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Cancer Prevention Research... Jun 2023Breastfeeding is inversely associated with breast cancer risk but the associations of breastfeeding with mammographic breast density (MBD) are not clear. We investigated...
UNLABELLED
Breastfeeding is inversely associated with breast cancer risk but the associations of breastfeeding with mammographic breast density (MBD) are not clear. We investigated the association between breastfeeding and volumetric measures of MBD [volumetric percent density (VPD), dense volume (DV), and non-dense volume (NDV)] and evaluated whether it differs by race, menopausal status, and body mass index (BMI). The study population was comprised of 964 women (67% non-Hispanic White, 29% non-Hispanic Black) who had screening mammography at Washington University School of Medicine, St. Louis, MO. VPD, DV and NDV were log10 transformed. We performed multivariable linear regression models adjusted for age, BMI, family history of breast cancer, race, and age at menarche among all participants and exclusively in parous women. Mean age was 50.7 years. VPD was 12% lower among women who breastfed 0-6 months, [10β = 0.88, 95% confidence interval (CI; 0.79-0.98)] compared with nulliparous women. Breastfeeding was not associated with VPD among women who breastfed >7 months. Breastfeeding was inversely associated with DV [parous never breastfed: 10β = 0.93; 95% CI (0.83-1.04), breastfed 0-6 months: 10β = 0.91, 95% CI (0.79-1.05), breastfed 7-12 months: 10β = 0.94; 95% CI (0.81-1.10), breastfed >12 months: 10β = 0.87, 95% CI (0.78-0.98), Ptrend = 0.03]. BMI modified the association between breastfeeding and VPD. Women who breastfed for 0-6 months and had a BMI < 25 kg/m2 had lower VPD compared with nulliparous women, but among women with a BMI ≥ 25 kg/m2 there was no association (Pinteraction = 0.04). In this diverse study population, the association of breastfeeding with VPD appears to be modified by BMI, but not by race or menopausal status. Future research exploring the associations of breastfeeding with other mammographic features are needed.
PREVENTION RELEVANCE
Breastfeeding for up to 6 months may be associated with lower VPD among women with a BMI < 25 kg/m2. The potential role of MBD in mediating the associations of breastfeeding with breast cancer risk in a select group of women deserves further evaluation. See related Spotlight, p. 309.
Topics: Humans; Female; Middle Aged; Breast Density; Breast Neoplasms; Mammography; Cross-Sectional Studies; Breast Feeding; Early Detection of Cancer; Risk Factors
PubMed: 36930943
DOI: 10.1158/1940-6207.CAPR-22-0482 -
Journal of Preventive Medicine and... Nov 2016The established theory that breast density is an independent predictor of breast cancer risk is based on studies targeting white women in the West. More Asian women than... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The established theory that breast density is an independent predictor of breast cancer risk is based on studies targeting white women in the West. More Asian women than Western women have dense breasts, but the incidence of breast cancer is lower among Asian women. This meta-analysis investigated the association between breast density in mammography and breast cancer risk in Asian women.
METHODS
PubMed and Scopus were searched, and the final date of publication was set as December 31, 2015. The effect size in each article was calculated using the interval-collapse method. Summary effect sizes (sESs) and 95% confidence intervals (CIs) were calculated by conducting a meta-analysis applying a random effect model. To investigate the dose-response relationship, random effect dose-response meta-regression (RE-DRMR) was conducted.
RESULTS
Six analytical epidemiology studies in total were selected, including one cohort study and five case-control studies. A total of 17 datasets were constructed by type of breast density index and menopausal status. In analyzing the subgroups of premenopausal vs. postmenopausal women, the percent density (PD) index was confirmed to be associated with a significantly elevated risk for breast cancer (sES, 2.21; 95% CI, 1.52 to 3.21; I=50.0%). The RE-DRMR results showed that the risk of breast cancer increased 1.73 times for each 25% increase in PD in postmenopausal women (95% CI, 1.20 to 2.47).
CONCLUSIONS
In Asian women, breast cancer risk increased with breast density measured using the PD index, regardless of menopausal status. We propose the further development of a breast cancer risk prediction model based on the application of PD in Asian women.
