Breast Density as a Predictor of Mammographic Detection: Comparison of Interval- and Screen-Detected Cancers

Mandelson, Margaret T.

doi:10.1093/jnci/92.13.1081

Cited by 922 publications

(627 citation statements)

References 34 publications

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“…This was true independent of use of HRT. This result was in agreement with the study of Mandelson et al, 29 who found an odds ratio of 6.14 for interval cancer when comparing women with extremely dense breasts to women with extremely fat breasts. Use of HRT and its effect on breast density has been in focus recently.…”

Section: Breast Density and Use Of Hrtsupporting

confidence: 93%

Interval cancers in the Norwegian breast cancer screening program: Frequency, characteristics and use of HRT

et al. 2001

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Key words: mammography screening; interval cancer; breast density; HRTAs a result of the mortality reduction found in several randomized controlled clinical trials, 1,2 breast cancer screening programs have been implemented in several western countries. 3 The Norwegian Breast Cancer Screening Program is a population-based program that offers women aged 50 -69 years biannual mammography screening. The program started as a pilot project in 4 counties in 1996, and the results from the first screening round were reported earlier. 4 Interval cancers can be defined as breast cancer diagnosed in screened women during the interval between 2 screening rounds, where the diagnosis does not follow from the screening examination. 5 The benefit of attending a screening program is reduced for women diagnosed with interval cancer. Thus the effect of a screening program in terms of mortality reduction can diminish if the frequency of interval cancer is high. This frequency depends, among other factors, on sensitivity of the test and length of the screening interval.Most interval cancers are diagnosed because of symptoms, hence interval and screening-detected cancers might be expected to have different characteristics. High breast density and use of hormone replacement therapy (HRT) have been discussed as possible contributors to reduction of screening sensitivity, and this may be related to occurrence of interval cancers. 6 -11 The purpose of our study was to quantify the interval cancers in the pilot project and to explore characteristics and factors that may be associated with interval cancer. To study the relations between use of HRT, breast density and interval cancer, data from a blinded review (breast density) and a questionnaire (use of HRT) were linked. MATERIAL AND METHODS Screening populationThe Norwegian Breast Cancer Screening Program is population based and covers women aged 50 -69 years. The screening population is identified through the Central Population Register, in which each inhabitant in Norway has a unique 11-digit number. Women are invited into the Norwegian Breast Cancer Screening Program irrespective of previous breast cancer history. The screening interval is 2 years. Two-view mammograms and independent double reading are standard. The pilot project included 4 counties with about 40% of the Norwegian female population aged 50 -69 years. During the first round (1996-97), 159,887 women born from 1927-46 were invited and 127,064 women were examined (79.5%). 4 Study subjectsWomen who had their first screening examination within the pilot project after July 31, 1998 (n ϭ 411) and women who experienced recurrence in the same breast as a previous lesion (n ϭ 6) were excluded from the study. Women who received a cancer diagnosis in the first screening round (n ϭ 854) were not included as being at risk of interval cancer. However, women who were screen-positive but cleared after assessment were included. This left 125,793 women at risk of developing interval cancer. The women were followed until the date an in...

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Section: Breast Density and Use Of Hrtsupporting

confidence: 93%

Interval cancers in the Norwegian breast cancer screening program: Frequency, characteristics and use of HRT

et al. 2001

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“…Screening mammography has been demonstrated to increase the early detection of invasive and pre-invasive breast cancer, even if it has a high false-negative rate in women with dense breast tissue and is not an accurate methodology for early accurate measurement of response or for prediction of therapeutic response (20). Similarly, ultrasonography and CT are not extremely accurate in predicting therapeutic response.…”

Section: Discussionmentioning

confidence: 99%

Imaging and dosimetry of 99mTc EC annexin V: Preliminary clinical study targeting apoptosis in breast tumors

Kurihara

Yang

Cristofanilli

et al. 2008

Applied Radiation and Isotopes

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“…Além disso, um possível mecanismo relacionando estroma a agressividade tumoral por meio de fatores de crescimento aí produzidos também pode estar associado 7 .…”

Section: Discussionunclassified

“…Essa involução é progressiva, porém não uniforme, pois algumas mulheres mantêm um padrão mamográfi co denso, traduzindo-se em predomínio de tecido fi broglandular 5 . Essa densidade radiológica elevada assume importância, pois é considerada por alguns como um dos fatores de risco independentes para câncer de mama 1,[5][6][7][8] .…”

Section: (Figura 1)unclassified

Associação entre os polimorfismos HaeIII e MspI do gene para o receptor alfa de estrogênio e densidade mamográfica em mulheres após a menopausa

Ramos¹,

Kemp

Silva³

2006

Rev. Bras. Ginecol. Obstet.

