Mammographic density as a risk factor for breast cancer in a German case–control study

Heusinger, Katharina; Loehberg, Christian R.; Haeberle, Lothar; Jud, Sebastian M.; Klingsiek, Peter; Hein, Alexander; Bayer, Christian; Rauh, Claudia; Uder, Michael; Cavallaro, Alexander; May, Matthias; Adamietz, Boris; Schulz-Wendtland, R.; Wittenberg, Thomas; Wagner, Florian; Beckmann, Matthias W.; Fasching, Peter A.

doi:10.1097/cej.0b013e328341e2ce

Cited by 54 publications

(48 citation statements)

References 37 publications

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“…Following the initial report that greater mammographic density is associated with an increased risk of breast cancer (Wolfe, 1976), the relationship between mammographic density and the risk of breast cancer has been studied extensively (Maskarinec and Meng, 2000;Nagao et al, 2003;Ursin et al, 2003;Maskarinec et al, 2005;Nagata et al, 2005;Vachon et al, 2007;Kotsuma et al, 2008;Heusinger et al, 2011;Razzaghi et al, 2012). However, these studies were predominantly carried out among Caucasian women and investigated the risk of later onset disease such as postmenopausal breast cancer (Maskarinec and Meng, 2000;Nagao et al, 2003;Ursin et al, 2003;Maskarinec et al, 2005;Kotsuma et al, 2008;Heusinger et al, 2011;Razzaghi et al, 2012).…”

Section: Introductionmentioning

confidence: 95%

“…However, these studies were predominantly carried out among Caucasian women and investigated the risk of later onset disease such as postmenopausal breast cancer (Maskarinec and Meng, 2000;Nagao et al, 2003;Ursin et al, 2003;Maskarinec et al, 2005;Kotsuma et al, 2008;Heusinger et al, 2011;Razzaghi et al, 2012). There are limited data on the relationship between mammographic density and breast cancer at a younger age, or for Asian women, including Korean women, in whom the average age at diagnosis of breast cancers is considerably younger.…”

Section: Introductionmentioning

confidence: 96%

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Mammographic density and risk of breast cancer in Korean women

Kim

Choi

Nguyen

et al. 2015

European Journal of Cancer Prevention

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We carried out this study to evaluate the association between mammographic density adjusted for age and BMI and early-onset breast cancer in Asian women. We recruited 213 Korean patients with breast cancer (45% diagnosed before the age of 50 years) and 630 controls matched for age, menopausal status, and examination date. The percentage and absolute size of dense areas on digital mammograms were measured using a computer-assisted thresholding technique (Cumulus). We carried out an analysis using the conditional logistic regression model with adjustment for covariates. An increase by 1 SD in age and BMI-adjusted absolute dense area and percentage dense area was associated with a 1.15-fold (95% confidence interval: 1.03, 1.29) and 1.20-fold (95% confidence interval: 1.06, 1.37) increased risk of breast cancer, respectively. These associations were stronger for premenopausal disease (P=0.07 and 0.01, respectively) and for disease diagnosed before age 50 (P=0.07 and 0.02, respectively) than for postmenopausal disease (P=0.16 and 0.23, respectively) or later onset disease (P=0.10 and 0.10, respectively). There was no difference in the associations with premenopausal versus postmenopausal and early-onset versus late-onset disease. After adjusting for age and BMI, both a greater absolute dense area and a greater percentage dense area were associated with an increased risk of breast cancer, particularly at a young age.

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Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 96%

Mammographic density and risk of breast cancer in Korean women

Kim

Choi

Nguyen

et al. 2015

European Journal of Cancer Prevention

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“…It is considered to be one of the strongest risk factors for breast cancer [1,2]. High mammographic density increases the risk of breast cancer by 4-6 fold [1,[3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Alcohol intake and mammographic density in postmenopausal Norwegian women

Qureshi

Couto

Hofvind

et al. 2011

Breast Cancer Res Treat

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Mammographic density is a strong risk factor for breast cancer. While alcohol intake has been associated with increased breast cancer risk, the association between alcohol consumption and mammographic density is not clear. We assessed the association between alcohol consumption and mammographic density among women who participated in the Norwegian Breast Cancer Screening Program in 2004. Mammographic density was assessed on digitized mammograms from 2,251 postmenopausal women aged 50-69 years, using a computer assisted method. Current intake of beer, wine (red and white), and liquor was assessed using a validated food frequency questionnaire. Non-drinkers were defined as complete abstainers (i.e., those who reported no intake of any type of alcohol). We used multivariate linear regression models to estimate least square means of percent mammographic density by categories of alcohol intake with adjustment for potential confounders. We also checked for possible effect modification by stratifying the analyses by age, body mass index, and hormone therapy. The mean percent mammographic density was almost similar for drinkers 18.3% (95% CI: 17.6-18.9%) and non-drinkers 17.8% (95% CI: 16.1-19.4%) (P = 0.59). There was no indication that amount of alcohol consumed was associated with percent mammographic density, with a mean percent density among women with the highest intake (>90 g of alcohol per week) of 18.2% (95% CI: 16.9-19.0%), only slightly different from that of non-drinkers 18.3% (17.3-19.6%) (P for trend = 0.99). There was no association between any type of alcohol consumed and mammographic density.There was no effect modification by body mass index, age, or hormone therapy use. We found no evidence of an association between alcohol intake and percent mammographic density.

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“…BMI, age, previous operations, breast composition, and breast density have been described as having an influence on the predictive value of mammography, ultrasound, and CBEs [16,31,32,54,55]. An association between age, BMI, and mammographic breast density has been described in numerous studies [56,57,58]. This study only included patients with BMI and age-adjusted data without previous breast surgery.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of Breast Medical Tactile Examiners (MTEs): A Prospective Pilot Study

et al. 2019

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Background: The usefulness of clinical breast examination (CBE) in general and in breast cancer screening programs has been a matter of debate. This study investigated whether adding vision-impaired medical tactile examiners (MTEs) improves the predictiveness of CBE for suspicious lesions and analyzed the feasibility and acceptability of this approach. Methods: The prospective study included 104 patients. Physicians and MTEs performed CBEs, and mammography and ultrasound results were used as the gold standard. Sensitivity and specificity were calculated and logistic regression models were used to compare the predictive value of CBE by physicians alone, MTEs alone, and physicians and MTEs combined. Results: For CBEs by physicians alone, MTEs alone, and both combined, sensitivity was 71, 82, and 89% and specificity was 55, 45, and 35%, respectively. Using adjusted logistic regression models, the validated areas under the curve were 0.685, 0.692, and 0.710 (median bootstrapped p value (DeLong) = 0.381). Conclusion: The predictive value for a suspicious breast lesion in CBEs performed by MTEs in patients without prior surgery was similar to that of physician-conducted CBEs. Including MTEs in the CBE procedure in breast units thus appears feasible and could be a way of utilizing their skills.

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Mammographic density as a risk factor for breast cancer in a German case–control study

Cited by 54 publications

References 37 publications

Mammographic density and risk of breast cancer in Korean women

Mammographic density and risk of breast cancer in Korean women

Alcohol intake and mammographic density in postmenopausal Norwegian women

Diagnostic Accuracy of Breast Medical Tactile Examiners (MTEs): A Prospective Pilot Study

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