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Erschienen in: Annals of Surgical Oncology 13/2014

01.12.2014 | Breast Oncology

High Volumetric Breast Density Predicts Risk for Breast Cancer in Postmenopausal, but not Premenopausal, Korean Women

verfasst von: In Hae Park, MD, Kyungran Ko, MD, Jungnam Joo, PhD, Boram Park, MS, So-Youn Jung, MD, Seeyoun Lee, MD, PhD, Youngmi Kwon, MD, PhD, Han-Sung Kang, MD, PhD, Eun Sook Lee, MD, PhD, Keun Seok Lee, MD, PhD, Jungsil Ro, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 13/2014

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ABSTRACT

Purpose

We investigated the association between mammographic breast density and breast cancer risk in Korean women according to menopausal status and breast cancer subtypes.

Methods

We enrolled 677 patients diagnosed with breast cancer and 1,307 healthy controls who participated in screening mammography at the National Cancer Center. Breast density was estimated using volumetric breast composition measurement.

Results

Of the total population, 1,156 (58.3 %) women were postmenopausal. The risk of breast cancer increased progressively with the increment of volumetric density grade (VDG) in postmenopausal women (p < 0.001). High breast density (VDG 4) was significantly associated with breast cancer compared with low breast density (VDG 1/2) regardless of body mass index. However, the association with parity and history of hormone replacement therapy (HRT) was only found in those with ≥2 children and those not receiving HRT. Breast density was positively associated with breast cancer risk regardless of histologic grade, tumor size, lymph node involvement, Ki67 index, and hormone receptor status. The association was more prominent in human epidermal growth factor receptor 2 (HER2)-positive tumors (VDG 1/2 vs. VDG 4 for HER2 normal, odds ratio [OR] 2.21, 95 % confidence interval [CI] 1.28–3.83, p < 0.001; for HER2 positive, OR 8.63, 95 % CI 3.26–22.83, p = 0.001; P heterogeneity = 0.030). However, no significant association was found between breast density and breast cancer risk in premenopausal women except for those with large-sized tumors (>2 cm) and a Ki67 index >15 %.

