TY - JOUR
T1 - Prenatal diethylstilbestrol exposure and mammographic density
AU - Strohsnitter, William C.
AU - Bertrand, Kimberly A.
AU - Troisi, Rebecca
AU - Scott, Christopher G.
AU - Cheville, Andrea L.
AU - Hoover, Robert N.
AU - Palmer, Julie R.
AU - Vachon, Celine M.
N1 - Funding Information:
The DES Combined Cohort Follow-up Study is a prospective cohort study of women who were confirmed to be either prenatally DES-exposed or unexposed via review of medical records or other physician-related verification, and has been described previously. Briefly, the medical records of women who received prenatal care at the Mayo Clinic from 1943 through 1959 were reviewed and mothers of 818 women were identified who had been prescribed DES while pregnant with them. Of these women, 633 were able to be traced and consented to be followed in the DES follow-up study. An additional 203 women whose medical records indicated that their mothers did not receive DES while pregnant with them were sampled and also consented to participate in the study. These women were followed by questionnaire for medical and reproductive outcomes, lifestyle and other exposures from 1975 through 1989 as part of the original cohort study, and beginning in 1994 and approximately every 5 years subsequently (1997, 2001, 2006, 2011) as part of the National Cancer Institute (NCI) DES Combined Cohort Follow-up Study.
PY - 2018/9/15
Y1 - 2018/9/15
N2 - In a prospective cohort study of the health effects associated with prenatal Diethylstilbestrol (DES) exposure, DES was associated with an increased breast cancer risk after 40 years of age. It is unknown whether it is associated with greater mammographic density, which strongly predicts breast cancer risk. A cohort of DES-exposed and unexposed women was assembled at the Mayo Clinic in 1975, and followed through 2012 as part of the National Cancer Institute's DES follow-up study. Mammographic density from 3,637 mammograms for 332 (222 DES-exposed, 110 unexposed) women in this cohort screened at the Mayo Clinic, Rochester between 1996 and 2015 was determined clinically using the Breast Imaging Reporting and Data System (BI-RADS). Any effect of prenatal DES exposure on mammographic density was estimated using repeated measures logistic regression. There was no association between prenatal DES exposure and high mammographic density for either premenopausal [Odds ratios (OR) = 0.92 (95% Confidence Interval (CI): 0.50, 1.7] or postmenopausal women (OR = 0.90; 95% CI: 0.54, 1.5). Among premenopausal women, associations differed by body mass index (BMI), with ORs of 1.47 (0.70, 3.1) for women with BMI above the median and 0.53 (0.23, 1.3) for those with BMI below the median (pinteraction = 0.05). Overall, however, prenatal DES exposure was not associated with high mammographic density in this sample of DES Study participants. Consequently, this study does not provide evidence that high mammographic density is involved with the influence of DES on breast cancer risk.
AB - In a prospective cohort study of the health effects associated with prenatal Diethylstilbestrol (DES) exposure, DES was associated with an increased breast cancer risk after 40 years of age. It is unknown whether it is associated with greater mammographic density, which strongly predicts breast cancer risk. A cohort of DES-exposed and unexposed women was assembled at the Mayo Clinic in 1975, and followed through 2012 as part of the National Cancer Institute's DES follow-up study. Mammographic density from 3,637 mammograms for 332 (222 DES-exposed, 110 unexposed) women in this cohort screened at the Mayo Clinic, Rochester between 1996 and 2015 was determined clinically using the Breast Imaging Reporting and Data System (BI-RADS). Any effect of prenatal DES exposure on mammographic density was estimated using repeated measures logistic regression. There was no association between prenatal DES exposure and high mammographic density for either premenopausal [Odds ratios (OR) = 0.92 (95% Confidence Interval (CI): 0.50, 1.7] or postmenopausal women (OR = 0.90; 95% CI: 0.54, 1.5). Among premenopausal women, associations differed by body mass index (BMI), with ORs of 1.47 (0.70, 3.1) for women with BMI above the median and 0.53 (0.23, 1.3) for those with BMI below the median (pinteraction = 0.05). Overall, however, prenatal DES exposure was not associated with high mammographic density in this sample of DES Study participants. Consequently, this study does not provide evidence that high mammographic density is involved with the influence of DES on breast cancer risk.
KW - breast density, prospective study
KW - diethylstilbestrol
KW - prenatal exposure
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U2 - 10.1002/ijc.31524
DO - 10.1002/ijc.31524
M3 - Article
C2 - 29658110
AN - SCOPUS:85046252796
VL - 143
SP - 1374
EP - 1378
JO - International Journal of Cancer
JF - International Journal of Cancer
SN - 0020-7136
IS - 6
ER -