Topics: Asian People; Breast Density; Breast Neoplasms; Databases, Factual; Female; Humans; Mammography; Postmenopause; Risk Factors
PubMed: 27951629
DOI: 10.3961/jpmph.16.054 -
Breast Cancer Research and Treatment Jul 2022Mammographic Density (MD) refers to the amount of fibroglandular breast tissue present in the breast and is an established risk factor for developing breast cancer. The...
PURPOSE
Mammographic Density (MD) refers to the amount of fibroglandular breast tissue present in the breast and is an established risk factor for developing breast cancer. The ability to evaluate treatment response dynamically renders neoadjuvant chemotherapy (NACT) the preferred treatment option in many clinical scenarios. Previous studies have suggested that MD can predict patients likely to achieve a pathological complete response (pCR) to NACT. We aimed to determine whether there is a causal relationship between BI-RADS breast composition categories for breast density at diagnosis and the pCR rate and residual cancer burden score (RCB) by performing a retrospective review on consecutive breast cancer patients who received NACT in a tertiary referral centre from 2015 to 2021.
METHODS
The Mann-Whitney U Test was used to test for differences between two independent groups (i.e. those who achieved pCR and those who did not). A binary logistic regression model was used to estimate odds ratios (OR) and corresponding 95% confidence intervals (CI) for an association between the independent variables of molecular subtype, MD, histological grade and FNA positivity and the dependant variable of pCR. Statistical analysis was conducted with SPSS (IBM SPSS for Mac, Version 26.0; IBM Corp).
RESULTS
292 patients were included in the current study. There were 124, 155 and 13 patients in the BI-RADS MD category b, c and d, respectively. There were no patients in the BI-RADS MD category a. The patients with less dense breast composition (MD category b) were significantly older than patients with denser breast composition (MD category c, d) (p = 0.001) and patients who had a denser breast composition (MD category d) were more likely to have ER+ tumours. There was no significant difference in PgR status, HER2 status, pathological complete response (pCR), FNA positivity, or RCB class dependent upon the three MD categories. A binary logistic regression revealed that patients with HER2-enriched breast cancer and triple-negative breast cancer are more likely to achieve pCR with an OR of 3.630 (95% CI 1.360-9.691, p = 0.010) and 2.445 (95% CI 1.131-5.288, p = 0.023), respectively.
CONCLUSION
Whilst dense MD was associated with ER positivity and these women were less likely to achieve a pCR, MD did not appear to independently predict pCR post-NACT.
Topics: Breast; Breast Density; Breast Neoplasms; Female; Humans; Mammography; Neoadjuvant Therapy
PubMed: 35606616
DOI: 10.1007/s10549-022-06616-1 -
Physics in Medicine and Biology Dec 2018Mammograms represent data that can inform future risk of breast cancer. Data from two case-control study populations were analyzed. Population 1 included women...
Mammograms represent data that can inform future risk of breast cancer. Data from two case-control study populations were analyzed. Population 1 included women (N = 180 age matched case-control pairs) with mammograms acquired with one indirect x-ray conversion mammography unit. Population 2 included women (N = 319 age matched case-control pairs) with mammograms acquired from 6 direct x-ray conversion units. The Fourier domain was decomposed into n concentric rings (radial spatial frequency bands). The power in each ring was summarized giving a set of measures. We investigated images in raw, for presentation (processed) and calibrated representations and made comparison with the percentage of breast density (BD) determined with the operator assisted Cumulus method. Breast cancer associations were evaluated with conditional logistic regression, adjusted for body mass index and ethnicity. Odds ratios (ORs), per standard deviation increase derived from the respective breast density distributions and 95% confidence intervals (CIs) were estimated. A measure from a lower radial frequency ring, corresponding 0.083-0.166 cycles mm and BD had significant associations with risk in both populations. In Population 1, the Fourier measure produced significant associations in each representation: OR = 1.76 (1.33, 2.32) for raw; OR = 1.43 (1.09, 1.87) for processed; and OR = 1.68 (1.26, 2.25) for calibrated. BD also provided significant associations in Population 1: OR = 1.72 (1.27, 2.33). In Population 2, the Fourier measure produced significant associations for each representation as well: OR = 1.47 (1.19, 1.80) for raw; OR = 1.38 (1.15, 1.67) for processed; and OR = 1.42 (1.15, 1.75) for calibrated. BD provided significant associations in Population 2: OR = 1.43 (1.17, 1.76). Other coincident spectral regions were also predictive of case-control status. In sum, generalized breast density measures were significantly associated with breast cancer in both FFDM technologies.
