Do Birth Weight and Weight Gain During Infancy and Early Childhood Explain Variation in Mammographic Density in Women in Midlife? Results From Cohort and Sibling Analyses

Terry, Mary Beth; Cohn, Barbara A.; Goldberg, Mandy; Flom, Julie D.; Wei, Ying; Houghton, Lauren C.; Tehranifar, Parisa; McDonald, Jasmine A.; Protacio, Angeline; Cirillo, Piera M.; Michels, Karin B.

doi:10.1093/aje/kwy229

Cited by 8 publications

(9 citation statements)

References 71 publications

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“…Specifically, birth weight was positively associated with dense area, whereas rapid weight gain in infancy and early childhood to four years were negatively associated with dense area (in the overall cohort and in the sibling subset). These results support that the pattern of BMI with breast cancer risk may also be reflected in breast density prior to menopause [13].…”

Section: Introductionsupporting

confidence: 81%

“…The consistency is also seen in women at a higher risk of breast cancer and across the full spectrum of absolute predicted risk [12]. The negative association for adolescent BMI does not extend to earlier in life, as birthweight remains positively associated with breast cancer risk and we have recently reported a similar positive association between birthweight and MBD [13]. Specifically, birth weight was positively associated with dense area, whereas rapid weight gain in infancy and early childhood to four years were negatively associated with dense area (in the overall cohort and in the sibling subset).…”

Section: Introductionmentioning

confidence: 63%

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Environmental Influences on Mammographic Breast Density in California: A Strategy to Reduce Breast Cancer Risk

Cohn

Terry

2019

IJERPH

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State legislation in many U.S. states, including California, mandates informing women if they have dense breasts on screening mammography, meaning over half of their breast tissue is comprised of non-adipose tissue. Breast density is important to interpret screening sensitivity and is an established breast cancer risk factor. Environmental chemical exposures may play an important role in this, especially during key windows of susceptibility for breast development: in utero, during puberty, pregnancy, lactation, and the peri-menopause. There is a paucity of research, however, examining whether environmental chemical exposures are associated with mammographic breast density, and even less is known about environmental exposures during windows of susceptibility. Now, with clinical breast density scoring being reported routinely for mammograms, it is possible to find out, especially in California, where there are large study populations that can link environmental exposures during windows of susceptibility to breast density. Density scores are now available throughout the state through electronic medical records. We can link these with environmental chemical exposures via state-wide monitoring. Studying the effects of environmental exposure on breast density may provide valuable monitoring and etiologic data to inform strategies to reduce breast cancer risk.

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Section: Introductionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 63%

Environmental Influences on Mammographic Breast Density in California: A Strategy to Reduce Breast Cancer Risk

Cohn

Terry

2019

IJERPH

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“…The role of adipose tissue in normal mammary gland development has been proposed as a possible explanation of the inverse association observed between obesity and premenopausal breast cancer [ 63 ]. Other explanations include disruptions to the menstrual cycle [ 64 ] and lower mammographic density [ 65 , 66 ] in obese premenopausal women.…”

Section: The Complex Relationship Between Obesity and Breast Cancermentioning

confidence: 99%

Crown-Like Structures in Breast Adipose Tissue: Early Evidence and Current Issues in Breast Cancer

Maliniak

Miller‐Kleinhenz

Cronin‐Fenton

et al. 2021

Cancers

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Obesity is an established risk factor for postmenopausal breast cancer and has been linked to worse breast cancer prognosis, most clearly for hormone receptor-positive breast cancers. The underlying mechanisms of the obesity–breast cancer association are not fully understood, but growing evidence points to the breast adipose tissue microenvironment playing an important role. Obesity-induced adipose tissue dysfunction can result in a chronic state of low-grade inflammation. Crown-like structures of the breast (CLS-B) were recently identified as a histologic marker of local inflammation. In this review, we evaluate the early evidence of CLS-B in breast cancer. Data from preclinical and clinical studies show that these inflammatory lesions within the breast are associated with local NF-κB activation, increased aromatase activity, and elevation of pro-inflammatory mediators (TNFα, IL-1β, IL-6, and COX-2-derived PGE2)—factors involved in multiple pathways of breast cancer development and progression. There is also substantial evidence from epidemiologic studies that CLS-B are associated with greater adiposity among breast cancer patients. However, there is insufficient evidence that CLS-B impact breast cancer risk or prognosis. Comparisons across studies of prognosis were complicated by differences in CLS-B evaluation and deficiencies in study design, which future studies should take into consideration. Breast adipose tissue inflammation provides a plausible explanation for the obesity–breast cancer association, but further study is needed to establish its role and whether markers such as CLS-B are clinically useful.

