1
|
Yaghjyan L, Wang Z, Warner ET, Rosner B, Heine J, Tamimi RM. Reproductive Factors Related to Childbearing and a Novel Automated Mammographic Measure, V. Cancer Epidemiol Biomarkers Prev 2024; 33:804-811. [PMID: 38497795 PMCID: PMC11147729 DOI: 10.1158/1055-9965.epi-23-1318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/06/2024] [Accepted: 03/13/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND We investigated the associations between several reproductive factors related to childbearing and the variation (V) measure (a novel, objective, single summary measure of breast image intensity) by menopausal status. METHODS Our study included 3,814 cancer-free women within the Nurses' Health Study (NHS) and NHSII cohorts. The data on reproductive variables and covariates were obtained from biennial questionnaires closest to the mammogram date. V-measures were obtained from mammographic images using a previously developed algorithm capturing the standard deviation of pixel values. We used multivariate linear regression to examine the associations of parity, age at first birth, time between menarche and first birth, time since last pregnancy, and lifetime breastfeeding duration with V-measure, adjusting for breast cancer risk factors, including the percentage of mammographic density (PMD). We further examined whether these associations were statistically accounted for (mediated) by PMD. RESULTS Among premenopausal women, none of the reproductive factors were associated with V. Among postmenopausal women, inverse associations of parity and positive associations of age at first birth with V were mediated by PMD (percent mediated: nulliparity: 66.7%, P < 0.0001; parity: 50.5%, P < 0.01; age at first birth 76.1%, P < 0.001) and were no longer significant in PMD-adjusted models. Lifetime duration of breastfeeding was positively associated with V [>36 vs. 0 ≤1 months β = 0.29; 95% confidence interval (CI) 0.07; 0.52, Ptrend < 0.01], independent of PMD. CONCLUSIONS Parity, age at first birth, and breastfeeding were associated with postmenopausal V. IMPACT This study highlights associations of reproductive factors with mammographic image intensity.
Collapse
Affiliation(s)
- Lusine Yaghjyan
- Department of Epidemiology, University of Florida, College of Public Health and Health Professions and College of Medicine, Gainesville, Florida
| | - Zifan Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Erica T Warner
- Harvard Medical School, Boston, Massachusetts
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Bernard Rosner
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - John Heine
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Rulla M Tamimi
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| |
Collapse
|
2
|
Barnard ME, DuPré NC, Heine JJ, Fowler EE, Murthy DJ, Nelleke RL, Chan A, Warner ET, Tamimi RM. Reproductive risk factors for breast cancer and association with novel breast density measurements among Hispanic, Black, and White women. Breast Cancer Res Treat 2024; 204:309-325. [PMID: 38095811 PMCID: PMC10948301 DOI: 10.1007/s10549-023-07174-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/02/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE There are differences in the distributions of breast cancer incidence and risk factors by race and ethnicity. Given the strong association between breast density and breast cancer, it is of interest describe racial and ethnic variation in the determinants of breast density. METHODS We characterized racial and ethnic variation in reproductive history and several measures of breast density for Hispanic (n = 286), non-Hispanic Black (n = 255), and non-Hispanic White (n = 1694) women imaged at a single hospital. We quantified associations between reproductive factors and percent volumetric density (PVD), dense volume (DV), non-dense volume (NDV), and a novel measure of pixel intensity variation (V) using multivariable-adjusted linear regression, and tested for statistical heterogeneity by race and ethnicity. RESULTS Reproductive factors most strongly associated with breast density were age at menarche, parity, and oral contraceptive use. Variation by race and ethnicity was most evident for the associations between reproductive factors and NDV (minimum p-heterogeneity:0.008) and V (minimum p-heterogeneity:0.004) and least evident for PVD (minimum p-heterogeneity:0.042) and DV (minimum p-heterogeneity:0.041). CONCLUSION Reproductive choices, particularly those related to childbearing and oral contraceptive use, may contribute to racial and ethnic variation in breast density.
Collapse
Affiliation(s)
- Mollie E Barnard
- Slone Epidemiology Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, 02118, USA.
- University of Utah Intermountain Healthcare Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
| | - Natalie C DuPré
- Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | - John J Heine
- Division of Population Sciences, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Erin E Fowler
- Division of Population Sciences, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Divya J Murthy
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Rebecca L Nelleke
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ariane Chan
- Volpara Health Technologies Ltd., Wellington, New Zealand
| | - Erica T Warner
- Clinical Translational Epidemiology Unit, Department of Medicine, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Rulla M Tamimi
- Department of Population Health Sciences, Weill Cornell Medical, New York, NY, USA
| |
Collapse
|
3
|
Getz KR, Adedokun B, Xu S, Toriola AT. Breastfeeding and Mammographic Breast Density: A Cross-sectional Study. Cancer Prev Res (Phila) 2023; 16:353-361. [PMID: 36930943 PMCID: PMC10239347 DOI: 10.1158/1940-6207.capr-22-0482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/23/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023]
Abstract
Breastfeeding is inversely associated with breast cancer risk but the associations of breastfeeding with mammographic breast density (MBD) are not clear. We investigated the association between breastfeeding and volumetric measures of MBD [volumetric percent density (VPD), dense volume (DV), and non-dense volume (NDV)] and evaluated whether it differs by race, menopausal status, and body mass index (BMI). The study population was comprised of 964 women (67% non-Hispanic White, 29% non-Hispanic Black) who had screening mammography at Washington University School of Medicine, St. Louis, MO. VPD, DV and NDV were log10 transformed. We performed multivariable linear regression models adjusted for age, BMI, family history of breast cancer, race, and age at menarche among all participants and exclusively in parous women. Mean age was 50.7 years. VPD was 12% lower among women who breastfed 0-6 months, [10β = 0.88, 95% confidence interval (CI; 0.79-0.98)] compared with nulliparous women. Breastfeeding was not associated with VPD among women who breastfed >7 months. Breastfeeding was inversely associated with DV [parous never breastfed: 10β = 0.93; 95% CI (0.83-1.04), breastfed 0-6 months: 10β = 0.91, 95% CI (0.79-1.05), breastfed 7-12 months: 10β = 0.94; 95% CI (0.81-1.10), breastfed >12 months: 10β = 0.87, 95% CI (0.78-0.98), Ptrend = 0.03]. BMI modified the association between breastfeeding and VPD. Women who breastfed for 0-6 months and had a BMI < 25 kg/m2 had lower VPD compared with nulliparous women, but among women with a BMI ≥ 25 kg/m2 there was no association (Pinteraction = 0.04). In this diverse study population, the association of breastfeeding with VPD appears to be modified by BMI, but not by race or menopausal status. Future research exploring the associations of breastfeeding with other mammographic features are needed. PREVENTION RELEVANCE Breastfeeding for up to 6 months may be associated with lower VPD among women with a BMI < 25 kg/m2. The potential role of MBD in mediating the associations of breastfeeding with breast cancer risk in a select group of women deserves further evaluation. See related Spotlight, p. 309.
