La salud de la mujer / Woman's HealthLa densidad mineral ósea predice el riesgo de cáncer de mama
La densidad mineral ósea (DMO) de la cadera predice el riesgo de cáncer de mama en mujeres postmenopáusicas. La mayor DMO refleja la exposición a los estrógenos a lo largo de la vida, aunque no todos los cánceres dependen de esas hormonas.
El estudio se ha basado en 9.941 mujeres que formaron parte de la cohorte del Women’s Health Initiative (WHI). Cuando se inició las mujeres tenían una edad de 63 años, se sometieron a una densitometría y realizaron un cuestionario sobre el estilo de vida. El seguimiento de las mujeres fue de unos 8 años y se detectaron 327 casos de cáncer de mama.
El investigador Zhao Chen, de la Universidad de Arizona en Tucson, considera que la DMO puede predecir el riesgo de cáncer de mama con eficacia similar al índice de Gail basado en la edad actual de la mujer, edad de la primera menstruación, edad del primer nacimiento, historia de cáncer de mama, biopsias previas, y raza. Sus resultados indican que una DMO alta de cadera se asocia con riesgo de cáncer de mama. Estos resultados son contrarios a otros publicados en el 2005 en el Journal of the National Cancer Institute que no encontraron correlación entre DMO y cáncer de mama.
Chen Z, Arendell L, Aickin M, Cauley J, Lewis CE, Chlebowski R. Hip bone density predicts breast cancer risk independently of Gail score: results From the Women's Health Initiative. Cancer. 2008 Jul 29. [Epub ahead of print]
University of Arizona College of Public Health, Tucson, Arizona.
BACKGROUND.: The Gail model has been commonly used to estimate a woman's risk of breast cancer within a certain time period. High bone mineral density (BMD) is also a significant risk factor for breast cancer, but it appears to play no role in the Gail model. The objective of the current study was to investigate whether hip BMD predicts postmenopausal breast cancer risk independently of the Gail score. METHODS.: In this prospective study, 9941 postmenopausal women who had a baseline hip BMD and Gail score from the Women's Health Initiative were included in the analysis. Their average age was 63.0 +/- 7.4 years at baseline. RESULTS.: After an average of 8.43 years of follow-up, 327 incident breast cancer cases were reported and adjudicated. In a multivariate Cox proportional hazards model, the hazards ratios (95% confidence interval [95% CI]) for incident breast cancer were 1.35 (95% CI, 1.05-1.73) for high Gail score (>/=1.67%) and 1.25 (95% CI, 1.11-1.40) for each unit of increase in the total hip BMD T-score. Restricting the analysis to women with both BMD and a Gail score above the median, a sharp increase in incident breast cancer for women with the highest BMD and Gail scores was found (P < .05). CONCLUSIONS.: The contribution of BMD to the prediction of incident postmenopausal breast cancer across the entire population was found to be independent of the Gail score. However, among women with both high BMD and a high Gail score, there appears to be an interaction between these 2 factors. These findings suggest that BMD and Gail score may be used together to better quantify the risk of breast cancer. Cancer 2008. (c) 2008 American Cancer Society.
menopausia climaterio
salud de la mujer
women's health
ginecologia
health