Topics: Body Mass Index; Breast Density; Breast Neoplasms; Calibration; Case-Control Studies; Female; Fourier Analysis; Humans; Logistic Models; Mammography
PubMed: 30523909
DOI: 10.1088/1361-6560/aaf307 -
BMC Cancer Oct 2023Mammographic density (MD) is a strong risk factor for breast cancer. We aimed to evaluate the association between MD and breast cancer related risk factors among...
BACKGROUND
Mammographic density (MD) is a strong risk factor for breast cancer. We aimed to evaluate the association between MD and breast cancer related risk factors among average-risk women in rural China.
METHODS
This is a population-based screening study. 12518 women aged 45-64 years with complete MD data from three maternal and childcare hospitals in China were included in the final analysis. ORs and 95%CIs were estimated using generalized logit model by comparing each higher MD (BI-RADS b, c, d) to the lowest group (BI-RADS a). The cumulative logistic regression model was used to estimate the OR (95%CI) and P by treating MD as an ordinal variable.
RESULTS
Older age (OR = 0.81, 95%CI: 0.79-0.81, per 2-year increase), higher BMI (OR = 0.73, 95%CI: 0.71-0.75, per 2 kg/m2), more births (OR = 0.47, 95%CI: 0.41-0.54, 3 + vs. 0-1), postmenopausal status (OR = 0.42, 95%CI: 0.38-0.46) were associated with lower MD. For parous women, longer duration of breastfeeding was found to be associated with higher MD when adjusting for study site, age, BMI, and age of first full-term birth (OR = 1.53, 95%CI: 1.27-1.85, 25 + months vs. no breastfeeding; OR = 1.45, 95%CI: 1.20-1.75, 19-24 months vs. no breastfeeding), however, the association became non-significant when adjusting all covariates. Associations between examined risk factors and MD were similar in premenopausal and postmenopausal women except for level of education and oral hormone drug usage. Higher education was only found to be associated with an increased proportion of dense breasts in postmenopausal women (OR = 1.08, 95%CI: 1.02-1.15). Premenopausal women who ever used oral hormone drug were less likely to have dense breasts, though the difference was marginally significant (OR = 0.54, P = 0.045). In postmenopausal women, we also found the proportion of dense breasts increased with age at menopause (OR = 1.31, 95%CI: 1.21-1.43).
CONCLUSIONS
In Chinese women with average risk for breast cancer, we found MD was associated with age, BMI, menopausal status, lactation, and age at menopausal. This finding may help to understand the etiology of breast cancer and have implications for breast cancer prevention in China.
Topics: Female; Humans; Infant; Breast Density; Breast Neoplasms; Mammography; Risk Factors; China; Hormones; Breast
PubMed: 37814233
DOI: 10.1186/s12885-023-11444-7 -
Journal of Immigrant and Minority Health Dec 2021Breast cancer is the most common cancer in women. Asian American women have experienced steadily increasing breast cancer incidence rates over the past several decades....
Breast cancer is the most common cancer in women. Asian American women have experienced steadily increasing breast cancer incidence rates over the past several decades. The increased rate might be in part due to acculturation. We tested the hypothesis that higher level of acculturation was associated with higher mammographic breast density (MBD), an indicator of breast cancer risk, in a cohort of 425 premenopausal Chinese immigrant women in Philadelphia. Generalized estimating equations accounted for repeated observations and adjusted for age, type of mammographic image, body mass index, months of breastfeeding, number of live births, age at first birth, and menopausal stage (pre, early peri, late peri, post). Results indicated that acculturation level was not associated with any of the MBD measures. Findings were contrary to our hypothesis and previous, cross-sectional studies. In this study population, reproductive factors had a greater effect on MBD than acculturation-related behaviors in adulthood.
