Mammographic parenchymal patterns and risk of breast cancer in postmenopausal women

Horwitz, Ralph I.; Lamas, Ana M.; Peck, Dorothea R.

doi:10.1016/0002-9343(84)90351-6

Cited by 8 publications

(2 citation statements)

References 11 publications

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“…With one exception (Horwitz et al, 1984), this does not seem to be observed in other studies (Byrne et al, 1995;Kato et al, 1995;Ursin et al, 2003). It may be a chance finding or it may relate particularly to the population in our study.…”

Section: Discussionmentioning

confidence: 55%

Interaction of dense breast patterns with other breast cancer risk factors in a case–control study

Duffy

Jakes

et al. 2004

Br J Cancer

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The question of interactions between breast density and other breast cancer risk factors is of interest, since it bears upon the use of density as a marker for changes in breast cancer risk. We studied breast parenchymal patterns and 13 other potential risk factors for breast cancer in 172 breast cancer cases and 338 age-matched controls in Singapore. Dense breast patterns were defined as having Tabar parenchymal pattern IV or V. We found significant interactions between dense patterns and ethnic group (P ¼ 0.046), and between dense patterns and number of deliveries (P ¼ 0.04). Among women with nondense breast patterns, the non-Chinese had lower risk than the Chinese with an odds ratio (OR) of 0.47 (95% CI 0.24, 0.88), whereas in those with dense patterns, the nonChinese had considerably higher risks (OR ¼ 5.34, 95% CI 0.54, 52.51). Alternatively expressed, the increased risk with dense patterns was only observed in the non-Chinese (OR ¼ 13.99, 95% CI 1.33, 146.99). Among parous women, the protective effect of three or more deliveries was only observed in those with dense breast patterns (OR ¼ 0.21, 95% CI 0.06, 0.70). Suggestive but nonsignificant interactions with dense patterns were observed for ever having delivered, age at first delivery, breast feeding and body mass index. The results are consistent with dense breast patterns as a marker for hormonal modification of breast cancer risk. In recent years, there has been increasing interest in breast density as a risk factor for breast cancer, as a potential marker for changes in the breast and as a criterion for inclusion in prevention trials (Warner et al, 1992;Sala et al, 1998;Harrison et al, 2002;Warwick et al, 2003). Radiologically dense breasts are known to be associated with increased risk of breast cancer (Warner et al, 1992;Sala et al, 1998), to be associated with other risk factors for breast cancer (Jakes et al, 2000;Warwick et al, 2003) and to be amenable to exogenous hormonal stimuli (Atkinson et al, 1999;Atkinson and Bingham, 2002;Greendale et al, 2003).The last phenomenon is of particular interest. Increased density (i.e. high-risk pattern) is associated with preparations such as hormone replacement therapy, which increases exposure to oestrogens (Greendale et al, 2003) and therefore risk of breast cancer, and decreased density is associated with preparations such as tamoxifen or isoflavones, which reduce oestrogen exposure and breast cancer risk (Atkinson et al, 1999;Greendale et al, 2003). This suggests that breast density may be of use as an interim marker of response to hormonal chemoprevention therapy. The fundamental issue to be resolved is whether an induced change in breast density automatically confers the corresponding change in breast cancer risk. This may be ascertained by substudies within the chemoprevention trials such as IBIS (Cuzick et al, 2002;Warwick et al, 2003). In the meantime, however, some clues can be gained by studying the interrelationships of dense breast patterns, hormonal and other risk factors, and occurrence of br...

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Section: Discussionmentioning

confidence: 55%

Interaction of dense breast patterns with other breast cancer risk factors in a case–control study

Duffy

Jakes

et al. 2004

Br J Cancer

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“…2, 3, 10, 27, 29, 30, 32-44), whereas prevalence studies were case-control or crosssectional (Table 2; refs. 1,28,[45][46][47][48][49][50][51][52][53][54][55][56][57][58][59]. Nine studies were conducted using symptomatic populations or controls (Table 3; refs.…”

Section: Resultsmentioning

confidence: 99%

Breast Density and Parenchymal Patterns as Markers of Breast Cancer Risk: A Meta-analysis

McCormack

dos‐Santos‐Silva

2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

1,858

1,458

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Mammographic features are associated with breast cancer risk, but estimates of the strength of the association vary markedly between studies, and it is uncertain whether the association is modified by other risk factors. We conducted a systematic review and meta-analysis of publications on mammographic patterns in relation to breast cancer risk. Random effects models were used to combine study-specific relative risks. Aggregate data for >14,000 cases and 226,000 noncases from 42 studies were included. Associations were consistent in studies conducted in the general population but were highly heterogeneous in symptomatic populations. They were much stronger for percentage density than for Wolfe grade or Breast Imaging Reporting and Data System classification and were 20% to 30% stronger in studies of incident than of prevalent cancer. No differences were observed by age/menopausal status at mammography or by ethnicity. For percentage density measured using prediagnostic mammograms, combined relative risks of incident breast cancer in the general population were 1.79 (95% confidence interval, 1.48-2.16), 2.11 (1.70-2.63), 2.92 (2.49-3.42), and 4.64 (3.64-5.91) for categories 5% to 24%, 25% to 49%, 50% to 74%, and z75% relative to <5%. This association remained strong after excluding cancers diagnosed in the first-year postmammography. This review explains some of the heterogeneity in associations of breast density with breast cancer risk and shows that, in well-conducted studies, this is one of the strongest risk factors for breast cancer. It also refutes the suggestion that the association is an artifact of masking bias or that it is only present in a restricted age range. (Cancer Epidemiol Biomarkers Prev 2006;15(6):1159-69)

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Cyclical mastalgia: Clinical and mammographic observations in a screened population

Leinster

Whitehouse

Walsh

1987

Journal of British Surgery

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The incidence of cyclical mastalgia in well women presenting for breast screening was 69 per cent. The incidence of cyclical mastalgia increases with age up to the menopause. There was a higher incidence of 'high risk' mammographic patterns and a lower incidence of 'low risk' patterns, according to the Wolfe classification, in women with cyclical mastalgia compared with the rest of the screened population. This finding correlated with the severity, duration and need for treatment. The differences in breast pattern did not persist after the menopause. The question of whether or not cyclical mastalgia can be regarded as a risk factor for breast cancer is uncertain and needs further evaluation.

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Mammographic parenchymal patterns and risk of breast cancer in postmenopausal women

Cited by 8 publications

References 11 publications

Interaction of dense breast patterns with other breast cancer risk factors in a case–control study

Interaction of dense breast patterns with other breast cancer risk factors in a case–control study

Breast Density and Parenchymal Patterns as Markers of Breast Cancer Risk: A Meta-analysis

Cyclical mastalgia: Clinical and mammographic observations in a screened population

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