Bone Mineral Density as a Potential Predictive Factor for Luminal-type Breast Cancer in Postmenopausal Women.

BACKGROUND/AIM: We performed a case-control study to evaluate whether bone mineral density (BMD) can be considered a potential predictive factor for luminal-type breast cancer (BC), that could be useful in constructing a predictive risk model. MATERIALS AND METHODS: The medical records of 297 postmenopausal women with luminal-type node-negative BC who underwent lumbar-spine dual-energy X-ray absorptiometry (DXA) with BMD measurement before surgery, were analyzed and compared with those of 297 age-matched randomly selected healthy controls. The correlations between women's reproductive history, including the age at menarche and menopause, parity, oral contraceptives and hormone replacement therapy (HRT) use, the results of DXA, and BC risk were evaluated in univariate and multivariate analyses. RESULTS: Overall, 168 (28.3%) women had osteoporosis and/or osteopenia (low BMD). Both bone alterations were protective factors for BC, especially when they were considered together (p=0.001). Only the interval between menarche and menopause (MMI), dichotomized at 37.5 years as an optimal cut-off, and the HRT use reached a statistical significance (p<0.01) as risk factors. The three parameters were independent because they remained significant in the stepwise logistic regression analysis. The area under the receiver operating characteristic (ROC) curve (AUC) obtained with the model was 0.694 (95%CI=0.694-0.731). CONCLUSION: This hypothesized predictive model is fairly accurate and could identify patients at increased risk of developing luminal-type BC in a population of postmenopausal women who performed DXA, simply based on their history.

Bone turnover markers in women with early stage breast cancer who developed bone metastases. A prospective study with multivariate logistic regression analysis of accuracy.

BACKGROUND: The skeleton is the most common site of metastasis for breast cancer and the periodic measurement of circulating bone turnover markers (BTMs) can be useful. The aim of this study was to prospectively evaluate the diagnostic accuracy of a panel of BTMs in the early detection of bone metastases (BMs). METHODS: We reviewed the medical records of 297 postmenopausal women with early stage luminal-type invasive ductal carcinoma (IDC). Twenty-six patients who developed isolated BMs during follow-up and 24 randomly selected controls were studied. The two groups were matched according to age, final disease staging, and follow-up. All patients underwent periodic measurement of total and bone-specific (BSAP) alkaline phosphatase, CTX, ICTP, osteocalcin, NTX, PINP, and TRACP5b. RESULTS: Only BSAP, CTX, PINP, and TRACP5b were significantly (p<0.05) associated with the group, and the logistic regression analysis excluded CTX from the model. The AUC (ROC curve) for TRACP5b alone, which was the most accurate marker, and for the combination of BSAP+PINP+TRACP5b was 0.784 (95% CI: 0.651-0.916) and 0.889 (95% CI: 0.798-0.981), respectively. CONCLUSION: According to our results, the measurement of these three markers together should be performed in all postmenopausal patients with luminal-type IDC, when an early diagnosis of BMs is required.