Collapse
Affiliation(s)
- Kayla R. Getz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Babatunde Adedokun
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Shuai Xu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Adetunji T. Toriola
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| |
Collapse
|
4
|
Ochi T, Tsunoda H, Yamauchi H, Takahashi O. Impact of childbirth history on dense breast in mammographic screening: a cross-sectional study. BMC Womens Health 2022; 22:194. [PMID: 35619123 PMCID: PMC9137205 DOI: 10.1186/s12905-022-01772-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background The evaluation of breast density is important, because dense breast has been shown to be associated with increased risk of breast cancer and a greater risk of a false-negative diagnostic performance due to masking a tumor. Although the relationship between parity and dense breast is under investigation, conclusive evidence is lacking. We aimed to investigate whether parity affects breast density. Methods The study design is a cross-sectional study. The subjects are healthy Japanese women who underwent opportunistic mammographic screening at the center for preventive medicine at a single institution from January 2016 to December 2018. Clinical characteristics and lifestyle factors were obtained from questionnaires. Breast density was categorized into 4 groups, namely, almost entirely fatty dense, scattered fibroglandular dense, heterogeneously dense, and extremely dense, according to the Breast Imaging Reporting and Data System. Heterogeneously and extremely dense were considered collectively as dense breast. Multivariate logistic regression analysis was conducted to investigate the relationship between parity and dense breast among premenopausal and postmenopausal women separately. Results 7612 premenopausal and 9252 postmenopausal women were investigated. Dense breast was shown in 62.6% of nulliparity, 57.3% of single parity, 47.3% of two parity, 37.6% of more than two parity among premenopausal women, and in 41.6% of nulliparity, 31.1% of single parity, 19.3% of two parity, 10.1% of more than two parity among postmenopausal women. For premenopausal women, two parity, single parity and nulliparity showed a higher risk for dense breast with statistically significance (Odds Ratio (OR) adjusted for potential confounding factors: 1.458 (95% Confidence interval (CI); 1.123–1.894), 2.349 (95%CI; 1.801–3.064), 3.222 (95%CI; 2.500–4.151), respectively), compared with more than two parity. For postmenopausal women, two parity, single parity and nulliparity had a higher risk (OR: 1.849 (95%CI; 1.479–2.312), 3.023 (95%CI; 2.385–3.830), 4.954 (95%CI; 3.975–6.174), respectively) with statistically significance, compared with more than two parity. Conclusions Parity showed an inverse trend of having dense breast among both premenopausal and postmenopausal women. In particular, nulliparous women need to recognize their higher risk of dense breast. In the future, the declining fertility rate may affect the prevalence of dense breast in the world.
Collapse
Affiliation(s)
- Tomohiro Ochi
- Graduate School of Public Health, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan. .,Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan. .,Department of Breast Surgery and Oncology, Nippon Medical School Hospital, Tokyo, Japan.
| | - Hiroko Tsunoda
- Department of Radiology, St. Luke's International Hospital, Tokyo, Japan
| | - Hideko Yamauchi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Osamu Takahashi
- Graduate School of Public Health, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan.,Division of General Internal Medicine, Department of Internal Medicine, St. Luke's International Hospital, Tokyo, Japan
| |
Collapse
|
5
|
Biological Mechanisms and Therapeutic Opportunities in Mammographic Density and Breast Cancer Risk. Cancers (Basel) 2021; 13:cancers13215391. [PMID: 34771552 PMCID: PMC8582527 DOI: 10.3390/cancers13215391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 12/13/2022] Open
Abstract
Mammographic density is an important risk factor for breast cancer; women with extremely dense breasts have a four to six fold increased risk of breast cancer compared to women with mostly fatty breasts, when matched with age and body mass index. High mammographic density is characterised by high proportions of stroma, containing fibroblasts, collagen and immune cells that suggest a pro-tumour inflammatory microenvironment. However, the biological mechanisms that drive increased mammographic density and the associated increased risk of breast cancer are not yet understood. Inflammatory factors such as monocyte chemotactic protein 1, peroxidase enzymes, transforming growth factor beta, and tumour necrosis factor alpha have been implicated in breast development as well as breast cancer risk, and also influence functions of stromal fibroblasts. Here, the current knowledge and understanding of the underlying biological mechanisms that lead to high mammographic density and the associated increased risk of breast cancer are reviewed, with particular consideration to potential immune factors that may contribute to this process.
Collapse
|
6
|
Jiménez T, García-Pérez J, van der Haar R, Alba MÁ, Lucas P, Sierra MÁ, de Larrea-Baz NF, Salas-Trejo D, Llobet R, Martínez I, Pino MN, Alguacil J, González-Galarzo MC, Martínez-Cortés M, Pérez-Gómez B, Pollán M, Lope V. Occupation, occupational exposures and mammographic density in Spanish women. ENVIRONMENTAL RESEARCH 2021; 195:110816. [PMID: 33524328 DOI: 10.1016/j.envres.2021.110816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Mammographic density (MD), the proportion of radiologically dense breast tissue, is a strong risk factor for breast cancer. Our objective is to investigate the influence of occupations and occupational exposure to physical, chemical, and microbiological agents on MD in Spanish premenopausal women. METHODS This is a cross-sectional study based on 1362 premenopausal workers, aged 39-50, who attended a gynecological screening in a breast radiodiagnosis unit of Madrid City Council. The work history was compiled through a personal interview. Exposure to occupational agents was evaluated using the Spanish job-exposure matrix MatEmESp. MD percentage was assessed using the validated semi-automated computer tool DM-Scan. The association between occupation, occupational exposures, and MD was quantified using multiple linear regression models, adjusted for age, educational level, body mass index, parity, previous breast biopsies, family history of breast cancer, energy intake, use of oral contraceptives, smoking, and alcohol consumption. RESULTS Although no occupation was statistically significantly associated with MD, a borderline significant inverse association was mainly observed in orchard, greenhouse, nursery, and garden workers (β = -6.60; 95% confidence interval (95%CI) = -14.27; 1.07) and information and communication technology technicians (β = -7.27; 95%CI = -15.37; 0.84). On the contrary, a positive association was found among technicians in art galleries, museums, and libraries (β = 8.47; 95%CI = -0.65; 17.60). Women occupationally exposed to fungicides, herbicides, and insecticides tended to have lower MD. The percentage of density decreased by almost 2% for every 5 years spent in occupations exposed to the mentioned agents. CONCLUSIONS Although our findings point to a lack of association with the occupations and exposures analyzed, this study supports a deeper exploration of the role of certain occupational agents in MD, such as pesticides.
Collapse
Affiliation(s)
- Tamara Jiménez
- Department of Preventive Medicine, Public Health and Microbiology, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.
| | | | - Miguel Ángel Alba
- Área de Higiene Industrial, Quirón Prevención, S.L.U., Barcelona, Spain
| | - Pilar Lucas
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - María Ángeles Sierra
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Nerea Fernández de Larrea-Baz
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Dolores Salas-Trejo
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Valencian Breast Cancer Screening Program, General Directorate of Public Health, València, Spain; Centro Superior de Investigación en Salud Pública CSISP, FISABIO, València, Spain
| | - Rafael Llobet
- Institute of Computer Technology, Universitat Politècnica de València, València, Spain
| | - Inmaculada Martínez
- Valencian Breast Cancer Screening Program, General Directorate of Public Health, València, Spain; Centro Superior de Investigación en Salud Pública CSISP, FISABIO, València, Spain
| | - Marina Nieves Pino
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - Mª Carmen González-Galarzo
- Department of Developmental and Educational Psychology, University of Valencia, Valencia, Spain; Center for Research in Occupational Disease, Universitat Pompeu Fabra, Barcelona, Spain
| | - Mercedes Martínez-Cortés
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Virginia Lope
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| |
Collapse
|
7
|
Kanbayti IH, Rae WID, McEntee MF, Ekpo EU. Mammographic density changes following BC treatment. Clin Imaging 2021; 76:88-97. [PMID: 33578136 DOI: 10.1016/j.clinimag.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/03/2020] [Accepted: 01/04/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mammographic density (MD) reduction is associated with lower risk of breast cancer (BC) recurrence and may be used as a marker of treatment outcome; however, trends in MD following BC therapies and the factors associated with such trends are poorly understood. The aim of this study was to investigate MD changes following BC treatment and the factors associated with these changes. METHODS A total of 226 BC-affected patients who received BC treatments were examined. MD was assessed by the Laboratory for individualized Radiodensity Assessment (LIBRA) software. A Wilcoxon ranked signed test was used to investigate the differences in MD before and after treatment and median independent test to assess the associated factors. RESULTS Significant differences in MD between baseline and follow-up mammograms were observed for all MD measures: percent density (p ≤ 0.005), dense area (p ≤ 0.004), and nondense area (p ≤ 0.02). After adjustment, these differences were more pronounced among younger at BC diagnosis (p ≤ 0.001), premenopausal (p ≤ 0.003), and obese women (p ≤ 0.05). Changes in MD were evident regardless of the treatment regimen. MD reduction was observed among patients with high baseline MD (p < 0.001), younger at BC diagnosis (p ≤ 0.04), premenopausal (p < 0.001), and normal body mass index (p = 0.04). Patients who experienced an increase in nondense area had high percent density at baseline (p ≤ 0.001). CONCLUSION Two different MD changes were observed over time: MD increase and decrease. Baseline MD, menopausal status, age at BC diagnosis, and body mass index influenced these changes.