Topics: Acculturation; Adult; Breast Density; Breast Neoplasms; China; Cross-Sectional Studies; Emigrants and Immigrants; Female; Humans; Mammography; Risk Factors
PubMed: 33040215
DOI: 10.1007/s10903-020-01107-1 -
BMC Cancer Apr 2018Breast density is known to affect breast cancer risk and screening sensitivity, but it may also be associated with breast cancer survival. The interpretation of results...
BACKGROUND
Breast density is known to affect breast cancer risk and screening sensitivity, but it may also be associated with breast cancer survival. The interpretation of results from previous studies on breast density and survival is complicated by the association between detection mode and survival. Here, we studied the effect of breast density on breast cancer-specific survival for different detection modes (screen-detected, interval ≤ 24 or > 24 months, non-participant).
METHODS
Data from the Nijmegen (Dutch) breast cancer screening programme were used. Women diagnosed with invasive breast cancer between 1975 and 2011 were included. Breast density was assessed visually, based on a dichotomized Wolfe scale: 'fatty breasts' (≤25%) and 'dense breasts' (> 25%). Cox proportional hazard regression was used to obtain hazard ratios (HR).
RESULTS
We identified 2742 eligible women, with a breast pattern available for 2233 women. A diagnosis of interval cancer (HR 2.06, 95% CI 1.62-2.61) led to a significantly increased risk of breast cancer death compared with screen-detected cancer. No significant cause-specific survival difference between women with dense and fatty breasts was observed (HR 0.94, 95% CI 0.77-1.15). The hazard was only higher for women with dense breasts among interval cancers ≤24 m (HR 1.07, 95% CI 0.74-1.56). The hazard appeared to be lower for women with dense breasts than for women with fatty breasts among screen-detected (HR 0.77, 95% CI 0.53-1.11) and interval cancers > 24 m (HR 0.80, 95% CI 0.53-1.20). None of the effects were statistically significant.
CONCLUSIONS
Detection mode is strongly associated with breast cancer death. No clear association is apparent between breast density and breast cancer death, regardless of detection mode.
Topics: Adult; Aged; Breast Density; Breast Neoplasms; Early Detection of Cancer; Female; Humans; Mammography; Mass Screening; Middle Aged; Netherlands; Proportional Hazards Models
PubMed: 29618328
DOI: 10.1186/s12885-018-4316-7 -
Nutrients Oct 2021Studies have investigated the associations of coffee and tea with mammographic breast density (MBD) in premenopausal women with inconsistent results. We analyzed data...
Studies have investigated the associations of coffee and tea with mammographic breast density (MBD) in premenopausal women with inconsistent results. We analyzed data from 375 premenopausal women who attended a screening mammogram at Washington University School of Medicine, St. Louis, MO in 2016, and stratified the analyses by race (non-Hispanic White (NHW) vs. Black/African American). Participants self-reported the number of servings of coffee, caffeinated tea, and decaffeinated tea they consumed. Volpara software was used to determine volumetric percent density (VPD), dense volume (DV), and non-dense volume (NDV). We used generalized linear regression models to quantify the associations of coffee and tea intake with MBD measures. Coffee: ≥1 time/day (β = 1.06; 95% CI = 0.93-1.21; -trend = 0.61) and caffeinated tea: ≥1 time/day (β = 1.01; 95% CI = 0.88-1.17; -trend = 0.61) were not associated with VPD. Decaffeinated tea (≥1 time/week) was positively associated with VPD in NHW women (β = 1.22; 95% CI = 1.06-1.39) but not in African American women (β = 0.93; 95% CI = 0.73-1.17; -interaction = 0.02). Coffee (≥1 time/day) was positively associated with DV in African American women (β = 1.52; 95% CI = 1.11-2.07) but not in NHW women (β = 1.10; 95% CI = 0.95-1.29; -interaction = 0.02). Our findings do not support associations of coffee and caffeinated tea intake with VPD in premenopausal women. Positive associations of decaffeinated tea with VPD, with suggestions of effect modification by race, require confirmation in larger studies with diverse study populations.
Topics: Adult; Beverages; Breast Density; Coffee; Diet Surveys; Drinking; Female; Humans; Linear Models; Mammography; Middle Aged; Premenopause; Racial Groups; Tea
PubMed: 34836118
DOI: 10.3390/nu13113852 -
Radiology Dec 2021Background While digital breast tomosynthesis (DBT) is rapidly replacing digital mammography (DM) in breast cancer screening, the potential of DBT density measures for...
