Differences in mammographic density between Asian and Caucasian populations: a comparative analysis

Rajaram, Nadia; Mariapun, Shivaani; Eriksson, Mikael; Tapia, José Carlos; Kwan, Pui Yoke; Ho, Weang Kee; Harun, Fatimah; Rahmat, Kartini; Czene, Kamila; Taib, Nur Aishah Mohd; Hall, Per; Teo, Soo‐Hwang

doi:10.1007/s10549-016-4054-y

Cited by 81 publications

(64 citation statements)

References 37 publications

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“…Variations in breast size and tissue composition across different populations may also affect the association between MD and TDLU features differently. Although not always consistent, studies comparing racial differences in MD suggest that Asian women have higher percent MD but smaller absolute dense area/volume and breast size compared to Western women after accounting for well‐known MD determinants such as age and BMI . It is also notable that intact TDLU structures were persistent even in very old women (up to age 79 years) in our study, whereas a high proportion of subjects showed complete involution among younger women (zero TDLU count: 25%; 40–65 years) in the STAMP study .…”

Section: Discussioncontrasting

confidence: 59%

“…Although not always consistent, studies comparing racial differences in MD suggest that Asian women have higher percent MD but smaller absolute dense area/volume and breast size compared to Western women after accounting for well-known MD determinants such as age and BMI. [21][22][23][24][25][26] It is also notable that intact TDLU structures were persistent even in very old women (up to age 79 years) in our study, whereas a high proportion of subjects showed complete involution among younger women (zero TDLU count: 25%; 40-65 years) in the STAMP study. 4,15 Furthermore, while we found strong correlations of all three TDLU measures (all Spearman's rho>0.63; Supporting Information Table 2), previous studies reported a strong correlation between TDLU size measures (acini count and span) but a weaker correlation of TDLU count with either size measure (all Spearman's rho<0.18).…”

Section: And the Stamp 4 Used Benign Tissues From Women With Bbdsupporting

confidence: 38%

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The relationship between terminal duct lobular unit features and mammographic density among Chinese breast cancer patients

Sung

Guo

et al. 2019

Intl Journal of Cancer

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Extensive mammographic density (MD), a well‐established breast cancer risk factor, is a radiological representation of stromal and epithelial breast tissue content. In studies conducted predominantly among Caucasian women, histologic measures of reduced terminal duct lobular unit (TDLU) involution have been correlated with extensive MD, but independently associated with breast cancer risk. We therefore examined associations between TDLU measures and MD among Chinese women, a low‐risk population but with high prevalence of dense breasts. Diagnostic pre‐treatment digital mammograms were obtained from 144 breast cancer cases at a tertiary hospital in Beijing and scored using the Breast Imaging Reporting and Data System (BI‐RADS) density classification. TDLU features were assessed using three standardized measures (count/100 mm2, span [μm], and acini count/TDLU) in benign tissues. Associations between each of TDLU measures and MD were examined using generalized linear models for TDLU count and span and polytomous logistic regression for acini count with adjustment for potential confounders stratified by age. Among women ≥50 years, 63% had dense breasts; cases with dense breasts (BI‐RADS, c‐d) had greater TDLU count (21.1 [SE = 2.70] vs. 9.0 [SE = 1.83]; p = 0.0004), longer span (480.6 μm [SE = 24.6] vs. 393.8 μm [SE = 31.8]; p = 0.03), and greater acini count (ORtrend = 16.1; 95%CI = 4.08–63.1; ptrend < 0.0001) compared to those with non‐dense breasts (BI‐RADS, a‐b). Among women <50 years, 91% had dense breasts, precluding our ability to detect associations. Our findings are consistent with previously reported associations between extensive MD and reduced TDLU involution, supporting the hypothesis that breast cancer risk associated with extensive MD may be related to the amount of “at‐risk” epithelium.

