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American Journal of Epidemiology Vol. 148, No. 1: 22-29
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Bone Mineral Density and Risk of Breast Cancer

Differences by Family History of Breast Cancer

Frances Leslie Lucas1,, Jane A. Cauley2, Roslyn A. Stone3, Steven R. Cummings4, Molly T. Vogt2,5, Joel L. Weissfeld2,6, Lewis H. Kuller2 and for the Study of Osteoporotic Fractures Research Group

1Division of Health Services Research, Maine Medical Center Portland, ME
2Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh Pittsburgh, PA
3Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh Pittsburgh, PA
4Department of Biostatistics and Epidemiology, University of California San Francisco, San Francisco, CA
5Department of Orthopedic Surgery, School of Medicine, University of Pittsburgh Pittsburgh, PA
6Pittsburgh Cancer Institute Pittsburgh, PA

Reprint requests to Dr. Frances L. Lucas, Division of Health Services Research, Maine Medical Center, 22 Bramhall Street, Portland, ME 04102-3175.

Recent studies have suggested that bone mineral density (BMD) is related to risk of breast cancer in elderly women. This study investigated whether the level of breast cancer risk associated with BMD in women with a positive family history of breast cancer is different from that in women without a family history of breast cancer. Radial and calcaneus BMD were measured at baseline (1986–1988) in 7, 250 elderly white women enrolled in the Study of Osteoporotic Fractures, and initial breast cancer status was ascertained at year 1 of follow-up. After a mean of 3.2 years of additional follow-up, 104 incident breast cancer cases, 20 of which appeared in women with a family history of breast cancer, were identified and confirmed by medical record review. Modification of the BMD effect by family history status was assessed by inclusion of interaction terms in proportional hazards regression models. Among women without a family history of breast cancer, those with a proximal radius BMD in the highest fertile were at a 1.48-fold increased risk compared with women in the lowest tertile; among women with a positive family history of breast cancer, those with highest fertile BMD were at a 3.41–fold increased risk compared with women in the lowest tertile. These results suggest that the association between BMD and breast cancer may be different in subgroups of women defined by family history. Am J Epidemiol 1998; 148: 22–9.

aged; bone density; breast neoplasms; cohort studies; estrogen replacement therapy; family characteristic


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