Collapse
Affiliation(s)
- Ibrahem H Kanbayti
- Diagnostic Radiography Technology Department, Faculty of Applied Medical Sciences, King Abdul-Aziz University, Saudi Arabia; Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Australia.
| | - William I D Rae
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Australia
| | - Mark F McEntee
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Australia; Department of Medicine Roinn na Sláinte, UG 12 Áras Watson, Brookfield Health Sciences |T12 AK54, Ireland
| | - Ernest U Ekpo
- Medical Image Optimisation and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Australia; Orange Radiology, Laboratories and Research Centre, Calabar, Nigeria
| |
Collapse
|
8
|
Lope V, Del Pozo MDP, Criado-Navarro I, Pérez-Gómez B, Pastor-Barriuso R, Ruiz E, Castelló A, Lucas P, Sierra Á, Salas-Trejo D, Llobet R, Martínez I, Romieu I, Chajès V, Priego-Capote F, Pollán M. Serum Phospholipid Fatty Acids and Mammographic Density in Premenopausal Women. J Nutr 2020; 150:2419-2428. [PMID: 32584993 DOI: 10.1093/jn/nxaa168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/26/2020] [Accepted: 05/19/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The role of fatty acids (FAs) on mammographic density (MD) is unclear, and available studies are based on self-reported dietary intake. OBJECTIVES This study assessed the association between specific serum phospholipid fatty acids (PLFAs) and MD in premenopausal women. METHODS The cross-sectional study DDM-Madrid recruited 1392 Spanish premenopausal women, aged 39-50 y, who attended a screening in a breast radiodiagnosis unit of Madrid City Council. Women completed lifestyle questionnaires and FFQs. Percentage MD was estimated using a validated computer tool (DM-Scan), and serum PLFA percentages were measured by GC-MS. Multivariable linear regression models were used to quantify the association of FA tertiles with MD. Models were adjusted for age, education, BMI, waist circumference, parity, oral contraceptive use, previous breast biopsies, and energy intake, and they were corrected for multiple testing. RESULTS Women in the third tertile of SFAs showed significantly higher MD compared with those in the first tertile (βT3vsT1 = 7.53; 95% CI: 5.44, 9.61). Elevated relative concentrations of palmitoleic (βT3vsT1 = 3.12; 95% CI: 0.99, 5.25) and gondoic (βT3vsT1 = 2.67; 95% CI: 0.57, 4.77) MUFAs, as well as high relative concentrations of palmitelaidic (βT3vsT1 = 5.22; 95% CI: 3.15, 7.29) and elaidic (βT3vsT1 = 2.69; 95% CI: 0.59, 4.79) trans FAs, were also associated with higher MD. On the contrary, women with elevated relative concentrations of n-6 (ω-6) linoleic (βT3vsT1 = -5.49; 95% CI; -7.62, -3.35) and arachidonic (βT3vsT1 = -4.68; 95% CI: -6.79, -2.58) PUFAs showed lower MD. Regarding desaturation indices, an elevated palmitoleic to palmitic ratio and a low ratio of oleic to steric and arachidonic to dihomo-γ-linolenic acids were associated with higher MD. CONCLUSIONS Spanish premenopausal women with high relative concentrations of most SFAs and some MUFAs and trans FAs showed an increased MD, whereas those with high relative concentrations of some n-6 PUFAs presented lower density. These results, which should be confirmed in further studies, underscore the importance of analyzing serum FAs individually.
Collapse
Affiliation(s)
- Virginia Lope
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - María Del Pilar Del Pozo
- Department of Preventive Medicine, Public Health, and Microbiology, Autonomous University of Madrid, Madrid, Spain
| | - Inmaculada Criado-Navarro
- Department of Analytical Chemistry, Annex Marie Curie Building, Campus of Rabanales, University of Cordoba, Cordoba, Spain
- Maimónides Institute of Biomedical Research, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Roberto Pastor-Barriuso
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Emma Ruiz
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Adela Castelló
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
- Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Pilar Lucas
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Ángeles Sierra
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Dolores Salas-Trejo
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
- Valencian Breast Cancer Screening Program, General Directorate of Public Health, Valencia, Spain
- Center for Public Health Research CSISP, FISABIO, Valencia, Spain
| | - Rafael Llobet
- Institute of Computer Technology, Polytechnic University of Valencia, Valencia, Spain
| | - Inmaculada Martínez
- Valencian Breast Cancer Screening Program, General Directorate of Public Health, Valencia, Spain
- Center for Public Health Research CSISP, FISABIO, Valencia, Spain
| | - Isabelle Romieu
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico
- Huber Department of Global Health, Emory University, Atlanta, GA, USA
| | - Véronique Chajès
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Feliciano Priego-Capote
- Department of Analytical Chemistry, Annex Marie Curie Building, Campus of Rabanales, University of Cordoba, Cordoba, Spain
- Maimónides Institute of Biomedical Research, Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| |
Collapse
|
9
|
Nakajima E, Iwase T, Miyagi Y, Fujita T, Ikeda N, Ishikawa T, Iwata H. Association of Parity and Infant Feeding Method with Breast Density on Mammography. Acad Radiol 2020; 27:e24-e26. [PMID: 31072765 DOI: 10.1016/j.acra.2019.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/25/2019] [Accepted: 03/25/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Mammography (MMG) is widely used for the screening and diagnosis of breast cancer. High breast density on MMG prevents breast cancer detection. In the present study, we analyzed the effects of parity and infant feeding method on mammographic breast density. MATERIALS AND METHODS Ninety women diagnosed as having breast cancer were analyzed. Using the results of medical questionnaires, subjects were grouped according to their parity and infant feeding method, into either nulliparity or parity, and formula-feeding or breastfeeding. Each group consisted of 30 consecutive women from 45 to 49 years. Nulliparous group was unaffected by either parity or breastfeeding, formula-feeding group was affected by parity but not breastfeeding, and breastfeeding group was affected by both parity and breastfeeding. Mammographic breast density was evaluated on the contralateral and cancer-free breast, and was classified into ≥ 50% dense as high breast density and < 50% dense according to the Boyd quantitative scale. The association of parity and infant feeding method with breast density on MMG was analyzed using the Fisher's exact test. RESULTS Regarding parity, high breast densities were observed in 40% and 17% of nulliparous and parous breasts, respectively. Nulliparous breasts had significantly higher density than parous breasts (p = 0.010). Regarding infant feeding method, 17% of breasts in both the formula-feeding and breastfeeding groups had high densities. Infant feeding method was not associated with mammographic breast density (p = 1.0). CONCLUSION Nulliparity is associated with higher breast density, and parity, regardless of infant feeding method, induces atrophic changes of breast tissue.
