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Reduced Bone Mineral Density Is Associated with Breast Arterial Calcification

Department of Obstetrics, Gynecology, and Reproductive Biology (J.R.), Brigham and Women’s Hospital, Boston, Massachusetts 02115; Departments of Medicine (J.P.B., L.M.), Pharmacology (J.P.B.), and Radiology (S.J.S.), Columbia University College of Physicians and Surgeons, New York, New York 10032

Address all correspondence and requests for reprints to: Dr. Lori Mosca, Preventive Cardiology Program, New York Presbyterian Hospital, 622 W 168th Street, PH 10-203B, New York, New York 10032. E-mail: ljm10{at}columbia.edu (copy to: lmr2{at}columbia.edu).

Background: Arterial calcification, a marker of atherosclerosis, results from a complex process of biomineralization resembling bone formation. Breast arterial calcification (BAC) has been associated with angiographic and clinical cardiovascular disease. The purpose of this study was to determine the association between reduced bone mineral density (BMD) and BAC, which may share a common pathophysiology.

Methods: We conducted a retrospective study of 228 women (55% Hispanic, mean age 64 ±10 yr) who had both mammography and BMD evaluation at Columbia University Medical Center from 2001–2003. Each mammogram was reviewed for the presence of BAC using standardized methods. BMD was measured using dual-energy x-ray absorptiometry and categorized as normal, low bone density (osteopenia), or osteoporosis as defined by the World Health Organization. Univariate and multivariate logistic regression analyses were performed to evaluate the association between reduced BMD and BAC.

Results: The prevalence of BAC, low bone density (osteopenia), and osteoporosis was 39, 42, and 29%, respectively. Women with BAC were significantly more likely to be older, Hispanic, and postmenopausal and have osteoporosis as compared with women without BAC. In age-adjusted analyses, women with BAC were more likely to have reduced BMD (odds ratio 3.0, P < 0.01) as compared with women without BAC. Furthermore, osteoporosis was strongly associated with the presence of BAC (odds ratio 3.5, P < 0.01).

Conclusion: These data suggest that osteoporosis and arterial calcification are strongly and independently correlated. Reduced BMD may identify women at risk of vascular disease.