Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen/European Metropolitan Area Nuremberg (CCC ER-EMN), Erlangen, Germany.
Institute of Biometry and Epidemiology, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
Cancer Med. 2017 Jun;6(6):1473-1481. doi: 10.1002/cam4.1066. Epub 2017 May 2.
Percentage mammographic breast density (PMD) is one of the most important risk factors for breast cancer (BC). Calcium, vitamin D, bisphosphonates, and denosumab have been considered and partly confirmed as factors potentially influencing the risk of BC. This retrospective observational study investigated the association between serum calcium level and PMD. A total of 982 BC patients identified in the research database at the University Breast Center for Franconia with unilateral BC, calcium and albumin values, and mammogram at the time of first diagnosis were included. PMD was assessed, using a semiautomated method by two readers. Linear regression analyses were conducted to investigate the impact on PMD of the parameters of serum calcium level adjusted for albumin level, and well-known clinical predictors such as age, body mass index (BMI), menopausal status and confounder for serum calcium like season in which the BC was diagnosed. Increased calcium levels were associated with reduced PMD (P = 0.024). Furthermore, PMD was inversely associated with BMI (P < 0.001) and age (P < 0.001). There was also an association between PMD and menopausal status (P < 0.001). The goodness-of-fit of the regression model was moderate. This is the first study assessing the association between serum calcium level and PMD. An inverse association with adjusted serum calcium levels was observed. These findings add to previously published data relating to vitamin D, bisphosphonates, denosumab, and the RANK/RANKL signaling pathway in breast cancer risk and prevention.
乳腺摄影密度（PMD）百分比是乳腺癌（BC）的最重要危险因素之一。钙、维生素 D、双膦酸盐和地舒单抗已被认为并部分证实为潜在影响 BC 风险的因素。这项回顾性观察性研究调查了血清钙水平与 PMD 之间的关系。在弗兰科尼亚大学乳腺中心的研究数据库中，共纳入了 982 名单侧 BC 患者，这些患者的钙和白蛋白值以及首次诊断时的乳房 X 光片均在研究范围内。采用两种方法评估 PMD，一种是半自动方法，另一种是由两位读者评估。进行线性回归分析，以研究调整白蛋白水平后的血清钙水平参数以及年龄、体重指数（BMI）、绝经状态等已知临床预测因子对 PMD 的影响，以及血清钙的混杂因子，如诊断 BC 的季节。较高的钙水平与较低的 PMD 相关（P = 0.024）。此外，PMD 与 BMI（P < 0.001）和年龄（P < 0.001）呈负相关。PMD 与绝经状态之间也存在关联（P < 0.001）。回归模型的拟合优度为中等。这是第一项评估血清钙水平与 PMD 之间关系的研究。观察到与调整后的血清钙水平呈负相关。这些发现增加了先前关于维生素 D、双膦酸盐、地舒单抗以及乳腺癌风险和预防中的 RANK/RANKL 信号通路的已发表数据。
