Volumetric mammographic density, age-related decline, and breast cancer risk factors in a national breast cancer screening program
Menée en Norvège à partir de données portant sur 46 428 participantes au programme national de dépistage du cancer du sein et âgées entre 49 et 71 ans, cette étude de cohorte analyse l'association entre la densité volumétrique mammaire, d'autres facteurs tels que l'âge, le statut ménopausique, l'indice de masse corporelle, et le risque de cancer du sein
Background: Volumetric mammographic density (VMD) measures can be obtained automatically, but it is not clear how these relate to breast cancer risk factors. Methods: The cohort consisted of 46 428 women (aged 49-71 years) who participated in BreastScreen Norway between 2007 and 2014 and had information on VMD and breast cancer risk factors. We estimated means of percent and absolute VMD associated with age, menopausal status, body mass index (BMI), and other factors. Results: The associations between VMD and most breast cancer risk factors were modest, although highly significant. BMI was positively associated with absolute VMD, while inversely associated with percent VMD. Percent VMD was inversely associated with a five-years older age at screening in premenopausal and postmenopausal women (-0.18% versus -0.08% for percent VMD and -0.11 cm³ versus -0.03 cm³ for absolute VMD). This difference was largest among postmenopausal women with BMI<25 kg/m² (p for interaction with percent VMD<0.0001), never users of postmenopausal hormone therapy (p for interaction<0.0001), and premenopausal women with a family history of breast cancer (p for interaction with absolute VMD=0.054). Conclusions: VMD is associated with several breast cancer risk factors, the strongest being BMI, where the direction of the association differ for percent and absolute VMD. The inverse association with age appears modified by menopausal status and other breast cancer risk factors. Impact: Since VMD methods are becoming widely available in screening and clinical settings, the association between VMD measures and breast cancer risk factors should be investigated further in longitudinal studies.