Conclusion

High volumetric breast density is significantly associated with the risk of breast cancer in postmenopausal women; however, these relationships were not found in premenopausal women.
Literatur
1.
Zurück zum Zitat McCormack V, dosSantosSilva I. Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomark Prev. 2006;15:1159–69.CrossRef McCormack V, dosSantosSilva I. Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomark Prev. 2006;15:1159–69.CrossRef
2.
Zurück zum Zitat Yaghjyan L, Colditz G, Collins L, et al. Mammographic breast density and subsequent risk of breast cancer in postmenopausal women according to tumor characteristics. J Natl Cancer Inst. 2011;103:1179–89.PubMedCentralPubMedCrossRef Yaghjyan L, Colditz G, Collins L, et al. Mammographic breast density and subsequent risk of breast cancer in postmenopausal women according to tumor characteristics. J Natl Cancer Inst. 2011;103:1179–89.PubMedCentralPubMedCrossRef
3.
Zurück zum Zitat Conroy S, Pagano I, Kolonel L, et al. Mammographic density and hormone receptor expression in breast cancer: the Multiethnic Cohort Study. Cancer Epidemiol. 2011;35:448–52.PubMedCentralPubMedCrossRef Conroy S, Pagano I, Kolonel L, et al. Mammographic density and hormone receptor expression in breast cancer: the Multiethnic Cohort Study. Cancer Epidemiol. 2011;35:448–52.PubMedCentralPubMedCrossRef
4.
Zurück zum Zitat Sala E, Solomon L, Warren R, et al. Size, node status and grade of breast tumours: association with mammographic parenchymal patterns. Eur Radiol. 2000;10:157–61.PubMedCrossRef Sala E, Solomon L, Warren R, et al. Size, node status and grade of breast tumours: association with mammographic parenchymal patterns. Eur Radiol. 2000;10:157–61.PubMedCrossRef
5.
Zurück zum Zitat Li J, Humphreys K, Eriksson L, et al. Mammographic density reduction is a prognostic marker of response to adjuvant tamoxifen therapy in postmenopausal patients with breast cancer. J Clin Oncol. 2013;31:2249–56.PubMedCentralPubMedCrossRef Li J, Humphreys K, Eriksson L, et al. Mammographic density reduction is a prognostic marker of response to adjuvant tamoxifen therapy in postmenopausal patients with breast cancer. J Clin Oncol. 2013;31:2249–56.PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Kim J, Han W, Moon H-G, et al. Breast density change as a predictive surrogate for response to adjuvant endocrine therapy in hormone receptor positive breast cancer. Breast Cancer Res. 2012;14:R102.PubMedCentralPubMedCrossRef Kim J, Han W, Moon H-G, et al. Breast density change as a predictive surrogate for response to adjuvant endocrine therapy in hormone receptor positive breast cancer. Breast Cancer Res. 2012;14:R102.PubMedCentralPubMedCrossRef
7.
Zurück zum Zitat Porter G, Evans A, Cornford E, et al. Influence of mammographic parenchymal pattern in screening-detected and interval invasive breast cancers on pathologic features, mammographic features, and patient survival. AJR Am J Roentgenol. 2007;188:676–83.PubMedCrossRef Porter G, Evans A, Cornford E, et al. Influence of mammographic parenchymal pattern in screening-detected and interval invasive breast cancers on pathologic features, mammographic features, and patient survival. AJR Am J Roentgenol. 2007;188:676–83.PubMedCrossRef
8.
9.
Zurück zum Zitat Gierach G, Ichikawa L, Kerlikowske K, et al. Relationship between mammographic density and breast cancer death in the Breast Cancer Surveillance Consortium. J Natl Cancer Inst. 2012;104:1218–27.PubMedCentralPubMedCrossRef Gierach G, Ichikawa L, Kerlikowske K, et al. Relationship between mammographic density and breast cancer death in the Breast Cancer Surveillance Consortium. J Natl Cancer Inst. 2012;104:1218–27.PubMedCentralPubMedCrossRef
10.
Zurück zum Zitat Vanel D. The American College of Radiology (ACR) Breast Imaging and Reporting Data System (BI-RADS): a step towards a universal radiological language? Eur J Radiol. 2007;61:183.PubMedCrossRef Vanel D. The American College of Radiology (ACR) Breast Imaging and Reporting Data System (BI-RADS): a step towards a universal radiological language? Eur J Radiol. 2007;61:183.PubMedCrossRef
11.
Zurück zum Zitat Kerlikowske K, Grady D, Barclay J, et al. Variability and accuracy in mammographic interpretation using the American College of Radiology Breast Imaging Reporting and Data System. J Natl Cancer Inst. 1998;90:1801–09.PubMedCrossRef Kerlikowske K, Grady D, Barclay J, et al. Variability and accuracy in mammographic interpretation using the American College of Radiology Breast Imaging Reporting and Data System. J Natl Cancer Inst. 1998;90:1801–09.PubMedCrossRef
12.
Zurück zum Zitat Martin K, Helvie M, Zhou C, et al. Mammographic density measured with quantitative computer-aided method: comparison with radiologists’ estimates and BI-RADS categories. Radiology. 2006;240:656–65.PubMedCrossRef Martin K, Helvie M, Zhou C, et al. Mammographic density measured with quantitative computer-aided method: comparison with radiologists’ estimates and BI-RADS categories. Radiology. 2006;240:656–65.PubMedCrossRef
13.
Zurück zum Zitat Assi V, Warwick J, Cuzick J, Duffy S. Clinical and epidemiological issues in mammographic density. Nat Rev Clin Oncol. 2012;9:33–40.CrossRef Assi V, Warwick J, Cuzick J, Duffy S. Clinical and epidemiological issues in mammographic density. Nat Rev Clin Oncol. 2012;9:33–40.CrossRef
14.
Zurück zum Zitat Highnam R, Brady M, Yaffe MJ, et al. Robust breast composition measurement – Volpara™. Girona: Springer; 2010. p. 342–349. Highnam R, Brady M, Yaffe MJ, et al. Robust breast composition measurement – Volpara™. Girona: Springer; 2010. p. 342–349.
