Beyond Breast Cancer: Mammographic Features and Mortality Risk in a Population of Healthy Women

Murphy, Rachel A.; Schairer, Catherine; Gierach, Gretchen L.; Byrne, Celia; Sherman, Mark E.; Register, Thomas C.; Ding, Jingzhong; Kritchevsky, Stephen B.; Harris, Tamara B.

doi:10.1371/journal.pone.0078722

Cited by 5 publications

(4 citation statements)

References 43 publications

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“…Our results support the idea of a differential effect of breast density, with high breast density being a risk factor for breast cancer but not necessarily conferring a worse prognosis in diagnosed cancers. Some authors have reported that non-dense breasts, which are associated with a higher percentage of fatty tissue, may be linked to lipogenic regulation pathways of prognostic significance (32). This idea is supported by the results of Gierach and colleagues, (30) who found an increased risk of death among obese women with non-dense breasts in a large cohort of U.S. women.…”

Section: Discussionmentioning

confidence: 86%

Survival and Disease-Free Survival by Breast Density and Phenotype in Interval Breast Cancers

Sala

Domingo

Louro

et al. 2018

Cancer Epidemiology, Biomarkers &Amp; Prevention

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We aimed to evaluate survival and disease-free survival in different subtypes of interval cancers by breast density, taking into account clinical and biological characteristics. We included 374 invasive breast tumors (195 screen-detected cancers; 179 interval cancers, classified into true interval, false-negatives, occult tumors and minimal-sign cancers) diagnosed in women ages 50-69 years undergoing biennial screening from 2000-2009, followed up to 2014. Breast density was categorized into non-dense (<25% dense tissue) and mixed dense breasts (≥25%). Survival curves were generated by the Kaplan-Meier method and compared by the log-rank test. Cox proportional hazard regression models were computed to estimate the adjusted hazard ratios (aHRs) and 95% confidence intervals (95% CIs) for death and recurrences by comparing women with interval and true interval cancers versus women with screen-detected cancers, controlling for tumor and patient characteristics. All analyses were stratified by breast density. Interval cancers were detected in younger women, at more advanced stages, in denser breasts and showed a higher proportion of triple-negative cancers, especially among true interval cancers. Women with interval cancer and non-dense breasts had an aHR for death of 3.40 (95% CI, 0.92-12.62). Women with true interval cancers detected in non-dense breasts had the highest adjusted risk of death (aHR, 6.55; 95% CI, 1.37-31.39). Women with true interval cancer in non-dense breasts had a higher risk of death than women with screen-detected cancers. These results support the advisability of routinely collecting information on breast density, both for further tailoring of screening strategies and as a prognostic factor for diagnosed breast cancers. .

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Section: Discussionmentioning

confidence: 86%

Survival and Disease-Free Survival by Breast Density and Phenotype in Interval Breast Cancers

Sala

Domingo

Louro

et al. 2018

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…BD is essentially the ratio of fibroglandular tissue to fat. Three metrics that reflect the tissue composition of the breast commonly are used to characterize mammographic BD: 1) nondense area, which is breast fat tissue; 2) dense area, which is fibroglandular and stromal tissue; and 3) percentage density, which is the amount of dense tissue relative to the total breast area . Several factors are known to be associated with dense BD; among these are young age and premenopausal status, as well as the use of postmenopausal estrogen replacement .…”

Section: Introductionmentioning

confidence: 99%

“…Three metrics that reflect the tissue composition of the breast commonly are used to characterize mammographic BD: 1) nondense area, which is breast fat tissue; 2) dense area, which is fibroglandular and stromal tissue; and 3) percentage density, which is the amount of dense tissue relative to the total breast area. 3 Several factors are known to be associated with dense BD; among these are young age and premenopausal status, as well as the use of postmenopausal estrogen replacement. [4][5][6][7][8][9] In addition, it is hypothesized that there may be a genetic predisposition toward increased BD; however, to the best of our knowledge, the specific genetic factors remain unknown.…”

Section: Introductionmentioning

confidence: 99%

Mammographic breast density is associated with the development of contralateral breast cancer

Raghavendra

Sinha

Le‐Petross

et al. 2017

Cancer

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Background Women with dense mammographic breast density (BD) have a twofold increased risk of developing primary breast cancer (BC). We hypothesized that dense mammographic BD is also associated with an increased risk of developing contralateral breast cancer (CBC). Methods Among female patients treated at The University of Texas MD Anderson Cancer Center for sporadic, stage I–III BC between January 1997 and December 2012, we identified patients who had developed metachronous CBC (cases) and selected 1:2 matched controls who did not develop CBC using incidence density sampling, matched on attainted age, year of diagnosis and hormone receptor status of the first BC. Mammographic BD, assessed at the time of first BC diagnosis, was categorized as “non-dense” (American College of Radiology [ACR] breast categories of fatty or scattered density) or “dense” (ACR categories of heterogeneously dense or extremely dense). Multivariable conditional logistic regression models were used for statistical analysis. Results We evaluated 229 cases and 451 controls. Among the cases, 39.3% had non-dense breast tissue and 60.7% had dense breast tissue. Among controls, 48.3% had non-dense breast tissue and 51.7% had dense breast tissue. After adjustment for potential prognostic risk factors for BC, the odds of developing CBC were significantly higher for patients with dense breasts (odds ratio = 1.80; 95% confidence interval: 1.22–2.64; p-value < 0.01) than for those with non-dense breasts. Patients who received chemotherapy or endocrine therapy were less likely to develop CBC. Conclusions In women with primary BC, mammographic BD appears to be a risk factor for the development of CBC.

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“…Later menopause is associated with a higher risk of breast cancer, but also with lower risk of mortality 9 , 10 . One study reported an association of higher MD with lower mortality in women without breast cancer 11 . To explore the possibility that MD may reflect a reduced susceptibility to age-related disease, we examined whether MD was associated with blood telomere length (TL), a potential marker of susceptibility to chronic disease 12 .…”

Section: Introductionmentioning

confidence: 99%

Mammographic density, blood telomere length and lipid peroxidation

Erdmann

Harrington

Martin

2017

Sci Rep

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Extensive mammographic density is a strong risk factor for breast cancer, but may also be an indicator of biological age. In this study we examined whether mammographic density is related to blood telomere length, a potential marker of susceptibility to age-related disease. We measured mammographic density by a computer assisted method and blood telomere length using a validated PCR method. Urinary malondialdehyde (MDA), a marker of lipid peroxidation, was measured in 24 hour urine collections. In the 342 women examined telomere length was negatively correlated with age, was lower in postmenopausal compared to premenopausal women and in smokers compared to non-smokers, and was positively correlated with urinary MDA. Telomere length was not associated with percent mammographic density or dense area, before or after adjustment for risk factors and MDA. However, there was a significant interaction between telomere length and MDA in their association with mammographic density. At lower levels of MDA, mammographic density and telomere length were inversely associated; while at high levels of MDA, there was evidence of a J-shaped association between mammographic density and telomere length. Further work is need to replicate these results and to examine the association of mammographic density with age-related chronic disease and mortality.

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Beyond Breast Cancer: Mammographic Features and Mortality Risk in a Population of Healthy Women

Cited by 5 publications

References 43 publications

Survival and Disease-Free Survival by Breast Density and Phenotype in Interval Breast Cancers

Survival and Disease-Free Survival by Breast Density and Phenotype in Interval Breast Cancers

Mammographic breast density is associated with the development of contralateral breast cancer

Mammographic density, blood telomere length and lipid peroxidation

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