Breast cancer risk factors and mammographic breast density in women over age 70

Modugno, Francesmary; Ngo, Duyen L.; Allen, Glenn O.; Kuller, Lewis H.; Ness, Roberta B.; Vogel, Victor G.; Costantino, Joseph P.; Cauley, Jane A.

doi:10.1007/s10549-005-9105-8

Cited by 37 publications

(40 citation statements)

References 61 publications

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“…Our main finding for reduced percent density with greater number of births support most previous findings [12,16,17,35,36]. In our data, this association was most pronounced among thinner women, although the interaction term for number of births and BMI was not statistically significant.…”

Section: Discussionsupporting

confidence: 91%

“…A similar trend was observed in a previous study evaluating reproductive factors in relation to dense and non-dense breast area, with the hypothesis that factors associated with dense breast area were more etiologically relevant [35]. Most previous studies reported no association between age at menarche and percent density [12,[15][16][17]35,36].…”

Section: Discussionsupporting

confidence: 79%

“…Parity, or having a full-term birth, is most consistently reported to be inversely associated with density [12,13], although stronger associations with greater number of births has only been reported for qualitative density measures, such as parenchymal patterns, and not with quantitative measures such as the percent of the breast occupied by dense tissue [14]. Less consistently, later age at FFTB has been directly associated with mammographic density [12,15], whereas little evidence has been reported for an association between age at menarche and density [12,16,17].…”

Section: Introductionmentioning

confidence: 99%

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Menstrual and reproductive factors in relation to mammographic density: the Study of Women’s Health Across the Nation (SWAN)

Butler¹,

Gold²,

Greendale

et al. 2007

Breast Cancer Res Treat

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Menstrual and reproductive factors may increase breast cancer risk through a pathway that includes increased mammographic density. We assessed whether known or suspected menstrual and reproductive breast cancer risk factors were cross-sectionally associated with mammographic density, by measuring area of radiographic density and total breast area on mammograms from 801 participants in the Study of Women's Health Across the Nation (SWAN), a multi-ethnic cohort of pre-and early perimenopausal women. From multivariable linear regression, the following menstrual or reproductive factors were independently associated with percent mammographic density (area of dense breast/breast area): older age at menarche (β = 10.3, P < 0.01, for >13 vs. <12 years), premenstrual cravings and bloating (β = −3.36, P = 0.02), younger age at first full-term birth (β = −8.12, P < 0.01 for ≤23 years versus no births), greater number of births (β = −6.80, P < 0.01 for ≥3 births versus no births), and premenopausal status (β = 3.78, P < 0.01 versus early perimenopausal). Only number of births remained associated with percent density after adjustment for age, race/ ethnicity, study site, body mass index (BMI), and smoking. In addition, stratified analyses revealed that the association with number of births was confined to women within the lowest BMI tertile (β = −12.2, P < 0.01 for ≥3 births versus no births). Our data support a mechanism for parity and breast cancer that involves mammographic density among pre-and early perimenopausal women that may be modified by body size.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Menstrual and reproductive factors in relation to mammographic density: the Study of Women’s Health Across the Nation (SWAN)

Butler¹,

Gold²,

Greendale

et al. 2007

Breast Cancer Res Treat

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“…14 The predicted age at which density ceased to decline was 65 years, at the upper limit of the included age range, broadly in agreement with data from 2 other studies. 2,15 We found that mean levels of breast density are affected by both immediate and distal factors, but that its rate of change at ages 50-65 years is affected only by immediate factors, i.e., use of HT and menopause. Credibility of these findings are supported by their striking similarity with those from the Minnesota Breast Cancer Family Study.…”

Section: Epidemiology 458mentioning

confidence: 87%

Changes and tracking of mammographic density in relation to Pike's model of breast tissue aging: a UK longitudinal study