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“…From similarly studying 490 women in the Tasmanian Longitudinal Health Study, negative regression coefficients were found for the association between childhood BMI and both absolute and percent mammographic density [25]. Similar results were found from studying 163 women from the New York Women’s Birth Cohort for weight changes from 1 to 7 years and absolute and percentage densities [26], and in 661 women from the Early Determinants of Mammographic Density study, in which childhood weight data were available up to the age of 4 [27]. Our study is, thus, clearly the largest one on this topic, and although we and the UK researchers used categories, whereas the Australian and US studies used continuous measures, it is reassuring that the results of the studies all point in the same direction.…”

Section: Discussionmentioning

confidence: 67%

Mammographic Density and Screening Sensitivity, Breast Cancer Incidence and Associated Risk Factors in Danish Breast Cancer Screening

Lynge

Vejborg

Andersen

et al. 2019

JCM

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Background: Attention in the 2000s on the importance of mammographic density led us to study screening sensitivity, breast cancer incidence, and associations with risk factors by mammographic density in Danish breast cancer screening programs. Here, we summarise our approaches and findings. Methods: Dichotomized density codes: fatty, equal to BI-RADS density code 1 and part of 2, and other mixed/dense data from the 1990s—were available from two counties, and BI-RADS density codes from one region were available from 2012/13. Density data were linked with data on vital status, incident breast cancer, and potential risk factors. We calculated screening sensitivity by combining data on screen-detected and interval cancers. We used cohorts to study high density as a predictor of breast cancer risk; cross-sectional data to study the association between life style factors and density, adjusting for age and body mass index (BMI); and time trends to study the prevalence of high density across birth cohorts. Results: Sensitivity decreased with increasing density from 78% in women with BI-RADS 1 to 47% in those with BI-RADS 4. For women with mixed/dense compared with those with fatty breasts, the rate ratio of incident breast cancer was 2.45 (95% CI 2.14–2.81). The percentage of women with mixed/dense breasts decreased with age, but at a higher rate the later the women were born. Among users of postmenopausal hormone therapy, the percentage of women with mixed/dense breasts was higher than in non-users, but the patterns across birth cohorts were similar. The occurrence of mixed/dense breast at screening age decreased by a z-score unit of BMI at age 13—odds ratio (OR) 0.56 (95% CI 0.53–0.58)—and so did breast cancer risk and hazard ratio (HR) 0.92 (95% CI 0.84–1.00), but it changed to HR 1.01 (95% CI 0.93–1.11) when controlled for density. Age and BMI adjusted associations between life style factors and density were largely close to unity; physical activity OR 1.06 (95% CI 0.93–1.21); alcohol consumption OR 1.01 (95% CI 0.81–1.27); air pollution OR 0.96 (95% 0.93–1.01) per 20 μg/m3; and traffic noise OR 0.94 (95% CI 0.86–1.03) per 10 dB. Weak negative associations were seen for diabetes OR 0.61 (95% CI 0.40–0.92) and cigarette smoking OR 0.86 (95% CI 0.75–0.99), and a positive association was found with hormone therapy OR 1.24 (95% 1.14–1.35). Conclusion: Our data indicate that breast tissue in middle-aged women is highly dependent on childhood body constitution while adult life-style plays a modest role, underlying the need for a long-term perspective in primary prevention of breast cancer.

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Do Birth Weight and Weight Gain During Infancy and Early Childhood Explain Variation in Mammographic Density in Women in Midlife? Results From Cohort and Sibling Analyses

Cited by 8 publications

References 71 publications

Environmental Influences on Mammographic Breast Density in California: A Strategy to Reduce Breast Cancer Risk

Environmental Influences on Mammographic Breast Density in California: A Strategy to Reduce Breast Cancer Risk

Crown-Like Structures in Breast Adipose Tissue: Early Evidence and Current Issues in Breast Cancer

Mammographic Density and Screening Sensitivity, Breast Cancer Incidence and Associated Risk Factors in Danish Breast Cancer Screening

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