Collapse
Affiliation(s)
- Eiji Nakajima
- Department of Thoracic Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami-machi, Inashiki-gun, Ibaraki 300-0395, Japan; Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan.
| | - Takuji Iwase
- Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of Japanese Foundation For Cancer Research, Tokyo, Japan
| | - Yumi Miyagi
- Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of Japanese Foundation For Cancer Research, Tokyo, Japan
| | - Takashi Fujita
- Department of Breast Oncology, Jichi Medical University, Tochigi, Japan
| | - Norihiko Ikeda
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takashi Ishikawa
- Department of Breast Surgery, Tokyo Medical University, Tokyo, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center, Aichi, Japan
| |
Collapse
|
10
|
Tossas-Milligan K, Shalabi S, Jones V, Keely PJ, Conklin MW, Elicerie KW, Winn R, Sistrunk C, Geradts J, Miranda-Carboni G, Dietze EC, Yee LD, Seewaldt VL. Mammographic density: intersection of advocacy, science, and clinical practice. CURRENT BREAST CANCER REPORTS 2019; 11:100-110. [PMID: 33312342 PMCID: PMC7728377 DOI: 10.1007/s12609-019-00316-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Purpose Here we aim to review the association between mammographic density, collagen structure and breast cancer risk. Findings While mammographic density is a strong predictor of breast cancer risk in populations, studies by Boyd show that mammographic density does not predict breast cancer risk in individuals. Mammographic density is affected by age, parity, menopausal status, race/ethnicity, and body mass index (BMI).New studies normalize mammographic density to BMI may provide a more accurate way to compare mammographic density in women of diverse race and ethnicity. Preclinical and tissue-based studies have investigated the role collagen composition and structure in predicting breast cancer risk. There is emerging evidence that collagen structure may activate signaling pathways associated with aggressive breast cancer biology. Summary Measurement of film mammographic density does not adequately capture the complex signaling that occurs in women with at-risk collagen. New ways to measure at-risk collagen potentially can provide a more accurate view of risk.
Collapse
Affiliation(s)
| | - Sundus Shalabi
- City of Hope Comprehensive Cancer Center, Duarte, CA
- Al Quds University, Jerusalem, West Bank
| | | | | | | | | | - Robert Winn
- University of Illinois, Chicago Cancer Center, Chicago, IL
| | | | | | | | | | - Lisa D. Yee
- City of Hope Comprehensive Cancer Center, Duarte, CA
| | | |
Collapse
|
11
|
Toribio MJ, Lope V, Castelló A, Salas D, Vidal C, Ascunce N, Santamariña C, Moreo P, Pedraz-Pingarrón C, Sánchez-Contador C, Aragonés N, Pérez-Gómez B, Pollán M. Prevalence of healthy lifestyles against cancer in Spanish women. Sci Rep 2019; 9:10638. [PMID: 31337864 PMCID: PMC6650391 DOI: 10.1038/s41598-019-47180-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/11/2019] [Indexed: 01/30/2023] Open
Abstract
Modifying behavior towards healthier lifestyles could prevent a significant number of malignant tumors. We evaluated the prevalence of healthy habits against cancer in Spanish women free of this disease, taking as a reference the recommendations for cancer prevention included in the European Code Against Cancer (ECAC), and we explored the characteristics associated with it. Our population comprised 3,584 women recruited in a population-based cross-sectional study carried out in 7 breast cancer screening programs. Information was directly surveyed and used to calculate a score based on ECAC recommendations referred to bodyweight, physical activity, diet, breastfeeding, tobacco, alcohol and hormone replacement therapy use. The degree of adherence was estimated with a score that evaluated null (0 points), partial (0.5 points) and full adherence (1 point) of each specific recommendation. Associations were explored using binary and ordinal logistic regression models. The median score was 5.7 out of 9 points. Recommendations with lower adherence were those related to intake of red/processed meat and foods high in salt (23% of total adherence), physical activity (24%) and body weight (29%), and recommendations with greater adherence where those related to hormone replacement therapy use (91%), vegetable intake (84%), alcohol (83%) and tobacco (61%). Overall adherence was better among older women, parous women, and in those living in rural areas, and worse among women with higher caloric intake. These recommendations should be evaluated periodically. Screening programs can be an appropriate place to disseminate this information.
Collapse
Affiliation(s)
- María José Toribio
- Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Virginia Lope
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.
| | - Adela Castelló
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Dolores Salas
- General Directorate Public Health, and FISABIO, Valencia, Spain
| | - Carmen Vidal
- Cancer Prevention and Control Unit, Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Nieves Ascunce
- Navarra Breast cancer Screening Program, Public Health Institute, Pamplona, Spain
| | - Carmen Santamariña
- Galicia Breast Cancer Screening Program, Regional Authority of Health, Galicia Regional Government, Corunna, Spain
| | - Pilar Moreo
- Aragon Breast Cancer Screening Program, Health Service of Aragon, Zaragoza, Spain
| | - Carmen Pedraz-Pingarrón
- Castile-Leon Breast Cancer Screening Program, General Directorate Public Health SACYL, Burgos, Spain
| | - Carmen Sánchez-Contador
- Balearic Islands Breast Cancer Screening Program, Health Promotion for Women and Childhood, General Directorate Public Health and Participation, Regional Authority of Health and Consumer Affairs, Balearic Islands, Palma, Spain
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
- Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| |
Collapse
|
12
|
Lope V, Toribio MJ, Pérez-Gómez B, Castelló A, Mena-Bravo A, Sierra MÁ, Lucas P, Herrán-Vidaurrázaga MDC, González-Vizcayno C, Pino MN, Cruz-Campos I, Roca-Navarro MJ, Aragonés N, Romieu I, Martínez-Cortés M, Luque de Castro MD, Pollán M. Serum 25-hydroxyvitamin D and mammographic density in premenopausal Spanish women. J Steroid Biochem Mol Biol 2019; 189:101-107. [PMID: 30836177 DOI: 10.1016/j.jsbmb.2019.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/29/2019] [Accepted: 03/01/2019] [Indexed: 10/27/2022]
Abstract
The role of vitamin D in mammographic density is still unclear. This study examines the association between serum 25-hydroxyvitamin D (25(OH)D) and mammographic density, overall and by specific women characteristics. DDM-Madrid is a cross-sectional study that recruited 1403 premenopausal women in a breast radiodiagnosis unit of Madrid City Council. Information was collected with a questionnaire and plasma 25(OH)D was measured by solid-phase extraction on-line coupled to liquid chromatography-tandem mass spectrometry. Percent mammographic density was assessed using a semi-automated computer tool (DM-Scan). Multivariable linear regression models were used to quantify the associations, categorizing 25(OH)D levels (nmol/L) into 3 groups according to the cut-offs established by the US Endocrine Society. Models were adjusted for age, education, body mass index, age at menarche, parity, previous breast biopsies, family history of breast cancer, physical activity, energy intake, use of corticoids, hypercholesterolemia and day of sample extraction. Mean serum 25(OH)D level was 49.4 + 18.9 nmol/L. Women with sufficient concentrations of 25(OH)D showed a slight decrease in mammographic density (β >75nmol/L=-3.40; p = 0.037). No differences were observed according to women characteristics except for parity, where the protective effect of 25(OH)D was only seen among nulliparous (β >75nmol/L=-13.00; p-heterogeneity = 0.006). In light of the protective effect of vitamin D on mammographic density and the high prevalence of vitamin D insufficiency in our population, improving these levels could be an effective measure for the prevention of health problems related to the lack of this essential vitamin.