15.
Zurück zum Zitat Highnam R, Sauber N, Destounis S, et al. Breast density into clinical practice. Berlin: Springer; 2012. p. 466–473. Highnam R, Sauber N, Destounis S, et al. Breast density into clinical practice. Berlin: Springer; 2012. p. 466–473.
16.
Zurück zum Zitat Park JH, Yang HK, Nam EJ, et al. Cancer facts & figures 2013. President of National Cancer Center, Minister for Health and Welfare; 2013. Park JH, Yang HK, Nam EJ, et al. Cancer facts & figures 2013. President of National Cancer Center, Minister for Health and Welfare; 2013.
17.
Zurück zum Zitat Boyd N, Martin L, Yaffe M, Minkin S. Mammographic density and breast cancer risk: current understanding and future prospects. Breast Cancer Res. 2011;13:223.PubMedCentralPubMedCrossRef Boyd N, Martin L, Yaffe M, Minkin S. Mammographic density and breast cancer risk: current understanding and future prospects. Breast Cancer Res. 2011;13:223.PubMedCentralPubMedCrossRef
18.
Zurück zum Zitat Aitken Z, McCormack V, Highnam R, et al. Screen-film mammographic density and breast cancer risk: a comparison of the volumetric standard mammogram form and the interactive threshold measurement methods. Cancer Epidemiol Biomarkers Prev. 2010;19:418–28.PubMedCentralPubMedCrossRef Aitken Z, McCormack V, Highnam R, et al. Screen-film mammographic density and breast cancer risk: a comparison of the volumetric standard mammogram form and the interactive threshold measurement methods. Cancer Epidemiol Biomarkers Prev. 2010;19:418–28.PubMedCentralPubMedCrossRef
19.
Zurück zum Zitat Jeffreys M, Warren R, Highnam R, Davey Smith G. Breast cancer risk factors and a novel measure of volumetric breast density: cross-sectional study. Br J Cancer. 2008;98:210–16.PubMedCentralPubMedCrossRef Jeffreys M, Warren R, Highnam R, Davey Smith G. Breast cancer risk factors and a novel measure of volumetric breast density: cross-sectional study. Br J Cancer. 2008;98:210–16.PubMedCentralPubMedCrossRef
20.
Zurück zum Zitat Gweon H, Youk J, Kim J-A, Son E. Radiologist assessment of breast density by BI-RADS categories versus fully automated volumetric assessment. AJR Am J Roentgenol. 2013;201:692–7.PubMedCrossRef Gweon H, Youk J, Kim J-A, Son E. Radiologist assessment of breast density by BI-RADS categories versus fully automated volumetric assessment. AJR Am J Roentgenol. 2013;201:692–7.PubMedCrossRef
21.
Zurück zum Zitat del Carmen M, Halpern E, Kopans D, et al. Mammographic breast density and race. AJR Am J Roentgenol. 2007;188:1147–50.PubMedCrossRef del Carmen M, Halpern E, Kopans D, et al. Mammographic breast density and race. AJR Am J Roentgenol. 2007;188:1147–50.PubMedCrossRef
22.
Zurück zum Zitat Ursin G, Ma H, Wu A, et al. Mammographic density and breast cancer in three ethnic groups. Cancer Epidemiol Biomark Prev. 2003;12:332–38. Ursin G, Ma H, Wu A, et al. Mammographic density and breast cancer in three ethnic groups. Cancer Epidemiol Biomark Prev. 2003;12:332–38.
23.
Zurück zum Zitat Thomas D, Carter R, Bush W, et al. Risk of subsequent breast cancer in relation to characteristics of screening mammograms from women less than 50 years of age. Cancer Epidemiol Biomarkers Prev. 2002;11:565–71. Thomas D, Carter R, Bush W, et al. Risk of subsequent breast cancer in relation to characteristics of screening mammograms from women less than 50 years of age. Cancer Epidemiol Biomarkers Prev. 2002;11:565–71.
24.
Zurück zum Zitat Bertrand K, Tamimi R, Scott C, et al. Mammographic density and risk of breast cancer by age and tumor characteristics. Breast Cancer Res. 2013;15:104.PubMedCentralPubMedCrossRef Bertrand K, Tamimi R, Scott C, et al. Mammographic density and risk of breast cancer by age and tumor characteristics. Breast Cancer Res. 2013;15:104.PubMedCentralPubMedCrossRef
25.
Zurück zum Zitat Antoni S, Sasco A, dosSantosSilva I, McCormack V (2013) Is mammographic density differentially associated with breast cancer according to receptor status? A meta-analysis. Breast Cancer Res Treat. 137:337–47.PubMedCrossRef Antoni S, Sasco A, dosSantosSilva I, McCormack V (2013) Is mammographic density differentially associated with breast cancer according to receptor status? A meta-analysis. Breast Cancer Res Treat. 137:337–47.PubMedCrossRef
26.
Zurück zum Zitat Ghosh K, Brandt KR, Reynolds C, et al. Tissue composition of mammographically dense and non-dense breast tissue. Breast Cancer Res Treat. 2012;131:267–75.PubMedCentralPubMedCrossRef Ghosh K, Brandt KR, Reynolds C, et al. Tissue composition of mammographically dense and non-dense breast tissue. Breast Cancer Res Treat. 2012;131:267–75.PubMedCentralPubMedCrossRef
27.
Zurück zum Zitat Mao Y, Keller ET, Garfield DH, et al. Stromal cells in tumor microenvironment and breast cancer. Cancer Metastasis Rev. 2013;32:303–12.PubMedCrossRef Mao Y, Keller ET, Garfield DH, et al. Stromal cells in tumor microenvironment and breast cancer. Cancer Metastasis Rev. 2013;32:303–12.PubMedCrossRef
Metadaten
Titel
High Volumetric Breast Density Predicts Risk for Breast Cancer in Postmenopausal, but not Premenopausal, Korean Women
verfasst von
In Hae Park, MD
Kyungran Ko, MD
Jungnam Joo, PhD
Boram Park, MS
So-Youn Jung, MD
Seeyoun Lee, MD, PhD
Youngmi Kwon, MD, PhD
Han-Sung Kang, MD, PhD
Eun Sook Lee, MD, PhD
Keun Seok Lee, MD, PhD
Jungsil Ro, MD, PhD
Publikationsdatum
01.12.2014
Verlag
Springer US
Erschienen in
Annals of Surgical Oncology / Ausgabe 13/2014
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3832-1

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