Background While digital breast tomosynthesis (DBT) is rapidly replacing digital mammography (DM) in breast cancer screening, the potential of DBT density measures for breast cancer risk assessment remains largely unexplored. Purpose To compare associations of breast density estimates from DBT and DM with breast cancer. Materials and Methods This retrospective case-control study used contralateral DM/DBT studies from women with unilateral breast cancer and age- and ethnicity-matched controls (September 19, 2011-January 6, 2015). Volumetric percent density (VPD%) was estimated from DBT using previously validated software. For comparison, the publicly available Laboratory for Individualized Breast Radiodensity Assessment software package, or LIBRA, was used to estimate area-based percent density (APD%) from raw and processed DM images. The commercial Quantra and Volpara software packages were applied to raw DM images to estimate VPD% with use of physics-based models. Density measures were compared by using Spearman correlation coefficients (), and conditional logistic regression was performed to examine density associations (odds ratios [OR]) with breast cancer, adjusting for age and body mass index. Results A total of 132 women diagnosed with breast cancer (mean age ± standard deviation [SD], 60 years ± 11) and 528 controls (mean age, 60 years ± 11) were included. Moderate correlations between DBT and DM density measures ( = 0.32-0.75; all < .001) were observed. Volumetric density estimates calculated from DBT (OR, 2.3 [95% CI: 1.6, 3.4] per SD for VPD%) were more strongly associated with breast cancer than DM-derived density for both APD% (OR, 1.3 [95% CI: 0.9, 1.9] [ < .001] and 1.7 [95% CI: 1.2, 2.3] [ = .004] per SD for LIBRA raw and processed data, respectively) and VPD% (OR, 1.6 [95% CI: 1.1, 2.4] [ = .01] and 1.7 [95% CI: 1.2, 2.6] [ = .04] per SD for Volpara and Quantra, respectively). Conclusion The associations between quantitative breast density estimates and breast cancer risk are stronger for digital breast tomosynthesis compared with digital mammography. © RSNA, 2021 See also the editorial by Yaffe in this issue.
Topics: Breast; Breast Density; Breast Neoplasms; Case-Control Studies; Female; Humans; Mammography; Middle Aged; Retrospective Studies
PubMed: 34519572
DOI: 10.1148/radiol.2021210190 -
Journal of Women's Health (2002) Jul 2022Most U.S. states require written notification of breast density after mammograms, yet effects of notifications on knowledge are mixed. Little is known about potential...
Most U.S. states require written notification of breast density after mammograms, yet effects of notifications on knowledge are mixed. Little is known about potential misunderstandings. We used a sequential mixed-methods study design to assess women's knowledge about breast density, after receiving a notification. We conducted a telephone survey among a racially/ethnically and health-literacy level diverse sample ( = 754) and qualitative interviews with 61 survey respondents. In survey results, 58% of women correctly indicated that breast density is not related to touch, with higher accuracy among non-Hispanic White women and those with greater health literacy. Next, 87% of women recognized that breast density is identified visually mammogram, with no significant differences in responses by race/ethnicity or health literacy. Most (81%) women recognized that a relationship exists between breast tissue types and density; Non-Hispanic White women were less likely to respond correctly. Only 47% of women correctly indicated that having dense breasts increases one's risk of breast cancer; women with low health literacy were more often correct. Qualitative results revealed additional dimensions of understanding: Some women incorrectly reported that density could be felt, or dense breasts were lumpier, thicker, or more compacted; others identified "dense" tissue as fatty. Interpretations of risk included that breast density was an early form of breast cancer. We found areas of consistent knowledge and identified misperceptions surrounding breast density across race/ethnicity and health literacy levels. Further education to address disparities and correct misunderstandings is essential to promote better knowledge, to foster informed decisions.
Topics: Breast Density; Breast Neoplasms; Early Detection of Cancer; Female; Health Literacy; Humans; Male; Mammography; Surveys and Questionnaires
PubMed: 35230164
DOI: 10.1089/jwh.2021.0343