Collapse
Affiliation(s)
- Virginia Lope
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.
| | - María José Toribio
- Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Beatriz Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Adela Castelló
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Antonio Mena-Bravo
- Department of Analytical Chemistry, University of Córdoba, Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain
| | - María Ángeles Sierra
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Pilar Lucas
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | | | | | - Marina Nieves Pino
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | | | | | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health of Madrid, Spain
| | - Isabelle Romieu
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico; Hubert Department of Global Health, Emory University, Atlanta, GA, USA
| | - Mercedes Martínez-Cortés
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | - María D Luque de Castro
- Department of Analytical Chemistry, University of Córdoba, Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain
| | - Marina Pollán
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| |
Collapse
|
13
|
Okamoto T, Ito A. Association between alcohol consumption and mammographic density: a hospital-based cross-sectional study. Breast Cancer 2019; 26:478-484. [PMID: 30680689 DOI: 10.1007/s12282-019-00946-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 01/10/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mammographic density (MD), the proportion of radiological dense breast, has been reported to be a strong risk factor for breast cancer in many studies. Epidemiological evidence indicates that alcohol consumption increases the risk of breast cancer. In Western countries, a positive association between alcohol consumption and MD has been reported. METHODS To investigate the effect of alcohol consumption on MD, we conducted a cross-sectional analysis of healthy women enrolled in a breast cancer screening program at the Ebina Health Service Center, Japan, in 2012, comprising 477 premenopausal women and 308 postmenopausal women. Alcohol consumption was assessed using a self-report questionnaire. Unconditional logistic regression was applied to calculate the odds ratio (OR) and 95% confidence intervals (CI) while adjusting for confounders. RESULTS The study included 497 women with high breast density (HD group) and 288 women with low breast density (LD group). In all women, multivariate analysis revealed that the OR for HD was significantly increased among women with the highest alcohol intake (≥ 140 g/week of ethanol) compared with abstainers (OR 2.1, 95% CI 1.2-3.9 p = 0.01). The linear trend with increasing alcohol consumption was statistically significant (p = 0.009). CONCLUSION MD was positively associated with alcohol consumption in Japanese women.
Collapse
Affiliation(s)
- Takahide Okamoto
- Ebina Health Service Center, Kawaraguchi 1519, Ebina, Kanagawa, 243-0433, Japan.
| | - Akemi Ito
- Ebina Health Service Center, Kawaraguchi 1519, Ebina, Kanagawa, 243-0433, Japan
| |
Collapse
|
14
|
Xue Y, Wang J, Ding J, Zhang S, Li Q. A powerful test for ordinal trait genetic association analysis. Stat Appl Genet Mol Biol 2019; 18:/j/sagmb.ahead-of-print/sagmb-2017-0066/sagmb-2017-0066.xml. [PMID: 30685746 DOI: 10.1515/sagmb-2017-0066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Response selective sampling design is commonly adopted in genetic epidemiologic study because it can substantially reduce time cost and increase power of identifying deleterious genetic variants predispose to human complex disease comparing with prospective design. The proportional odds model (POM) can be used to fit data obtained by this design. Unlike the logistic regression model, the estimated genetic effect based on POM by taking data as being enrolled prospectively is inconsistent. So the power of resulted Wald test is not satisfactory. The modified POM is suitable to fit this type of data, however, the corresponding Wald test is not optimal when the genetic effect is small. Here, we propose a new association test to handle this issue. Simulation studies show that the proposed test can control the type I error rate correctly and is more powerful than two existing methods. Finally, we applied three tests to Anticyclic Citrullinated Protein Antibody data from Genetic Workshop 16.
Collapse
Affiliation(s)
- Yuan Xue
- School of Mathematical Sciences, University of Chinese Academy of Sciences, Beijing, China.,Key Laboratory of Big Data Mining and Knowledge Management, Chinese Academy of Sciences, Beijing, China
| | - Jinjuan Wang
- LSC, NCMIS, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing, China
| | - Juan Ding
- School of Mathematics and Statistics, Guangxi Normal University, Guilin, China
| | - Sanguo Zhang
- School of Mathematical Sciences, University of Chinese Academy of Sciences, Beijing, China.,Key Laboratory of Big Data Mining and Knowledge Management, Chinese Academy of Sciences, Beijing, China
| | - Qizhai Li
- LSC, NCMIS, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Zhongguancun East Road, 55, Beijing100190,China, Phone: +86-10-82541839
| |
Collapse
|
15
|
Gabrielson M, Chiesa F, Behmer C, Rönnow K, Czene K, Hall P. Association of reproductive history with breast tissue characteristics and receptor status in the normal breast. Breast Cancer Res Treat 2018; 170:487-497. [PMID: 29603032 PMCID: PMC6022521 DOI: 10.1007/s10549-018-4768-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/26/2018] [Indexed: 01/08/2023]
Abstract
Introduction Reproductive history has been associated with breast cancer risk, but more knowledge of the underlying biological mechanisms is needed. Because of limited data on normal breast tissue from healthy women, we examined associations of reproductive history and established breast cancer risk factors with breast tissue composition and markers of hormone receptors and proliferation in a nested study within the Karolinska Mammography project for risk prediction for breast cancer (Karma). Materials and methods Tissues from 153 women were obtained by ultrasound-guided core needle biopsy as part of the Karma project. Immunohistochemical staining was used to assessed histological composition of epithelial, stromal and adipose tissue, epithelial and stromal oestrogen receptor (ER) and progesterone receptor (PR) status, and Ki-67 proliferation status. An individualised reproductive score including parity, number of pregnancies without birth, number of births, age at first birth, and duration of breastfeeding, was calculated based on self-reported reproductive history at the time of the Karma study entry. All analyses were adjusted for age and BMI. Results Cumulated reproductive score was associated with increased total epithelial content and greater expression of epithelial ER. Parity was associated with greater epithelial area, increased epithelial–stromal ratio, greater epithelial ER expression and a lower extent of stromal proliferation. Increasing numbers of pregnancies and births were associated with a greater epithelial area in the entire study set, which remained significant among postmenopausal women. Increasing numbers of pregnancies and births were also associated with a greater expression of epithelial ER among postmenopausal women. Longer duration of breastfeeding was associated with greater epithelial area and greater expression of epithelial PR both in the entire study set and among postmenopausal women. Breastfeeding was also positively associated with greater epithelial ER expression among postmenopausal women. Prior use of oral contraceptives was associated with lower epithelial–stromal ratio amongst all participants and among pre- and postmenopausal women separately. Conclusion Reproductive risk factors significantly influence the epithelial tissue compartment and expression of hormone receptors in later life. These changes remain after menopause. This study provides deeper insights of the biological mechanisms by which reproductive history influences epithelial area and expression of hormone receptors, and as a consequence the risk of breast cancer. Electronic supplementary material The online version of this article (10.1007/s10549-018-4768-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Marike Gabrielson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, 171 77, Stockholm, Sweden.
