TY - JOUR
T1 - Combined effect of volumetric breast density and body mass index on breast cancer risk
AU - Engmann, Natalie J.
AU - Scott, Christopher G.
AU - Jensen, Matthew R.
AU - Winham, Stacey
AU - Miglioretti, Diana L.
AU - Ma, Lin
AU - Brandt, Kathleen
AU - Mahmoudzadeh, Amir
AU - Whaley, Dana H.
AU - Hruska, Carrie
AU - Wu, Fang
AU - Norman, Aaron D.
AU - Hiatt, Robert A.
AU - Heine, John
AU - Shepherd, John
AU - Pankratz, V. Shane
AU - Vachon, Celine M.
AU - Kerlikowske, Karla
N1 - Funding Information:
Funding This research was supported by the National Institutes of Health, National Cancer Institute grants (R01CA177150-03, PI’s: C.M. Vachon, K. Kerlikowske; and F31CA213804-01, PI: N.J. Engmann), as well as the Mayo Clinic Specialized Program of Research Excellence (SPORE) in Breast Cancer (P50 CA116201, PI’s: M. Goetz and J. Ingle), and the National Cancer Institute funded Program Project (P01CA154292, PI: K. Kerlikowske), which supported the collection of digital images.
Funding Information:
Conflict of interest Carrie Hruska received payment from Gamma Medica for patents and royalties. Celine M. Vachon receives research funding from GRAIL. Karla Kerlikowske receives grant funding from Google Sciences and is an unpaid consultant for GRAIL on the STRIVE study. John Shepherd is a consultant for Hologic, GE Healthcare. The remaining authors have no relationships to disclose.
Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2019/8/30
Y1 - 2019/8/30
N2 - Background: Breast density and body mass index (BMI) are used for breast cancer risk stratification. We evaluate whether the positive association between volumetric breast density and breast cancer risk is strengthened with increasing BMI. Methods: The San Francisco Mammography Registry and Mayo Clinic Rochester identified 781 premenopausal and 1850 postmenopausal women with breast cancer diagnosed between 2007 and 2015 that had a screening digital mammogram at least 6 months prior to diagnosis. Up to three controls (N = 3535) were matched per case on age, race, date, mammography machine, and state. Volumetric percent density (VPD) and dense volume (DV) were measured with Volpara™. Breast cancer risk was assessed with logistic regression stratified by menopause status. Multiplicative interaction tests assessed whether the association of density measures was differential by BMI categories. Results: The increased risk of breast cancer associated with VPD was strengthened with higher BMI for both premenopausal (pinteraction = 0.01) and postmenopausal (pinteraction = 0.0003) women. For BMI < 25, 25–30, and ≥ 30 kg/m2, ORs for breast cancer for a 1 SD increase in VPD were 1.24, 1.65, and 1.97 for premenopausal, and 1.20, 1.55, and 2.25 for postmenopausal women, respectively. ORs for breast cancer for a 1 SD increase in DV were 1.39, 1.33, and 1.51 for premenopausal (pinteraction = 0.58), and 1.31, 1.34, and 1.65 (pinteraction = 0.03) for postmenopausal women for BMI < 25, 25–30 and ≥ 30 kg/m2, respectively. Conclusions: The effect of volumetric percent density on breast cancer risk is strongest in overweight and obese women. These associations have clinical relevance for informing prevention strategies.
AB - Background: Breast density and body mass index (BMI) are used for breast cancer risk stratification. We evaluate whether the positive association between volumetric breast density and breast cancer risk is strengthened with increasing BMI. Methods: The San Francisco Mammography Registry and Mayo Clinic Rochester identified 781 premenopausal and 1850 postmenopausal women with breast cancer diagnosed between 2007 and 2015 that had a screening digital mammogram at least 6 months prior to diagnosis. Up to three controls (N = 3535) were matched per case on age, race, date, mammography machine, and state. Volumetric percent density (VPD) and dense volume (DV) were measured with Volpara™. Breast cancer risk was assessed with logistic regression stratified by menopause status. Multiplicative interaction tests assessed whether the association of density measures was differential by BMI categories. Results: The increased risk of breast cancer associated with VPD was strengthened with higher BMI for both premenopausal (pinteraction = 0.01) and postmenopausal (pinteraction = 0.0003) women. For BMI < 25, 25–30, and ≥ 30 kg/m2, ORs for breast cancer for a 1 SD increase in VPD were 1.24, 1.65, and 1.97 for premenopausal, and 1.20, 1.55, and 2.25 for postmenopausal women, respectively. ORs for breast cancer for a 1 SD increase in DV were 1.39, 1.33, and 1.51 for premenopausal (pinteraction = 0.58), and 1.31, 1.34, and 1.65 (pinteraction = 0.03) for postmenopausal women for BMI < 25, 25–30 and ≥ 30 kg/m2, respectively. Conclusions: The effect of volumetric percent density on breast cancer risk is strongest in overweight and obese women. These associations have clinical relevance for informing prevention strategies.
KW - Body mass index
KW - Breast cancer
KW - Breast density
KW - Mammographic density
UR - http://www.scopus.com/inward/record.url?scp=85066283120&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85066283120&partnerID=8YFLogxK
U2 - 10.1007/s10549-019-05283-z
DO - 10.1007/s10549-019-05283-z
M3 - Article
C2 - 31129803
AN - SCOPUS:85066283120
SN - 0167-6806
VL - 177
SP - 165
EP - 173
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 1
ER -