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Section: Discussioncontrasting

confidence: 59%

Section: And the Stamp 4 Used Benign Tissues From Women With Bbdsupporting

confidence: 38%

The relationship between terminal duct lobular unit features and mammographic density among Chinese breast cancer patients

Sung

Guo

et al. 2019

Intl Journal of Cancer

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“…VMD measures have produced reasonably strong associations with breast cancer risk when validated against visual assessment and computer-assisted methods (11). As VMD methods are becoming increasingly used in epidemiologic studies of density (12)(13)(14)(15)(16)(17)(18), it becomes important to understand not only how VMD measures are associated to breast cancer risk, but also how they relate to established breast cancer risk factors.…”

Section: Introductionmentioning

confidence: 99%

Volumetric Mammographic Density, Age-Related Decline, and Breast Cancer Risk Factors in a National Breast Cancer Screening Program

Hjerkind

Ellingjord-Dale

Johansson

et al. 2018

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Volumetric mammographic density (VMD) measures can be obtained automatically, but it is not clear how these relate to breast cancer risk factors. The cohort consisted of 46,428 women (ages 49-71 years) who participated in BreastScreen Norway between 2007 and 2014 and had information on VMD and breast cancer risk factors. We estimated means of percent and absolute VMD associated with age, menopausal status, body mass index (BMI), and other factors. The associations between VMD and most breast cancer risk factors were modest, although highly significant. BMI was positively associated with absolute VMD, whereas inversely associated with percent VMD. Percent VMD was inversely associated with a 5-year older age at screening in premenopausal and postmenopausal women (-0.18% vs. -0.08% for percent VMD and -0.11 cm vs. -0.03 cm for absolute VMD). This difference was largest among postmenopausal women with BMI < 25 kg/m ( for interaction with percent VMD < 0.0001), never users of postmenopausal hormone therapy ( for interaction < 0.0001), and premenopausal women with a family history of breast cancer ( for interaction with absolute VMD = 0.054). VMD is associated with several breast cancer risk factors, the strongest being BMI, where the direction of the association differs for percent and absolute VMD. The inverse association with age appears modified by menopausal status and other breast cancer risk factors. Because VMD methods are becoming widely available in screening and clinical settings, the association between VMD measures and breast cancer risk factors should be investigated further in longitudinal studies. .

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“…Jung Sun Lee 1 *, Minkyung Oh 2 breast density on mammography and breast cancer risk for Asian women, regardless of menopausal status. However, Rajaram et al, (2017) suggested that premenopausal Asian and Caucasian women are at similar risk of breast cancer regardless of different breast density. Furthermore, several reproductive and lifestyle factors that influence the risk of breast cancer have been consistently associated with breast density (Brisson et al, 1984;Boyd et al, 2005;Sellers et al, 2007;Martin et al, 2008;Martin et al, 2010).…”

Section: Breast Density Of Mammography Is Correlated With Reproductivmentioning

confidence: 99%

Breast Density of Mammography is Correlated with Reproductive Risk Factors Regardless of Menopausal Status: A Cross-Sectional Study of the Korean National Screening Program

Lee

2020

Asian Pac J Cancer Prev

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Objective: To clarify the limitations of mammography screening for women with dense breasts, we examined breast density and its effects on screening results. Patients and Methods: We performed a cross-sectional, observational study on women who underwent mammography. Data from the National Cancer Screening Program(NCSP) from 2009 to 2013 were used. The study population consisted of participants with high breast density. We used a logistic regression analysis to evaluate the relationships between breast density and reproductive factors and screening results according to menopause status. Results: High breast density was reported for 57.5% of all participants (3,417,319 participants). Screening results indicated breast density of <25%, 25-50%, 51-75%, and ≥76% for 16.4%, 26.3%, 37.8%, and 19.5%, respectively, of participants. According to the screening results, high breast density was correlated with high deferment and recall rates. Reproductive factors, especially parity, breastfeeding, and use of oral contraceptives, had consistent effects on screening results of premenopausal and postmenopausal women. Regardless of menopausal status, age, early onset of menarche (15 years or younger), fewer live births (≤1 birth), and previous benign breast disease were correlated with increased breast density. In postmenopausal women, early-onset menopause and longer-term hormone replacement therapy (≥2 years) also independently increased breast density. Conclusion: Breast density influenced screening results, which could increase the rate of recall. Breast density was also influenced by reproductive factors, with patterns similar to those of breast cancer risk, regardless of menopausal status. We need to identify high-risk women with high density who would probably benefit from supplemental breast cancer screening.

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Differences in mammographic density between Asian and Caucasian populations: a comparative analysis

Cited by 81 publications

References 37 publications

The relationship between terminal duct lobular unit features and mammographic density among Chinese breast cancer patients

The relationship between terminal duct lobular unit features and mammographic density among Chinese breast cancer patients

Volumetric Mammographic Density, Age-Related Decline, and Breast Cancer Risk Factors in a National Breast Cancer Screening Program

Breast Density of Mammography is Correlated with Reproductive Risk Factors Regardless of Menopausal Status: A Cross-Sectional Study of the Korean National Screening Program

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