| | - Flaminia Chiesa
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, 171 77, Stockholm, Sweden
| | - Catharina Behmer
- Department of Mammography, Unilabs, Jan Waldenströms gata 22, 205 02, Malmö, Sweden
| | - Katarina Rönnow
- Department of Mammography, Unilabs, Hospital of Helsingborg, 251 87, Helsingborg, Sweden
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, 171 77, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12A, 171 77, Stockholm, Sweden
- Department of Oncology, South General Hospital, 118 83, Stockholm, Sweden
| |
Collapse
|
16
|
García-Pérez J, Pollán M, Pérez-Gómez B, González-Sánchez M, Cortés Barragán RA, Maqueda Blasco J, González-Galarzo MC, Alba MÁ, van der Haar R, Casas S, Vicente C, Medina P, Ederra M, Santamariña C, Moreno MP, Casanova F, Pedraz-Pingarrón C, Moreo P, Ascunce N, García M, Salas-Trejo D, Sánchez-Contador C, Llobet R, Lope V. Occupation and mammographic density: A population-based study (DDM-Occup). ENVIRONMENTAL RESEARCH 2017; 159:355-361. [PMID: 28843166 DOI: 10.1016/j.envres.2017.08.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 07/21/2017] [Accepted: 08/14/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION High mammographic density is one of the main risk factors for breast cancer. Although several occupations have been associated with breast cancer, there are no previous occupational studies exploring the association with mammographic density. Our objective was to identify occupations associated with high mammographic density in Spanish female workers. METHODS We conducted a population-based cross-sectional study of occupational determinants of high mammographic density in Spain, based on 1476 women, aged 45-68 years, recruited from seven screening centers within the Spanish Breast Cancer Screening Program network. Reproductive, family, personal, and occupational history data were collected. The latest occupation of each woman was collected and coded according to the 1994 National Classification of Occupations. Mammographic density was assessed from the cranio-caudal mammogram of the left breast using a semi-automated computer-assisted tool. Association between mammographic density and occupation was evaluated by using mixed linear regression models, using log-transformed percentage of mammographic density as dependent variable. Models were adjusted for age, body mass index, menopausal status, parity, smoking, alcohol intake, educational level, type of mammography, first-degree relative with breast cancer, and hormonal replacement therapy use. Screening center and professional reader were included as random effects terms. RESULTS Mammographic density was higher, although non-statistically significant, among secondary school teachers (eβ = 1.41; 95%CI = 0.98-2.03) and nurses (eβ = 1.23; 95%CI = 0.96-1.59), whereas workers engaged in the care of people (eβ = 0.81; 95%CI = 0.66-1.00) and housewives (eβ = 0.87; 95%CI = 0.79-0.95) showed an inverse association with mammographic density. A positive trend for every 5 years working as secondary school teachers was also detected (p-value = 0.035). CONCLUSIONS Nurses and secondary school teachers were the occupations with the highest mammographic density in our study, showing the latter a positive trend with duration of employment. Future studies are necessary to confirm if these results are due to chance or are the result of a true association whose causal hypothesis is, for the moment, unknown.
Collapse
Affiliation(s)
- Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Mario González-Sánchez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain.
| | | | - Jerónimo Maqueda Blasco
- Instituto Nacional de Seguridad e Higiene en el Trabajo, Ministerio de Empleo y Seguridad Social, Madrid, Spain.
| | | | - Miguel Ángel Alba
- Área de Higiene Industrial, PREMAP Seguridad y Salud S.L.U., Barcelona, Spain.
| | | | - Silvia Casas
- Programa de Detección Precoz de Cáncer de Mama, Dirección General de Salud Pública y Participación, Palma, Spain.
| | - Cándida Vicente
- Programa de Prevención de Cáncer de Mama, Dirección General de Salud Pública, Valencia, Spain.
| | - Pilar Medina
- Programa de Prevención y Control del Cáncer, Unidad de Biomarcadores y Susceptibilidad, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain.
| | - María Ederra
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain; Navarra Breast Cancer Screening Program, Public Health Institute, Pamplona, Spain.
| | - Carmen Santamariña
- Galicia Breast Cancer Screening Program, Regional Authority of Health, Galicia Regional Government, Corunna, Spain.
| | - María Pilar Moreno
- Aragon Breast Cancer Screening Program, Aragon Health Service, Zaragoza, Spain.
| | - Francisco Casanova
- Sección de Promoción de la Salud del Servicio Territorial de Sanidad de Burgos, Dirección General de Salud Pública de la Consejería de Sanidad de Castilla y León, Burgos, Spain.
| | - Carmen Pedraz-Pingarrón
- Sección de Promoción de la Salud del Servicio Territorial de Sanidad de Burgos, Dirección General de Salud Pública de la Consejería de Sanidad de Castilla y León, Burgos, Spain.
| | - Pilar Moreo
- Aragon Breast Cancer Screening Program, Aragon Health Service, Zaragoza, Spain.
| | - Nieves Ascunce
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain; Navarra Breast Cancer Screening Program, Public Health Institute, Pamplona, Spain.
| | - Montse García
- Programa de Prevención y Control del Cáncer, Unidad de Biomarcadores y Susceptibilidad, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain.
| | - Dolores Salas-Trejo
- Programa de Prevención de Cáncer de Mama, Dirección General de Salud Pública, Valencia, Spain.
| | - Carmen Sánchez-Contador
- Programa de Detección Precoz de Cáncer de Mama, Dirección General de Salud Pública y Participación, Palma, Spain.
| | - Rafael Llobet
- Institute of Computer Technology, Universitat Politècnica de València, Valencia, Spain.
| | - Virginia Lope
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain.
| |
Collapse
|
17
|
Lope V, García-Pérez J, Pérez-Gómez B, Pedraza-Flechas AM, Alguacil J, González-Galarzo MC, Alba MA, van der Haar R, Cortés-Barragán RA, Pedraz-Pingarrón C, Moreo P, Santamariña C, Ederra M, Vidal C, Salas-Trejo D, Sánchez-Contador C, Llobet R, Pollán M. Occupational exposures and mammographic density in Spanish women. Occup Environ Med 2017; 75:124-131. [PMID: 29074552 DOI: 10.1136/oemed-2017-104580] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/20/2017] [Accepted: 09/28/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The association between occupational exposures and mammographic density (MD), a marker of breast cancer risk, has not been previously explored. Our objective was to investigate the influence of occupational exposure to chemical, physical and microbiological agents on MD in adult women. METHODS This is a population-based cross-sectional study based on 1476 female workers aged 45-65 years from seven Spanish breast cancer screening programmes. Occupational history was surveyed by trained staff. Exposure to occupational agents was assessed using the Spanish job-exposure matrix MatEmESp. Percentage of MD was measured by two radiologists using a semiautomatic computer tool. The association was estimated using mixed log-linear regression models adjusting for age, education, body mass index, menopausal status, parity, smoking, alcohol intake, type of mammography, family history of breast cancer and hormonal therapy use, and including screening centre and professional reader as random effects terms. RESULTS Although no association was found with most of the agents, women occupationally exposed to perchloroethylene (eβ=1.51; 95% CI 1.04 to 2.19), ionising radiation (eβ=1.23; 95% CI 0.99 to 1.52) and mould spores (eβ=1.44; 95% CI 1.01 to 2.04) tended to have higher MD. The percentage of density increased 12% for every 5 years exposure to perchloroethylene or mould spores, 11% for every 5 years exposure to aliphatic/alicyclic hydrocarbon solvents and 3% for each 5 years exposure to ionising radiation. CONCLUSIONS Exposure to perchloroethylene, ionising radiation, mould spores or aliphatic/alicyclic hydrocarbon solvents in occupational settings could be associated with higher MD. Further studies are needed to clarify the accuracy and the reasons for these findings.
