Mammographic breast density response to aromatase inhibition

Celine M Vachon, Vera Jean Suman, Kathleen R Brandt, Matthew L. Kosel, Aman U. Buzdar, Janet E Olson, Fang Fang Wu, Lynn M. Flickinger, Giske Ursin, Catherine R. Elliott, Lois Shepherd, Richard M Weinshilboum, Paul E. Goss, James N. Ingle

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: Mammographic breast density (MBD) is decreased by tamoxifen, but the effect of aromatase inhibitors is less clear. Experimental Design: We enrolled early-stage postmenopausal patients with breast cancer initiating adjuvant aromatase inhibitor therapy and ascertained mammograms before and at an average 10 months of aromatase inhibitor therapy. We matched cases to healthy postmenopausal women (controls) from a large mammography screening cohort on age, baseline body mass index, baseline MBD, and interval between mammograms. We estimated change in MBD using a computer-assisted thresholding program (Cumulus) and compared differences between cases and matched controls. Results: In predominantly White women (96%), we found 14% of the 387 eligible cases had a MBD reduction of at least 5% after an average of 10 months of aromatase inhibitor therapy.MBDreductions were associated with higher baseline MBD, aromatase inhibitor use for more than 12 months, and prior postmenopausal hormone use. Comparing each case with her matched control, there was no evidence of an association of change in MBD with aromatase inhibitor therapy [median case-control difference among 369 pairs was -0.1% (10th and 90th percentile: -5.9%, 5.2%) P = 0.51]. Case-control differences were similar by type of aromatase inhibitor (P's 0.41 and 0.56); prior use of postmenopausal hormones (P = 0.85); baseline MBD (P = 0.55); and length of aromatase inhibitor therapy (P = 0.08). Conclusions: In postmenopausal women treated with aromatase inhibitors, 14% of cases had a MBD reduction of more than 5%, but these decreases did not differ from matched controls. These data suggest that MBD is not a clinically useful biomarker for predicting the value of aromatase inhibitor therapy in White postmenopausal women.

Original languageEnglish (US)
Pages (from-to)2144-2153
Number of pages10
JournalClinical Cancer Research
Volume19
Issue number8
DOIs
StatePublished - Apr 15 2013

Fingerprint

Aromatase Inhibitors
Aromatase
Therapeutics
Breast Density
Hormones
Mammography
Tamoxifen
Body Mass Index
Research Design
Biomarkers
Breast Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Mammographic breast density response to aromatase inhibition. / Vachon, Celine M; Suman, Vera Jean; Brandt, Kathleen R; Kosel, Matthew L.; Buzdar, Aman U.; Olson, Janet E; Wu, Fang Fang; Flickinger, Lynn M.; Ursin, Giske; Elliott, Catherine R.; Shepherd, Lois; Weinshilboum, Richard M; Goss, Paul E.; Ingle, James N.

In: Clinical Cancer Research, Vol. 19, No. 8, 15.04.2013, p. 2144-2153.

Research output: Contribution to journalArticle

Vachon, CM, Suman, VJ, Brandt, KR, Kosel, ML, Buzdar, AU, Olson, JE, Wu, FF, Flickinger, LM, Ursin, G, Elliott, CR, Shepherd, L, Weinshilboum, RM, Goss, PE & Ingle, JN 2013, 'Mammographic breast density response to aromatase inhibition', Clinical Cancer Research, vol. 19, no. 8, pp. 2144-2153. https://doi.org/10.1158/1078-0432.CCR-12-2789
Vachon, Celine M ; Suman, Vera Jean ; Brandt, Kathleen R ; Kosel, Matthew L. ; Buzdar, Aman U. ; Olson, Janet E ; Wu, Fang Fang ; Flickinger, Lynn M. ; Ursin, Giske ; Elliott, Catherine R. ; Shepherd, Lois ; Weinshilboum, Richard M ; Goss, Paul E. ; Ingle, James N. / Mammographic breast density response to aromatase inhibition. In: Clinical Cancer Research. 2013 ; Vol. 19, No. 8. pp. 2144-2153.
@article{e6b6f21aeb784588a96f523f57bb3d14,
title = "Mammographic breast density response to aromatase inhibition",
abstract = "Purpose: Mammographic breast density (MBD) is decreased by tamoxifen, but the effect of aromatase inhibitors is less clear. Experimental Design: We enrolled early-stage postmenopausal patients with breast cancer initiating adjuvant aromatase inhibitor therapy and ascertained mammograms before and at an average 10 months of aromatase inhibitor therapy. We matched cases to healthy postmenopausal women (controls) from a large mammography screening cohort on age, baseline body mass index, baseline MBD, and interval between mammograms. We estimated change in MBD using a computer-assisted thresholding program (Cumulus) and compared differences between cases and matched controls. Results: In predominantly White women (96{\%}), we found 14{\%} of the 387 eligible cases had a MBD reduction of at least 5{\%} after an average of 10 months of aromatase inhibitor therapy.MBDreductions were associated with higher baseline MBD, aromatase inhibitor use for more than 12 months, and prior postmenopausal hormone use. Comparing each case with her matched control, there was no evidence of an association of change in MBD with aromatase inhibitor therapy [median case-control difference among 369 pairs was -0.1{\%} (10th and 90th percentile: -5.9{\%}, 5.2{\%}) P = 0.51]. Case-control differences were similar by type of aromatase inhibitor (P's 0.41 and 0.56); prior use of postmenopausal hormones (P = 0.85); baseline MBD (P = 0.55); and length of aromatase inhibitor therapy (P = 0.08). Conclusions: In postmenopausal women treated with aromatase inhibitors, 14{\%} of cases had a MBD reduction of more than 5{\%}, but these decreases did not differ from matched controls. These data suggest that MBD is not a clinically useful biomarker for predicting the value of aromatase inhibitor therapy in White postmenopausal women.",
author = "Vachon, {Celine M} and Suman, {Vera Jean} and Brandt, {Kathleen R} and Kosel, {Matthew L.} and Buzdar, {Aman U.} and Olson, {Janet E} and Wu, {Fang Fang} and Flickinger, {Lynn M.} and Giske Ursin and Elliott, {Catherine R.} and Lois Shepherd and Weinshilboum, {Richard M} and Goss, {Paul E.} and Ingle, {James N.}",
year = "2013",
month = "4",
day = "15",
doi = "10.1158/1078-0432.CCR-12-2789",
language = "English (US)",
volume = "19",
pages = "2144--2153",
journal = "Clinical Cancer Research",
issn = "1078-0432",
publisher = "American Association for Cancer Research Inc.",
number = "8",

