Association of mammographic density with the pathology of subsequent breast cancer among postmenopausal women

Karthik Ghosh, Kathleen R Brandt, Thomas A. Sellers, Carol Reynolds, Christopher G. Scott, Shaun D. Maloney, Michael J. Carston, V. Shane Pankratz, Celine M Vachon

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background: Limited studies have examined the associations between mammographic density and subsequent breast tumor characteristics. Methods: Eligible women were part of a case-control study of postmenopausal breast cancer, were 40 years or older and had a routine mammogram 4 years or more before their diagnosis. Mammographic density (percent density, dense area, and nondense area) was estimated using a computer-assisted thresholding program. At the time of cancer diagnosis, cases were classified as asymptomatic or symptomatic based on medical record review and breast imaging workup. Pathologic review was done blinded to the density status. Linear regression models and tests for trend examined the association between pathologic characteristics of the breast tumor and the components of density for all participants, and stratified by symptom status at diagnosis. Results: Of the 286 eligible cases, 77% were 60 years or older and mean percent density was 29.5% (SD, 14.6%). Density was not significantly associated with tumor size (P = 0.22), histologic type (P = 0.77), estrogen receptor (P = 0.11) or progesterone receptor (P = 0.37) status, mitotic activity (P = 0.12), or nuclear pleomorphism (P = 0.09; P values for percent density). An inverse association was suggested between tumor grade and percent density (32.0%, 30.3%, 26.7% for grades 1-3; P = 0.06 for trend). The inverse association with tumor grade and its components (nuclear pleomorphism and tubular differentiation) was only evident among the 97 symptomatic women; positive associations of estrogen receptor (P = 0.009) and progesterone receptor (P = 0.04) were also seen with percent density only in this subgroup. Conclusions: The inverse association between tumor grade and percent density in the symptomatic population could inform the biology of the association between mammographic density and breast cancer risk.

Original languageEnglish (US)
Pages (from-to)872-879
Number of pages8
JournalCancer Epidemiology Biomarkers and Prevention
Volume17
Issue number4
DOIs
StatePublished - Apr 2008

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Pathology
Breast Neoplasms
Progesterone Receptors
Neoplasms
Estrogen Receptors
Linear Models
Medical Records
Case-Control Studies
Breast
Breast Density
Population

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Association of mammographic density with the pathology of subsequent breast cancer among postmenopausal women. / Ghosh, Karthik; Brandt, Kathleen R; Sellers, Thomas A.; Reynolds, Carol; Scott, Christopher G.; Maloney, Shaun D.; Carston, Michael J.; Pankratz, V. Shane; Vachon, Celine M.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 17, No. 4, 04.2008, p. 872-879.

Research output: Contribution to journalArticle

Ghosh, Karthik ; Brandt, Kathleen R ; Sellers, Thomas A. ; Reynolds, Carol ; Scott, Christopher G. ; Maloney, Shaun D. ; Carston, Michael J. ; Pankratz, V. Shane ; Vachon, Celine M. / Association of mammographic density with the pathology of subsequent breast cancer among postmenopausal women. In: Cancer Epidemiology Biomarkers and Prevention. 2008 ; Vol. 17, No. 4. pp. 872-879.
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abstract = "Background: Limited studies have examined the associations between mammographic density and subsequent breast tumor characteristics. Methods: Eligible women were part of a case-control study of postmenopausal breast cancer, were 40 years or older and had a routine mammogram 4 years or more before their diagnosis. Mammographic density (percent density, dense area, and nondense area) was estimated using a computer-assisted thresholding program. At the time of cancer diagnosis, cases were classified as asymptomatic or symptomatic based on medical record review and breast imaging workup. Pathologic review was done blinded to the density status. Linear regression models and tests for trend examined the association between pathologic characteristics of the breast tumor and the components of density for all participants, and stratified by symptom status at diagnosis. Results: Of the 286 eligible cases, 77{\%} were 60 years or older and mean percent density was 29.5{\%} (SD, 14.6{\%}). Density was not significantly associated with tumor size (P = 0.22), histologic type (P = 0.77), estrogen receptor (P = 0.11) or progesterone receptor (P = 0.37) status, mitotic activity (P = 0.12), or nuclear pleomorphism (P = 0.09; P values for percent density). An inverse association was suggested between tumor grade and percent density (32.0{\%}, 30.3{\%}, 26.7{\%} for grades 1-3; P = 0.06 for trend). The inverse association with tumor grade and its components (nuclear pleomorphism and tubular differentiation) was only evident among the 97 symptomatic women; positive associations of estrogen receptor (P = 0.009) and progesterone receptor (P = 0.04) were also seen with percent density only in this subgroup. Conclusions: The inverse association between tumor grade and percent density in the symptomatic population could inform the biology of the association between mammographic density and breast cancer risk.",
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AU - Ghosh, Karthik