Collapse
Affiliation(s)
- Virginia Lope
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Ana María Pedraza-Flechas
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Huelva, Spain
| | | | - Miguel Angel Alba
- Área de Higiene Industrial, PREMAP Seguridad y Salud S.L.U, Barcelona, Spain
| | | | | | | | - Pilar Moreo
- Aragon Breast Cancer Screening Program, Aragon Health Service, Zaragoza, Spain
| | - Carmen Santamariña
- Servicio de Alertas Epidemiolóxicas, Programa Galego Diagnostico Precoz Cancro de Mama, Unidade Central A Coruña, Conselleria de Sanidade, A Coruña, Spain
| | - María Ederra
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Public Health Institute, Navarra Breast Cancer Screening Programme, Pamplona, Spain
| | - Carmen Vidal
- Prevention and Control Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Dolores Salas-Trejo
- Valencia Breast Cancer Screening Program, General Directorate Public Health, Valencia, Spain
| | | | - Rafael Llobet
- Institute of Computer Technology, Universitat Politècnica de València, Valencia, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| |
Collapse
|
18
|
Hack CC, Emons J, Jud SM, Heusinger K, Adler W, Gass P, Haeberle L, Heindl F, Hein A, Schulz-Wendtland R, Uder M, Hartmann A, Beckmann MW, Fasching PA, Pöhls UG. Association between mammographic density and pregnancies relative to age and BMI: a breast cancer case-only analysis. Breast Cancer Res Treat 2017; 166:701-708. [PMID: 28828694 DOI: 10.1007/s10549-017-4446-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 08/05/2017] [Indexed: 12/29/2022]
Abstract
PURPOSE Percentage mammographic density (PMD) is a major risk factor for breast cancer (BC). It is strongly associated with body mass index (BMI) and age, which are themselves risk factors for breast cancer. This analysis investigated the association between the number of full-term pregnancies and PMD in different subgroups relative to age and BMI. METHODS Patients were identified in the breast cancer database of the University Breast Center for Franconia. A total of 2410 patients were identified, for whom information on parity, age, and BMI, and a mammogram from the time of first diagnosis were available for assessing PMD. Linear regression analyses were conducted to investigate the influence on PMD of the number of full-term pregnancies (FTPs), age, BMI, and interaction terms between them. RESULTS As in previous studies, age, number of FTPs, and BMI were found to be associated with PMD in the expected direction. However, including the respective interaction terms improved the prediction of PMD even further. Specifically, the association between PMD and the number of FTPs differed in young patients under the age of 45 (mean decrease of 0.37 PMD units per pregnancy) from the association in older age groups (mean decrease between 2.29 and 2.39 PMD units). BMI did not alter the association between PMD and the number of FTPs. CONCLUSIONS The effect of pregnancies on mammographic density does not appear to become apparent before the age of menopause. The mechanism that drives the effect of pregnancies on mammographic density appears to be counter-regulated by other influences on mammographic density in younger patients.
Collapse
Affiliation(s)
- Carolin C Hack
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen/European Metropolitan Area Nuremberg (CCC ER-EMN), Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Julius Emons
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen/European Metropolitan Area Nuremberg (CCC ER-EMN), Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Sebastian M Jud
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen/European Metropolitan Area Nuremberg (CCC ER-EMN), Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Katharina Heusinger
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen/European Metropolitan Area Nuremberg (CCC ER-EMN), Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Werner Adler
- Institute of Biometry and Epidemiology, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Paul Gass
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen/European Metropolitan Area Nuremberg (CCC ER-EMN), Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Lothar Haeberle
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen/European Metropolitan Area Nuremberg (CCC ER-EMN), Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Felix Heindl
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen/European Metropolitan Area Nuremberg (CCC ER-EMN), Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Alexander Hein
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen/European Metropolitan Area Nuremberg (CCC ER-EMN), Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | | | - Michael Uder
- Institute of Diagnostic Radiology, Erlangen University Hospital, Erlangen, Germany
| | - Arndt Hartmann
- Institute of Pathology, Erlangen University Hospital, Comprehensive Cancer Center Erlangen/European Metropolitan Area Nuremberg (CCC ER-EMN), Erlangen, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen/European Metropolitan Area Nuremberg (CCC ER-EMN), Universitätsstrasse 21-23, 91054, Erlangen, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen/European Metropolitan Area Nuremberg (CCC ER-EMN), Universitätsstrasse 21-23, 91054, Erlangen, Germany.
| | - Uwe G Pöhls
- Practice of Dr. Pöhls, Women's Health Center of Würzburg, Würzburg, Germany
| |
Collapse
|
19
|
Secco JM, Elias S, de Carvalho CV, da Silva IDCG, de Campos KJ, Facina G, Nazário ACP. Mammographic density among indigenous women in forested areas in the state of Amapá, Brazil: a cross-sectional study. SAO PAULO MED J 2017; 135:355-362. [PMID: 28767986 PMCID: PMC10016001 DOI: 10.1590/1516-3180.2016.0146150317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 03/15/2017] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE: There is no register of breast cancer cases among indigenous populations in Brazil. The objective here was to evaluate the association of clinical and demographic characteristics with mammographic density among indigenous women. DESIGN AND SETTING: Cross-sectional analytical study conducted in indigenous territories in the state of Amapá, Brazil. METHODS: Women were recruited from three indigenous territories and underwent bilateral mammography and blood collection for hormonal analysis. They were interviewed with the aid of an interpreter. Mammographic density was calculated using computer assistance, and was expressed as dense or non-dense. RESULTS: A total of 137 indigenous women were included in this study, with an average age of 50.4 years, and an average age at the menarche of 12.8 years. Half (50.3%) of the 137 participants had not reached the menopause at the time of this study. The women had had an average of 8.7 children, and only two had never breastfed. The average body mass index of the population as a whole was 25.1 kg/m2. The mammographic evaluation showed that 82% of women had non-dense breasts. The clinical characteristics associated with mammographic density were age (P = 0.0001), follicle-stimulating hormone (FSH) (P < 0.001) and estrogen levels (P < 0.01). CONCLUSIONS: The majority of the indigenous women had non-dense breasts. Age, menopausal status and FSH and estrogen levels were associated with mammographic density.
Collapse
Affiliation(s)
- José Mauro Secco
- MD, PhD. Researcher, Universidade Federal de São Paulo (Unifesp), São Paulo (SP), and Adjunct Professor, Universidade Federal do Amapá (Unifap), Amapá (AP), Brazil.
| | - Simone Elias
- MD, PhD. Researcher, Universidade Federal de São Paulo (Unifesp), São Paulo (SP), Brazil.
| | - Cristina Valletta de Carvalho
- BSc, PhD. Researcher, Universidade Federal de São Paulo (Unifesp), and Adjunct Professor, Department of Biological Sciences, Centro Universitário Fundação Santo André, and Department of Genetics, Fundação ABC, São Paulo (SP), Brazil.
| | - Ismael Dale Cotrim Guerreiro da Silva
- MD, PhD. Researcher, Universidade Federal de São Paulo (Unifesp); Adjunct Professor and Coordinator of Molecular Gynecology Laboratory, Department of Gynecology; and Coordinator of Research and Technological Innovation within Biology, Universidade Federal de São Paulo (Unifesp), São Paulo (SP), Brazil.
| | - Kátia Jung de Campos
- MD, PhD. Researcher, Universidade Federal de São Paulo (Unifesp), São Paulo (SP), and Attending Physician and Residency Coordinator, Department of Gynecology, Universidade Federal do Amapá, Amapá (AP), Brazil.
| | - Gil Facina
- MD, PhD. Full Professor, Department of Gynecology and Head of Department of Mastology, Universidade Federal de São Paulo (Unifesp), São Paulo (SP), Brazil.
| | - Afonso Celso Pinto Nazário
- MD, PhD. Researcher and Full Professor, Universidade Federal de São Paulo (Unifesp), São Paulo (SP), Brazil.