}

TY - JOUR

T1 - Mammographic breast density response to aromatase inhibition

AU - Vachon, Celine M

AU - Suman, Vera Jean

AU - Brandt, Kathleen R

AU - Kosel, Matthew L.

AU - Buzdar, Aman U.

AU - Olson, Janet E

AU - Wu, Fang Fang

AU - Flickinger, Lynn M.

AU - Ursin, Giske

AU - Elliott, Catherine R.

AU - Shepherd, Lois

AU - Weinshilboum, Richard M

AU - Goss, Paul E.

AU - Ingle, James N.

PY - 2013/4/15

Y1 - 2013/4/15

N2 - Purpose: Mammographic breast density (MBD) is decreased by tamoxifen, but the effect of aromatase inhibitors is less clear. Experimental Design: We enrolled early-stage postmenopausal patients with breast cancer initiating adjuvant aromatase inhibitor therapy and ascertained mammograms before and at an average 10 months of aromatase inhibitor therapy. We matched cases to healthy postmenopausal women (controls) from a large mammography screening cohort on age, baseline body mass index, baseline MBD, and interval between mammograms. We estimated change in MBD using a computer-assisted thresholding program (Cumulus) and compared differences between cases and matched controls. Results: In predominantly White women (96%), we found 14% of the 387 eligible cases had a MBD reduction of at least 5% after an average of 10 months of aromatase inhibitor therapy.MBDreductions were associated with higher baseline MBD, aromatase inhibitor use for more than 12 months, and prior postmenopausal hormone use. Comparing each case with her matched control, there was no evidence of an association of change in MBD with aromatase inhibitor therapy [median case-control difference among 369 pairs was -0.1% (10th and 90th percentile: -5.9%, 5.2%) P = 0.51]. Case-control differences were similar by type of aromatase inhibitor (P's 0.41 and 0.56); prior use of postmenopausal hormones (P = 0.85); baseline MBD (P = 0.55); and length of aromatase inhibitor therapy (P = 0.08). Conclusions: In postmenopausal women treated with aromatase inhibitors, 14% of cases had a MBD reduction of more than 5%, but these decreases did not differ from matched controls. These data suggest that MBD is not a clinically useful biomarker for predicting the value of aromatase inhibitor therapy in White postmenopausal women.

AB - Purpose: Mammographic breast density (MBD) is decreased by tamoxifen, but the effect of aromatase inhibitors is less clear. Experimental Design: We enrolled early-stage postmenopausal patients with breast cancer initiating adjuvant aromatase inhibitor therapy and ascertained mammograms before and at an average 10 months of aromatase inhibitor therapy. We matched cases to healthy postmenopausal women (controls) from a large mammography screening cohort on age, baseline body mass index, baseline MBD, and interval between mammograms. We estimated change in MBD using a computer-assisted thresholding program (Cumulus) and compared differences between cases and matched controls. Results: In predominantly White women (96%), we found 14% of the 387 eligible cases had a MBD reduction of at least 5% after an average of 10 months of aromatase inhibitor therapy.MBDreductions were associated with higher baseline MBD, aromatase inhibitor use for more than 12 months, and prior postmenopausal hormone use. Comparing each case with her matched control, there was no evidence of an association of change in MBD with aromatase inhibitor therapy [median case-control difference among 369 pairs was -0.1% (10th and 90th percentile: -5.9%, 5.2%) P = 0.51]. Case-control differences were similar by type of aromatase inhibitor (P's 0.41 and 0.56); prior use of postmenopausal hormones (P = 0.85); baseline MBD (P = 0.55); and length of aromatase inhibitor therapy (P = 0.08). Conclusions: In postmenopausal women treated with aromatase inhibitors, 14% of cases had a MBD reduction of more than 5%, but these decreases did not differ from matched controls. These data suggest that MBD is not a clinically useful biomarker for predicting the value of aromatase inhibitor therapy in White postmenopausal women.

UR - http://www.scopus.com/inward/record.url?scp=84877098037&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877098037&partnerID=8YFLogxK

U2 - 10.1158/1078-0432.CCR-12-2789

DO - 10.1158/1078-0432.CCR-12-2789

M3 - Article

VL - 19

SP - 2144

EP - 2153

JO - Clinical Cancer Research

JF - Clinical Cancer Research

SN - 1078-0432

IS - 8

ER -