Breast Cancer and Bone Mass in Older Women: is Bone Density Prescreening for Mammography Useful?
From: Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive, 0631-C, La Jolla, 92093-0631, USA. dsilverstein@ucsd.edu
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
- Publish Date: 2006
- ISSN: 0937-941X
- Volume: 17
- Issue: 8
- Pages: 1196-201
- Medium: Print
- Language: English
- Citation (JAMA): Kritz-Silverstein D, Schneider D L, Sandwell J, et al. Breast Cancer and Bone Mass in Older Women: is Bone Density Prescreening for Mammography Useful?. 2006;17:1196-201
Abstract
INTRODUCTION: The utility of screening mammography for older women with low bone mineral density (BMD) is controversial. This case-control study compares BMD at multiple sites in women with and without breast cancer to determine if BMD prescreening is useful in selecting women for continued screening mammograms. METHODS: Women diagnosed with breast cancer in the preceding 4 months and age-matched controls (+/-2 years) with a normal mammogram, all aged 65 years and older, were recruited on a 1:2 basis; 237 women participated: 79 women (cases) with breast cancer and 158 controls. BMD at the lumbar spine, hip, radius, and whole body was measured with dual x-ray absorptiometry (DXA). RESULTS: Among women with breast cancer, 17.1% had stage 0, 41.5% stage I, 40.0% stage II, and 1.4% stage III. Women with breast cancer had larger waist circumferences (p=0.002) and waist-hip ratios (p=0.01), and they exercised less (p=0.002) than women of the control group. However, there were no differences between the cases and controls for age, obesity, and reproductive and menopausal history variables, or other covariates (p>0.10). There were no differences in lumbar spine, total hip, femoral neck, midshaft radius, or total body BMD (p>0.10), although the cases had higher BMD at the ultradistal radius than the controls (means: 0.527 vs. 0.516, respectively; p=0.014). There were no differences in breast cancer risk by tertile of BMD or osteoporosis status at the hip or spine. CONCLUSION: There is little difference in BMD between women with and without breast cancer. BMD is not useful as a prescreening predicator of mammography in older women and using it as such would result in cases of breast cancer being missed.
Mesh Headings (Keywords): Aged, Aged, 80 and over, Bone Density, Breast Neoplasms, Case-Control Studies, Exercise, Female, Humans, Mammography, Risk Factors, Vitamin D
Check for Full Text / PubMed Unique Identifier (PMID): 16699738
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