Mammographic densities and the prevalence and incidence of histological types of benign breast disease

Abstract

There is now a large amount of evidence indicating that women with extensive areas of mammographic densities are 4-6 times more likely to develop breast cancer than those with little or no density in the mammogram. We have examined one potential biological explanation for this association by estimating the incidence of various histological types of benign breast disease in relation to mammographic density. We studied the large cohort of women taking part in the National Breast Screening Study (NBSS), a randomized trial of screening with mammography. Mammograms from subjects with biopsies (n = 423) and from a comparison group of subjects randomly selected from the NBSS (n = 465) were included. Histological slides from biopsied subjects (n = 353) were classified independently by the pathologists of the NBSS and by a review pathologist (H.M.J.). Mammographic density in more than 75% of the breast area was associated with an increased risk of incidence of hyperplasia without atypia, and of atypical hyperplasia and/or carcinoma in situ. The classifications of the review pathologist showed that, compared to women with no density, the relative risk of incident lesions for women with density in more than 75% of breast was 13.85 (95% CI 2.65-72.49) for hyperplasia, and 9.23 (95% CI 1.66-51.48) for atypical hyperplasia and/or carcinoma in situ. These findings suggest that the association between extensive mammographic density and breast cancer risk may, at least in part, be attributable to biological processes in the breast that give rise to these histological features that are known to be related to breast cancer risk.

Dietary and lifestyle determinants of mammographic breast density. A longitudinal study in a Mediterranean population

“…[24][25][26] The positive association of H-MBD with a previous breast biopsy is also consistent with the results of previous studies. 5,27,28 We found a positive association of borderline significance of H-MBD with a first degree family history of BC, although published results are not consistent. 5,27,29 To our knowledge, the inverse association we have found between MBD and high intake of vegetables has not emerged in other studies.…”

The Role of Various Modalities in Breast Imaging

“…When breast cancer has grown to the point where physical signs and symptoms appear, the patient feels a breast lump (usually painless) 3 . Other presentations include tenderness, skin irritation or dimpling, and nipple discharge or pain, scaliness, ulceration, or retraction.…”

“…Other presentations include tenderness, skin irritation or dimpling, and nipple discharge or pain, scaliness, ulceration, or retraction. Breast pain is commonly due to benign conditions and not usually the fi rst symptom of breast cancer 3 . Breast masses have a varied etiology, benign and malignant.…”

Breast composition: Measurement and clinical use

“…The method has shown strong positive association between breast density and cancer risk. 84,85 The driver for Boyd's work, although still subjective, was to try and introduce a more quantitative approach than offered by Wolfe.…”