McCormack

Perry

Vinnicombe

et al. 2010

Intl Journal of Cancer

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Percent mammographic density (PMD) is a strong marker of breast cancer risk. It may be a correlate of the rate of breast tissue aging, as proposed by Pike to explain breast cancer age-incidence. We examined longitudinal changes in PMD in 645 breast screening attendees in London, UK, in which each had between 2 and 5 screens spanning 3-12 years at ages 50-65 years and compare these to Pike's model. Within-woman PMD declined during these ages, with a slowing rate of decline. Annual rates of decline were 1.4% (95% confidence interval: 1.2-1.6), 0.7% (0.6-0.9) and 0.1% (-0.2 to 0.4) at ages 50, 57 and 64. Dense area declined similarly, but the absolute magnitude of the rate of increase of nondense area was almost double that of dense area. PMD dropped by 2.4% (1.4-3.4) on menopausal transition and increased by 2.4% (1.4-3.5) with the use of hormone therapy. Higher body mass index, greater parity and being Afro-Caribbean or South Asian ethnicities were associated with lower PMD, but did not affect rate of change of PMD at these ages. Within-woman rank correlation of PMD was 0.80 for readings taken 9 years apart. Effects of menopause and parity and the lack of effect of menarche on age-specific PMD at these ages are consistent with the predicted determinants in Pike's model. A high degree of tracking of PMD indicates that at ages 50-65 years high-risk women could be identified by a single early screen at age older than 50.Percent mammographic density (PMD), a measure of the proportion of radiodense fibroglandular tissue in the breast, is one of the strongest quantitative markers of breast cancer risk.1 Many breast cancer risk factors, such as parity, age at first birth and use of hormone therapy (HT), are determinants of PMD because of its possible intermediary causal role. However, PMD and breast cancer risk demonstrate opposite trends with age; risk increases whereas PMD decreases as women age, the latter observation having been made in both cross-sectional and longitudinal studies. [2][3][4] To explain this apparent anomaly, Boyd et al. noted that the decline of PMD with age parallels that of the rate of breast tissue aging in a model proposed by Pike to explain the age-incidence curve of breast cancer. 5,6 In this model, the age-specific rate of breast tissue aging is high between menarche and age at first birth, drops slightly after pregnancies and considerably after the menopause. Breast cancer incidence rates are related to breast tissue age (i.e., the cumulative rate of breast tissue aging). However, there are few longitudinal studies of PMD to investigate the PMD-breast tissue age analogy.A greater understanding of the nature and determinants of the profile of PMD and of changes in PMD within a woman over her life-course would help to identify periods of change, the processes that might account for them and factors that influence them. Reductions in PMD have been shown to be associated with reduced breast cancer, although not consistently. 4,[7][8][9] If PMD is causally related to breast cancer, factors that ...

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“…PIH has been fairly consistently associated with a reduction in breast cancer risk (e.g., [5, 21]), though some studies have found no (e.g., [6, 22]) or even increased risk [23, 24]. PIH is a multifactorial disease with genetic and environmental factors known to be involved in its etiology although full understanding of its pathogenesis remains elusive despite decades of research [25]. Likewise, the mechanism by which PIH affects breast cancer risk is unknown although potentially via the same etiologic basis as PIH, with theories focusing on placental dysfunction and a subsequent lowering of circulating estrogens [26], increase in serum insulin-like growth factor [27], and/or angiogenic factors [28].…”

Section: Discussionmentioning

confidence: 99%

First pregnancy events and future breast density: modification by age at first pregnancy and specific VEGF and IGF1R gene variants

Prebil

Ereman

Powell

et al. 2014

Cancer Causes Control

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Purpose Pregnancy characteristics have been associated with breast cancer risk, but information is limited on their relationship with breast density. Our objective was to examine the relationship between first pregnancy characteristics and later life breast density, and whether the association is modified by genotype.Methods The Marin Women’s Study was initiated to examine breast cancer in a high-incidence mammography population (Marin County, CA). Reproductive characteristics and pregnancy information including pregnancy-induced hypertension (PIH) were self-reported at the time of mammography. Forty-seven candidate single nucleotide polymorphisms were obtained from saliva samples; seven were assessed in relation to PIH and percent fibroglandular volume (%FGV). Breast density assessed as %FGV was measured on full-field digital mammograms by the San Francisco Mammography Registry.ResultsA multivariable regression model including 2,440 parous women showed that PIH during first pregnancy was associated with a statistically significant decrease in %FGV (b = −0.31, 95 % CI −0.52, −0.11), while each month of breast-feeding after first birth was associated with a statistically significant increase in %FGV (b = 0.01, 95 % CI 0.003, 0.02). PIH and breast-feeding associations with %FGV were modified by age at first birth. In a subsample of 1,240 women, there was evidence of modification in the association between PIH and %FGV by specific vascular endothelial growth factor (VEGF) (rs3025039) and insulin growth factor receptor-1 (IGFR1) (rs2016347) gene variants.ConclusionThese findings suggest that first pregnancy characteristics may exert an influence on extent of breast density later in life and that this influence may vary depending on inherited IGFR1 and VEGF genotypes.Electronic supplementary materialThe online version of this article (doi:10.1007/s10552-014-0386-2) contains supplementary material, which is available to authorized users.

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Breast cancer risk factors and mammographic breast density in women over age 70

Abstract: Factors associated with breast density in older, post-menopausal women differ from traditional breast cancer risk factors and from factors associated with breast density in pre-menopausal and younger post-menopausal women.

Cited by 37 publications

References 61 publications

Menstrual and reproductive factors in relation to mammographic density: the Study of Women’s Health Across the Nation (SWAN)

Menstrual and reproductive factors in relation to mammographic density: the Study of Women’s Health Across the Nation (SWAN)

Changes and tracking of mammographic density in relation to Pike's model of breast tissue aging: a UK longitudinal study

First pregnancy events and future breast density: modification by age at first pregnancy and specific VEGF and IGF1R gene variants

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