TY - JOUR
T1 - Mammographic density and risk of breast cancer by age and tumor characteristics
AU - Bertrand, Kimberly A.
AU - Tamimi, Rulla M.
AU - Scott, Christopher G.
AU - Jensen, Matthew R.
AU - Pankratz, V. S.
AU - Visscher, Daniel
AU - Norman, Aaron
AU - Couch, Fergus
AU - Shepherd, John
AU - Fan, Bo
AU - Chen, Yunn Yi
AU - Ma, Lin
AU - Beck, Andrew H.
AU - Cummings, Steven R.
AU - Kerlikowske, Karla
AU - Vachon, Celine M.
N1 - Funding Information:
This work was supported in part by the National Institutes of Health, National Cancer Institute (R01 CA140286, R01 CA128931, P50 CA58207, P50 CA116201, R01 CA97396, R01 CA 122340, P01 CA087969, R01 CA050385, R01 CA124865, and R01 CA131332), the Breast Cancer Research Foundation and the Department of Defense (DAMD 17-00-1-033). KAB was supported by the Nutritional Epidemiology of Cancer Training Grant (R25 CA098566). The authors would like to thank the participants and staff of the Nurses’ Health Study (NHS), NHSII and MMHS for their valuable contributions as well as the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, WY. Certain data used in this publication were obtained from the Connecticut Department of Public Health. The authors also thank Fang Fang Wu who provided percent MD estimates on all Mayo studies. The authors assume full responsibility for analyses and interpretation of these data.
PY - 2013/11/4
Y1 - 2013/11/4
N2 - Introduction: Understanding whether mammographic density (MD) is associated with all breast tumor subtypes and whether the strength of association varies by age is important for utilizing MD in risk models.Methods: Data were pooled from six studies including 3414 women with breast cancer and 7199 without who underwent screening mammography. Percent MD was assessed from digitized film-screen mammograms using a computer-assisted threshold technique. We used polytomous logistic regression to calculate breast cancer odds according to tumor type, histopathological characteristics, and receptor (estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (HER2)) status by age (<55, 55-64, and ≥65 years).Results: MD was positively associated with risk of invasive tumors across all ages, with a two-fold increased risk for high (>51%) versus average density (11-25%). Women ages <55 years with high MD had stronger increased risk of ductal carcinoma in situ (DCIS) compared to women ages 55-64 and ≥65 years (Page-interaction = 0.02). Among all ages, MD had a stronger association with large (>2.1 cm) versus small tumors and positive versus negative lymph node status (P's < 0.01). For women ages <55 years, there was a stronger association of MD with ER-negative breast cancer than ER-positive tumors compared to women ages 55-64 and ≥65 years (Page-interaction = 0.04). MD was positively associated with both HER2-negative and HER2-positive tumors within each age group.Conclusion: MD is strongly associated with all breast cancer subtypes, but particularly tumors of large size and positive lymph nodes across all ages, and ER-negative status among women ages <55 years, suggesting high MD may play an important role in tumor aggressiveness, especially in younger women.
AB - Introduction: Understanding whether mammographic density (MD) is associated with all breast tumor subtypes and whether the strength of association varies by age is important for utilizing MD in risk models.Methods: Data were pooled from six studies including 3414 women with breast cancer and 7199 without who underwent screening mammography. Percent MD was assessed from digitized film-screen mammograms using a computer-assisted threshold technique. We used polytomous logistic regression to calculate breast cancer odds according to tumor type, histopathological characteristics, and receptor (estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (HER2)) status by age (<55, 55-64, and ≥65 years).Results: MD was positively associated with risk of invasive tumors across all ages, with a two-fold increased risk for high (>51%) versus average density (11-25%). Women ages <55 years with high MD had stronger increased risk of ductal carcinoma in situ (DCIS) compared to women ages 55-64 and ≥65 years (Page-interaction = 0.02). Among all ages, MD had a stronger association with large (>2.1 cm) versus small tumors and positive versus negative lymph node status (P's < 0.01). For women ages <55 years, there was a stronger association of MD with ER-negative breast cancer than ER-positive tumors compared to women ages 55-64 and ≥65 years (Page-interaction = 0.04). MD was positively associated with both HER2-negative and HER2-positive tumors within each age group.Conclusion: MD is strongly associated with all breast cancer subtypes, but particularly tumors of large size and positive lymph nodes across all ages, and ER-negative status among women ages <55 years, suggesting high MD may play an important role in tumor aggressiveness, especially in younger women.
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U2 - 10.1186/bcr3570
DO - 10.1186/bcr3570
M3 - Article
C2 - 24188089
AN - SCOPUS:84887356248
SN - 1465-5411
VL - 15
JO - Breast Cancer Research
JF - Breast Cancer Research
IS - 6
M1 - R104
ER -