AU - Brandt, Kathleen R

AU - Sellers, Thomas A.

AU - Reynolds, Carol

AU - Scott, Christopher G.

AU - Maloney, Shaun D.

AU - Carston, Michael J.

AU - Pankratz, V. Shane

AU - Vachon, Celine M

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N2 - Background: Limited studies have examined the associations between mammographic density and subsequent breast tumor characteristics. Methods: Eligible women were part of a case-control study of postmenopausal breast cancer, were 40 years or older and had a routine mammogram 4 years or more before their diagnosis. Mammographic density (percent density, dense area, and nondense area) was estimated using a computer-assisted thresholding program. At the time of cancer diagnosis, cases were classified as asymptomatic or symptomatic based on medical record review and breast imaging workup. Pathologic review was done blinded to the density status. Linear regression models and tests for trend examined the association between pathologic characteristics of the breast tumor and the components of density for all participants, and stratified by symptom status at diagnosis. Results: Of the 286 eligible cases, 77% were 60 years or older and mean percent density was 29.5% (SD, 14.6%). Density was not significantly associated with tumor size (P = 0.22), histologic type (P = 0.77), estrogen receptor (P = 0.11) or progesterone receptor (P = 0.37) status, mitotic activity (P = 0.12), or nuclear pleomorphism (P = 0.09; P values for percent density). An inverse association was suggested between tumor grade and percent density (32.0%, 30.3%, 26.7% for grades 1-3; P = 0.06 for trend). The inverse association with tumor grade and its components (nuclear pleomorphism and tubular differentiation) was only evident among the 97 symptomatic women; positive associations of estrogen receptor (P = 0.009) and progesterone receptor (P = 0.04) were also seen with percent density only in this subgroup. Conclusions: The inverse association between tumor grade and percent density in the symptomatic population could inform the biology of the association between mammographic density and breast cancer risk.

AB - Background: Limited studies have examined the associations between mammographic density and subsequent breast tumor characteristics. Methods: Eligible women were part of a case-control study of postmenopausal breast cancer, were 40 years or older and had a routine mammogram 4 years or more before their diagnosis. Mammographic density (percent density, dense area, and nondense area) was estimated using a computer-assisted thresholding program. At the time of cancer diagnosis, cases were classified as asymptomatic or symptomatic based on medical record review and breast imaging workup. Pathologic review was done blinded to the density status. Linear regression models and tests for trend examined the association between pathologic characteristics of the breast tumor and the components of density for all participants, and stratified by symptom status at diagnosis. Results: Of the 286 eligible cases, 77% were 60 years or older and mean percent density was 29.5% (SD, 14.6%). Density was not significantly associated with tumor size (P = 0.22), histologic type (P = 0.77), estrogen receptor (P = 0.11) or progesterone receptor (P = 0.37) status, mitotic activity (P = 0.12), or nuclear pleomorphism (P = 0.09; P values for percent density). An inverse association was suggested between tumor grade and percent density (32.0%, 30.3%, 26.7% for grades 1-3; P = 0.06 for trend). The inverse association with tumor grade and its components (nuclear pleomorphism and tubular differentiation) was only evident among the 97 symptomatic women; positive associations of estrogen receptor (P = 0.009) and progesterone receptor (P = 0.04) were also seen with percent density only in this subgroup. Conclusions: The inverse association between tumor grade and percent density in the symptomatic population could inform the biology of the association between mammographic density and breast cancer risk.

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