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RESUMOObjetivo: Avaliar a presença dos polimorfi smos HaeIII e MspI do gene para o receptor de estrogênio alfa, bem como fatores clínicos e suas possíveis associações com a densidade mamográfi ca em mulheres após a menopausa. Métodos: Foram avaliadas 115 mulheres após a menopausa, não usuárias de terapia hormonal e sem lesão mamária clínica ou mamografi camente identifi cada. A densidade mamográfi ca foi determinada por três observadores independentes, tomando-se como base a classifi cação dos padrões mamográfi cos do ACR-BIRADS ® , 2003 (duas avaliações subjetivas e uma computadorizada -Adobe Photoshop ® 7.0). Amostras de raspado bucal foram obtidas para extração de DNA e em seguida foi realizada uma PCR-RFLP (Polymerase Chain Reation -Restriction Fragment Length Polymorphism) para análise de polimorfi smos presentes no íntron 1 e éxon 1 do gene do REα (HaeIII e MspI). Resultados: O polimorfi smo HaeIII foi encontrado em 43 (37,4%) das 115 mulheres, ao passo que o MspI estava presente em 96 (83,5%) das mesmas. Houve alto grau de concordância entre os três observadores na determinação da densidade mamográfi ca. Trinta e quatro (29,6%) mulheres tinham mamas densas, e 81 (70,4%), mamas lipossubstituídas. Conclusão: Não houve associação entre o polimorfi smo HaeIII do gene para o receptor de estrogênio alfa e densidade mamográfi ca (Fisher = 0,712). Houve associação próxima à signifi cância estatística entre o polimorfi smo MspI e densidade (Fisher = 0,098). Idade, paridade e índice de massa corporal mostraram-se associados com densidade mamográfi ca. PALAVRAS-CHAVE:Receptores estrogênicos; Polimorfi smo genético; Mamografi a; Neoplasias mamárias; Pós menopausa ABSTRACT Purpose: To assess the presence of estrogen receptor gene polymorphisms HaeIII and MspI as well as clinical factors, and their possible associations with high mammographic density in post-menopausal women. Methods: One hundred and fi fteen post-menopausal women, not in use of hormonal therapy and without clinical or mammographic lesions were evaluated. Three independent observers have determined the mammographic density pattern based on the ACR-BIRADS ® 2003 (two subjective and one objective evaluations -Adobe Photoshop 7.0 software). Oral swabs (Cytobrush) were obtained to extract DNA and the polymerase chain reaction -restriction fragment length polymorphism) was performed to assess the presence of polymorphisms in intron 1 and exon 1 from estrogen receptor gene (HaeIII and MspI). Results: The HaeIII polymorphism was found in 43 (37.4%) of the 115 women, while MspI was found in 96 (83.5%) of them. There was a good agreement among determinations of the three observers with regard to mammographic density. Thirty-four (29.6%) women had dense breasts and eighty-one (70.4%) had non-dense breasts. Conclusion: The estrogen receptor gene polymorphism Haelll showed no association with mammographic density (Fisher = 0.712), while the association between estrogen receptor gene polymorphism Mspl and mammographic density was near signifi cance (Fisher = 0.098)...

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Breast Density as a Predictor of Mammographic Detection: Comparison of Interval- and Screen-Detected Cancers

Abstract: Mammographic breast density appears to be a major risk factor for interval cancer.

Cited by 922 publications

References 34 publications

Interval cancers in the Norwegian breast cancer screening program: Frequency, characteristics and use of HRT

Interval cancers in the Norwegian breast cancer screening program: Frequency, characteristics and use of HRT

Imaging and dosimetry of 99mTc EC annexin V: Preliminary clinical study targeting apoptosis in breast tumors

Associação entre os polimorfismos HaeIII e MspI do gene para o receptor alfa de estrogênio e densidade mamográfica em mulheres após a menopausa

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