Association between the Adherence to the International Guidelines for Cancer Prevention and Mammographic Density

Abstract

IntroductionMammographic density (MD) is considered a strong predictor of Breast Cancer (BC). The objective of the present study is to explore the association between MD and the compliance with the World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR) recommendations for cancer prevention.MethodsData of 3584 women attending screening from a population-based multicenter cross-sectional study (DDM-Spain) collected from October 7, 2007 through July 14, 2008, was used to calculate a score that measures the level of compliance with the WCRF/AICR recommendations: R1)Maintain adequate body weight; R2)Be physically active; 3R)Limit the intake of high density foods; R4)Eat mostly plant foods; R5)Limit the intake of animal foods; R6)Limit alcohol intake; R7)Limit salt and salt preserved food intake; R8)Meet nutritional needs through diet. The association between the score and MD (assessed by a single radiologist using a semi-quantitative scale) was evaluated using ordinal logistic models with random center-specific intercepts adjusted for the main determinants of MD. Stratified analyses by menopausal status and smoking status were also carried out.ResultsA higher compliance with the WCRF/AICR recommendations was associated with lower MD (OR1-unit increase = 0.93 95%CI:0.86;0.99). The association was stronger in postmenopausal women (OR = 0.91 95%CI:0.84;0.99) and nonsmokers (OR = 0.87;95%CI:0.80;0.96 for nonsmokers, OR = 1.01 95%CI:0.91;1.12 for smokers, P-interaction = 0.042). Among nonsmokers, maintaining adequate body weight (OR = 0.81 95%CI:0.65;1.01), practicing physical activity (OR = 0.68 95%CI:0.48;0.96) and moderating the intake of high-density foods (OR = 0.58 95%CI:0.40;0.86) and alcoholic beverages (OR = 0.76 95%CI:0.55;1.05) were the recommendations showing the strongest associations with MD.Conclusionspostmenopausal women and non-smokers with greater compliance with the WCRF/AICR guidelines have lower MD. These results may provide guidance to design specific recommendations for screening attendants with high MD and therefore at higher risk of developing BC.

Adherence to nutrition‐based cancer prevention guidelines and breast, prostate and colorectal cancer risk in the MCC‐Spain case–control study

“…Several studies had evaluated the association between the WCRF/AICR score and breast cancer risk and most, but not all of them have reported a statistically significant reduced breast cancer risk in women following the WCRF/AICR recommendations. When we stratified by menopausal status, we observed this association in postmenopausal women, but not in premenopausal women.…”

“…directions between all components of the score and colon and rectal cancer, except for body fatness that was associated with colon but not with rectal cancer, and alcohol intake that was not associated with neither colon nor rectal cancer. Several studies had evaluated the association between the WCRF/AICR score and breast cancer risk and most, 4,5,20,21,25 but not all 6,8,10 of them have reported a statistically significant reduced breast cancer risk in women following the WCRF/AICR recommendations. When we stratified by menopausal status, we observed this association in postmenopausal women, but not in premenopausal women.…”

High Mammographic Density in Long-Term Night-Shift Workers: DDM-Spain/Var-DDM

“…This is a cross-sectional multicenter study included in DDM-Spain (Determinants of Mammographic Density in Spain)/Var-DDM (Variability of the Mammographic Density in Spanish Women) research project. More detail regarding the design of the study is provided elsewhere (17,22). Briefly, in Spain, the publicly funded and population-based breast cancer screening network invites all women between 50 and 69 years old (45-69 in some regions) to be screened every 2 years, with attendance rates ranging from 62.9% to 88.0% of its target population, depending on the region (23).…”

“…However, the relationship between MD and NSW has only been explored in a previous study with inconclusive results (21). If confirmed, this association could have practical effects: Being MD the leading potentially modifiable intermediate marker for breast cancer, preventive strategies to reduce MD (22) might moderate the excess of breast cancer risk associated to NSW.…”

Can Dietary and Physical Activity Modifications Reduce Breast Density in Postmenopausal Women? The DAMA Study, a Randomized Intervention Trial in Italy

“…Studies on the modulating effects of diet and PA on breast density have been mostly observational and results are mixed. Some studies suggested positive associations with high intake of saturated fatty acids (28,29), proteins and carbohydrates (30,31), alcohol (32)(33)(34)(35), consumption of sweet foods (36), and with the adherence to a Western-style diet (37). An inverse association with fiber and carotenoids (28), vitamin D, and calcium (38,35) emerged in some studies, but these findings were not confirmed by others (39)(40)(41)(42).…”