Breast Cancer and Bone Mineral Density in a U.S. Cohort of Middle-Aged Women: Associations with Phosphate Toxicity.

Simple Summary: Phosphate toxicity, the accumulation of toxic levels of phosphate in the body, is associated with tumor growth and bone mineral abnormalities. Based on shared associations with phosphate toxicity, the hypothesis of the present study proposes that breast cancer is associated with bone mineral abnormalities in middle-aged women from the U.S. Study of Women's Health Across the Nation. The results of the present mixed methods–grounded theory study confirmed that women self-reporting breast cancer had a greater magnitude of changes in bone mineral density over time compared with women who remained cancer-free. These findings have implications for phosphate toxicity as a potential cause of bone metastasis in metastatic breast cancer, and future studies should investigate a low-phosphate diet to reduce tumorigenesis and bone mineral abnormalities in breast cancer patients. Breast cancer is associated with phosphate toxicity, the toxic effect from dysregulated phosphate metabolism that can stimulate tumorigenesis. Phosphate toxicity and dysregulated phosphate metabolism are also associated with bone mineral abnormalities, including excessive bone mineral loss and deposition. Based on shared associations with dysregulated phosphate metabolism and phosphate toxicity, a hypothesis proposed in the present mixed methods–grounded theory study posits that middle-aged women with incidence of breast cancer had a greater magnitude of changes in bone mineral density over time compared with women who remained cancer-free. To test this hypothesis, a mixed-effects model was used to analyze the associations of breast cancer incidence with spinal bone mineral density changes in the U.S. Study of Women's Health Across the Nation. Compared with women in the cohort who remained cancer-free, women who self-reported breast cancer had higher bone mineral density at baseline, but had more rapid losses in bone mineral density during follow-up visits. These findings agree with the hypothesis that a greater magnitude of changes in bone mineral density over time is associated with breast cancer in a cohort of middle-aged women. The findings also have implications for studies investigating dysregulated phosphate metabolism and phosphate toxicity as causative factors of bone metastasis in metastatic breast cancer. Additionally, the authors previously found increased breast cancer risk associated with high dietary phosphate intake in the same cohort of middle-aged women, and more studies should investigate a low-phosphorus diet to reduce bone mineral abnormalities and tumorigenesis in breast cancer patients. [ABSTRACT FROM AUTHOR]