Annals of Epidemiology
Volume 17, Issue 8 , Pages 575-583, August 2007

The Association Between Mammographic Breast Density and Bone Mineral Density in the Study of Women's Health Across the Nation

From the David Geffen School of Medicine at University of California, Los Angeles, CA (C.J.C.); Division of Research-Kaiser Permanente, University of California Davis, Oakland, CA (B.S., L.A.H., N.O.); Division of Geriatrics, University of California, Los Angeles, CA (G.A.G., A.K., Y.Z.); Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA (J.J.); Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA (J.A.C.)

Received 7 November 2006; accepted 9 March 2007. published online 30 May 2007.

Background

Bone mineral density and mammographic breast density are each associated with markers of lifetime estrogen exposure. The association between mammographic breast density and bone mineral density in early perimenopausal women is unknown.

Methods

We analyzed data from a cohort (n = 501) of premenopausal (no change in menstrual regularity) and early perimenopausal (decreased menstrual regularity in past 3 months) participants of African-American, Caucasian, Chinese, and Japanese ethnicity in the Study of Women's Health Across the Nation. Using multivariable linear regression, we examined the cross-sectional association between percent mammographic density and bone mineral density (BMD).

Results

Percent mammographic density was statistically significantly inversely associated with hip BMD and lumbar spine BMD after adjustment (body mass index, ethnicity, age, study site, parity, alcohol intake, cigarette smoking, physical activity, age at first childbirth) in early perimenopausal, but not premenopausal, women. In early perimenopausal women, every 0.1g/cm2 greater hip BMD predicted a 2% lower percent mammographic density (95% confidence interval –37.0 to –0.6%, p = 0.04).

Conclusion

Mammographic breast density is inversely associated with BMD in the perimenopausal participants of this community-based cohort. The biological underpinnings of these findings may reflect differential responsiveness of breast and bone mineral density to the steroid milieu.

Key Words: Bone Mineral Density, Mammographic Density, Breast Density, Mammographic Breast Density

Selected Abbreviations and Acronyms: BMD, bone mineral density, SWAN, Study of Women's Health Across the Nation, BMI, body mass index

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 Dr. Crandall was supported by National Institute of Health research grant numbers 5K12AG01004 from National Institute on Aging and by grant 8KB-0035 from the California Breast Cancer Research Program. The Study of Women's Health Across the Nation Mammographic Density Ancillary Study was supported by the National Cancer Institute RO1CA89552. The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health, DHHS, through the National Institute on Aging, the National Institute of Nursing Research and the NIH Office of Research on Women's Health (grants NR004061, AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, AG012495).

PII: S1047-2797(07)00146-9

doi:10.1016/j.annepidem.2007.03.012

Annals of Epidemiology
Volume 17, Issue 8 , Pages 575-583, August 2007

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