Reduction of breast density following tamoxifen treatment evaluated by 3-D MRI: preliminary study

Chen, Jeon‐Hor; Chang, Yu‐Cheng; Chang, Daniel; Wang, Yiting; Nie, Ke; Chang, Ruey-Feng; Nalcioğlu, Orhan; Huang, Chiun‐Sheng; Su, Min‐Ying

doi:10.1016/j.mri.2010.07.009

Cited by 40 publications

(53 citation statements)

References 45 publications

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“…In several previous publications, we analyzed breast density on nonfat-suppressed images. 15,20,[22][23][24][25] The purpose of the present study is to address the current lack of published studies investigating the difference in breast density measured using fat-suppressed versus nonfat-suppressed sequences. Our breast MRI protocol follows the ACR recommendation and uses fat-suppressed sequence for the dynamic contrast enhanced study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of breast density measured on MR images acquired using fat‐suppressed versus nonfat‐suppressed sequences

et al. 2011

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Purpose: To investigate the difference of MR percent breast density measured from fat-suppressed versus nonfat-suppressed imaging sequences. Methods: Breast magnetic resonance imaging (MRI) with and without fat suppression was acquired from 38 subjects. Breasts were divided into subgroups of different morphological patterns ("central" and "intermingled" types). Breast volume, fibroglandular tissue volume, and percent density were measured. The results were compared using nonparametric statistical tests and regarded as significant at p < 0.05. Results: Breast volume, fibroglandular volume, and percent density between fat-suppressed and nonfat-suppressed sequences were highly correlated. Breast volumes measured on these two sequences were almost identical. Fibroglandular tissue volume and percent density, however, had small (<5%) yet significant differences between the two sequences-they were both higher on the fat-suppressed sequence. Intraobserver variability was within 4% for both sequences and different morphological types. The fibroglandular tissue volume measured on downsampled images showed a small (<5%) yet significant difference. Conclusions: The measurement of breast density made on MRI acquired using fat-suppressed and nonfat-suppressed T1W images was about 5% difference, only slightly higher than the intraobserver variability of 3%-4%. When the density data from multiple centers were to be combined, evaluating the degree of difference is needed to take this difference into account.

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Section: Discussionmentioning

confidence: 99%

Comparison of breast density measured on MR images acquired using fat‐suppressed versus nonfat‐suppressed sequences

et al. 2011

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“…(19–21) Research has not assessed response to treatment with tamoxifen and AI using volumetric density measures on FFDM, though a few studies using MRI suggest volumetric measures may more accurately measure density changes. (22,23) If volumetric density measures from FFDM provide precise estimates of longitudinal change in breast density, they may be used clinically to provide important prognostic information.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Changes in Volumetric Breast Density with Tamoxifen and Aromatase Inhibitors

Engmann

Scott

Jensen

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Reductions in breast density with tamoxifen and aromatase inhibitors may be an intermediate marker of treatment response. We compare changes in volumetric breast density among breast cancer cases using tamoxifen or aromatase inhibitors (AI) to untreated women without breast cancer. Materials and Methods Breast cancer cases with a digital mammogram prior to diagnosis and after initiation of tamoxifen (n=366) or AI (n=403), and a sample of controls (n=2170) were identified from the Mayo Clinic Mammography Practice and San Francisco Mammography Registry. Volumetric percent density (VPD) and dense breast volume (DV) were measured using Volpara™ (Matakina Technology) and Quantra™ (Hologic) software. Linear regression estimated the effect of treatment on annualized changes in density. Results Premenopausal women using tamoxifen experienced annualized declines in volumetric percent density of 1.17% to 1.70% compared with 0.30% to 0.56% for controls and declines in dense breast volume of 7.43 cm3 to 15.13 cm3 compared with 0.28 cm3 to 0.63 cm3 in controls, for Volpara and Quantra respectively. The greatest reductions were observed among women with ≥10% baseline density. Postmenopausal AI-users had greater declines in volumetric percent density than controls (Volpara p=0.02; Quantra p=0.03), and reductions were greatest among women with ≥10% baseline density. Declines in volumetric percent density among postmenopausal women using tamoxifen were only statistically greater than controls when measured with Quantra. Conclusions Automated software can detect volumetric breast density changes among women on tamoxifen and AI. Impact If declines in volumetric density predict breast cancer outcomes, these measures may be used as interim prognostic indicators.

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“…Of the studies on estrogen-receptor modulators, 10 assessed change in BD with TAM intervention and included 1 RCT, 10 2 nested CCSs, 8,9 1 CS, 11 and 6 post hoc analyses of RCTs. [33][34][35][36][37][38] The sample sizes of the 10 studies ranged from 16 to 1065 (n = 2877).…”

Section: Resultsmentioning

confidence: 99%

“…About 80% of the studies on TAM and tibolone did not adjust for BD confounders. Two of the studies on estrogen modulators had very small sample sizes, 11,17 and 1 study 99 reported duration of treatment but not dosage administered. There was variability in age, populations, and sample size between studies, thus making comparison of studies difficult.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Breast Density and Selective Estrogen-Receptor Modulators, Aromatase Inhibitors, Physical Activity, and Diet

et al. 2016

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Background. Lower breast density (BD) is associated with lower risk of breast cancer and may serve as a biomarker for the efficacy of chemopreventive strategies. This review explores parameters that are thought to be associated with lower BD. We conducted a systematic review of articles published to date using the PRISMA strategy. Articles that assessed change in BD with estrogen-receptor modulators (tamoxifene [TAM], raloxifene [RLX], and tibolone) and aromatase inhibitors (AIs), as well as cross-sectional and longitudinal studies (LSs) that assessed association between BD and physical activity (PA) or diet were reviewed. Results. Ten studies assessed change in BD with TAM; all reported TAM-mediated BD decreases. Change in BD with RLX was assessed by 11 studies; 3 reported a reduction in BD. Effect of tibolone was assessed by 5 RCTs; only 1 reported change in BD. AI-mediated BD reduction was reported by 3 out of 10 studies. The association between PA and BD was assessed by 21 studies; 4 reported an inverse association. The relationship between diet and BD was assessed in 34 studies. All studies on calcium and vitamin D as well as vegetable intake reported an inverse association with BD in premenopausal women. Two RCTs demonstrated BD reduction with a low-fat, high-carbohydrate intervention. Conclusion. TAM induces BD reduction; however, the effect of RLX, tibolone, and AIs on BD is unclear. Although data on association between diet and BD in adulthood are contradictory, intake of vegetables, vitamin D, and calcium appear to be associated with lower BD in premenopausal women.

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Reduction of breast density following tamoxifen treatment evaluated by 3-D MRI: preliminary study

Cited by 40 publications

References 45 publications

Comparison of breast density measured on MR images acquired using fat‐suppressed versus nonfat‐suppressed sequences

Comparison of breast density measured on MR images acquired using fat‐suppressed versus nonfat‐suppressed sequences

Longitudinal Changes in Volumetric Breast Density with Tamoxifen and Aromatase Inhibitors

Relationship Between Breast Density and Selective Estrogen-Receptor Modulators, Aromatase Inhibitors, Physical Activity, and Diet

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