estrogens and breast cancer in post menopausal women. J Natl Cancer Inst. 1995. 87:190–197.

13. Key T, Appleby P, Barnes I, Reeves G. Endogenous sex hormones and breast cancer in postmenopausal women:reanalysis of nine prospective studies. J Natl Cancer Inst. 2002. 94:606–616.

14. Ganry O, Baudoin C, Fardellone P, Peng J, Raverdy N. Bone mass density and risk of breast cancer and survival in older women. Eur J Epidemiol. 2004. 19:785–792.

15. O'Brien K. High bone mass as a marker for breast cancer risk. Nutr Rev. 1997. 55:284–286.

16. Ganry O, Peng J, Dubreuil A. Is there a reduced risk of breast cancer among women with hip fractures? Eur J Epidemiol. 1999. 15:313–315.

17. Ganry O, Tramier B, Fardellone P, Raverdy N, Dubreuil A. High bone-mass density as a marker for breast cancer in post-menopausal women. Breast. 2001. 10:313–317.

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

19. Bruning PF, Bonfrer JM, van Noord PA, Hart AA, de Jong-Bakker M, Nooijen WJ. Insulin resistance and breast-cancer risk. Int J Cancer. 1992. 52:511–516.

20. Hankinson SE, Willett WC, Colditz GA, Hunter DJ, Michaud DS, Deroo B, et al. Circulating concentrations of insulin-like growth factor-I and risk of breast cancer. Lancet. 1998. 351:1393–1396.

21. Langlois JA, Rosen CJ, Visser M, Hannan MT, Harris T, Wilson PW, et al. Association between insulin-like growth factor I and bone mineral density in older women and men: the Framingham Heart Study. J Clin Endocrinol Metab. 1998. 83:4257–4262.

22. van Daele PL, Stolk RP, Burger H, Algra D, Grobbee DE, Hofman A, et al. Bone density in non-insulin-dependent diabetes mellitus. The Rotterdam Study. Ann Intern Med. 1995. 122:409–414.

23. Oh SY, Kang MJ, Moon WS, Choi HY. Correlation between Expression of Insulin-like Growth Factor-I Receptor and Clinicopathologic Prognostic Factors in Invasive Ductal Carcinoma of the Breast. J Korean Breast Cancer Soc. 2002. 5:118–124.

24. Yee D, Lee AU. Crosstalk between the insalin-like growth factors and estrogens in breast Cancer. J Mammary Gland Bio 1 Neoplasia. 2000. 5:107–115.

25. Ziv E, Cauley J, Morin PA, Saiz R, Browner WS. Association between the T29°Ê polymorphism in the transforming growth factor beta1 gene and breast cancer among elderly white women. The Study of Osteoporotic Fractures. JAMA. 2001. 285:2859–2863.

26. Yamada Y, Miyauchi A, Goto J, Takagi Y, Okuizumi H, Kanematsu M, et al. Association of a polymorphism of the transforming growth factor-beta1 gene with genetic susceptibility to osteoporosis in postmenopausal Japanese women. J Bone Miner Res. 1998. 13:1569–1576.

27. Shin JH, Kim DY, Im GI, Kim CI, Song SH, Jeong HJ. Assessment of bone mineral density by dual energy x-ray absorptiometry in Korean postmenopausal women. J Korean Orthop Assoc. 1997. 32:593–599.

28. Koh SK, Cho SH, Hwang YY, Moon H, Kim DS, Cho JL, et al. Spinal bone mineral density of normal and osteoporotic women in Korea? J Korean Med Sci. 1992. 7:136–140.

29. Han IK, Park WK, Choi WW, Shin HH, Kim SW. A study on hormonal changes and bone densities in Korean menopausal women. J Kor Soc Endo. 1989. 4:21–28.

30. Song SH, Shim CG, Seo H. Change in bone mineral density according to aging in Korean women: Study of Using Quantitative Computerized Tomography. J Korean Orthop Assoc. 2000. 35:277–282.