| |
Collapse
|
20
|
Pedraza-Flechas AM, Lope V, Sánchez-Contador C, Santamariña C, Pedraz-Pingarrón C, Moreo P, Ederra M, Miranda-García J, Vidal C, Llobet R, Aragonés N, Salas-Trejo D, Pollán M, Pérez-Gómez B. High Mammographic Density in Long-Term Night-Shift Workers: DDM-Spain/Var-DDM. Cancer Epidemiol Biomarkers Prev 2017; 26:905-913. [DOI: 10.1158/1055-9965.epi-16-0507] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 07/08/2016] [Accepted: 01/13/2017] [Indexed: 11/16/2022] Open
|
21
|
Lope V, Fernández de Larrea N, Pérez-Gómez B, Martín V, Moreno V, Costas L, Longo F, Jiménez-Moleón JJ, Llorca J, Ascunce N, Peiró-Pérez R, Altzibar JM, Tardón A, Alguacil J, Navarro C, Sierra Á, Vega AB, Villafañe A, Castaño-Vinyals G, Kogevinas M, Pollán M, Aragonés N. Menstrual and Reproductive Factors and Risk of Gastric and Colorectal Cancer in Spain. PLoS One 2016; 11:e0164620. [PMID: 27776142 PMCID: PMC5077095 DOI: 10.1371/journal.pone.0164620] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 09/28/2016] [Indexed: 01/13/2023] Open
Abstract
Background Sex hormones play a role in gastric cancer and colorectal cancer etiology, however, epidemiological evidence is inconsistent. This study examines the influence of menstrual and reproductive factors over the risk of both tumors. Methods In this case-control study 128 women with gastric cancer and 1293 controls, as well as 562 female and colorectal cancer cases and 1605 controls were recruited in 9 and 11 Spanish provinces, respectively. Population controls were frequency matched to cases by age and province. Demographic and reproductive data were directly surveyed by trained staff. The association with gastric, colon and rectal cancer was assessed using logistic and multinomial mixed regression models. Results Our results show an inverse association of age at first birth with gastric cancer risk (five-year trend: OR = 0.69; p-value = 0.006). Ever users of hormonal contraception presented a decreased risk of gastric (OR = 0.42; 95%CI = 0.26–0.69), colon (OR = 0.64; 95%CI = 0.48–0.86) and rectal cancer (OR = 0.61; 95%CI = 0.43–0.88). Postmenopausal women who used hormone replacement therapy showed a decreased risk of colon and rectal tumors. A significant interaction of educational level with parity and months of first child lactation was also observed. Conclusion These findings suggest a protective role of exogenous hormones in gastric and colorectal cancer risk. The role of endogenous hormones remains unclear.
Collapse
Affiliation(s)
- Virginia Lope
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid 28029, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid 28222, Spain
- * E-mail:
| | - Nerea Fernández de Larrea
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid 28029, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid 28029, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid 28222, Spain
| | - Vicente Martín
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Grupo de Investigación en Interacciones Gen-Ambiente y Salud, Universidad de León, León 24071, Spain
| | - Victor Moreno
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- IDIBELL-Catalan Institute of Oncology, L’Hospitalet de Llobregat, Barcelona 08907, Spain
- Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, L'Hospitalet del Llobregat, Barcelona 08907, Spain
| | - Laura Costas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Barcelona 08907, Spain
- Department of Medicine, University of Barcelona, L'Hospitalet del Llobregat, Barcelona 08907, Spain
| | - Federico Longo
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid 28034, Spain
| | - José Juan Jiménez-Moleón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA)-Granada Health Research Institute (ibs.GRANADA), Granada 18012, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada 18016, Spain
| | - Javier Llorca
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Universidad de Cantabria-IDIVAL, Santander 39011, Spain
| | - Nieves Ascunce
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Navarra Breast Cancer Screening Programme, Public Health Institute, Pamplona 31003, Spain
| | - Rosana Peiró-Pérez
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Cancer and Public Health Area, Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia 46020, Spain
| | - Jone M. Altzibar
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Public Health Division of Gipuzkoa, Donostia 20013, San Sebastián, Spain
- Biodonostia Research Institute, Donostia 20014, San Sebastián, Spain
| | - Adonina Tardón
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Instituto Universitario de Oncología, Universidad de Oviedo, Oviedo 33006, Asturias, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Huelva 21071, Spain
| | - Carmen Navarro
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia 30008, Spain
- Department of Health and Social Sciences. Universidad de Murcia, Murcia 30003, Spain
| | - Ángeles Sierra
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid 28029, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid 28222, Spain
| | - Ana Belén Vega
- Gastroenterology, Hospital de Viladecans, Viladecans, Barcelona 08840, Spain
| | - Amaya Villafañe
- Servicio de Cirugía, Complejo Asistencial Universitario de León, León 24071, Spain
| | - Gemma Castaño-Vinyals
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona 08003, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain
- Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain
| | - Manolis Kogevinas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona 08003, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain
- Universitat Pompeu Fabra (UPF), Barcelona 08003, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid 28029, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid 28222, Spain
| | - Nuria Aragonés
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid 28029, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública, CIBERESP), Madrid 28029, Spain
- Cancer Epidemiology Research Group, Oncology and Hematology Area, IIS Puerta de Hierro (IDIPHIM), Madrid 28222, Spain
| |
Collapse
|
22
|
Reproducibility of data-driven dietary patterns in two groups of adult Spanish women from different studies. Br J Nutr 2016; 116:734-42. [PMID: 27374250 DOI: 10.1017/s000711451600252x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The objective of the present study was to assess the reproducibility of data-driven dietary patterns in different samples extracted from similar populations. Dietary patterns were extracted by applying principal component analyses to the dietary information collected from a sample of 3550 women recruited from seven screening centres belonging to the Spanish breast cancer (BC) screening network (Determinants of Mammographic Density in Spain (DDM-Spain) study). The resulting patterns were compared with three dietary patterns obtained from a previous Spanish case-control study on female BC (Epidemiological study of the Spanish group for breast cancer research (GEICAM: grupo Español de investigación en cáncer de mama)) using the dietary intake data of 973 healthy participants. The level of agreement between patterns was determined using both the congruence coefficient (CC) between the pattern loadings (considering patterns with a CC≥0·85 as fairly similar) and the linear correlation between patterns scores (considering as fairly similar those patterns with a statistically significant correlation). The conclusions reached with both methods were compared. This is the first study exploring the reproducibility of data-driven patterns from two studies and the first using the CC to determine pattern similarity. We were able to reproduce the EpiGEICAM Western pattern in the DDM-Spain sample (CC=0·90). However, the reproducibility of the Prudent (CC=0·76) and Mediterranean (CC=0·77) patterns was not as good. The linear correlation between pattern scores was statistically significant in all cases, highlighting its arbitrariness for determining pattern similarity. We conclude that the reproducibility of widely prevalent dietary patterns is better than the reproducibility of more population-specific patterns. More methodological studies are needed to establish an objective measurement and threshold to determine pattern similarity.
Collapse
|
23
|
Zhang W, Li Q. Incorporating Hardy-Weinberg Equilibrium Law to Enhance the Association Strength for Ordinal Trait Genetic Study. Ann Hum Genet 2015; 80:102-12. [DOI: 10.1111/ahg.12142] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 10/21/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Wei Zhang
- Key Lab of Systems and Control; Academy of Mathematics and Systems Science; CAS; Beijing China
| | - Qizhai Li
- Key Lab of Systems and Control; Academy of Mathematics and Systems Science; CAS; Beijing China
| |
Collapse
|
24
|
Shawky MS, Ricciardelli C, Lord M, Whitelock J, Ferro V, Britt K, Thompson EW. Proteoglycans: Potential Agents in Mammographic Density and the Associated Breast Cancer Risk. J Mammary Gland Biol Neoplasia 2015; 20:121-31. [PMID: 26501889 DOI: 10.1007/s10911-015-9346-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 10/16/2015] [Indexed: 12/28/2022] Open
Abstract
Although increased mammographic density (MD) has been well established as a marker for increased breast cancer (BC) risk, its pathobiology is far from understood. Altered proteoglycan (PG) composition may underpin the physical properties of MD, and may contribute to the associated increase in BC risk. Numerous studies have investigated PGs, which are a major stromal matrix component, in relation to MD and BC and reported results that are sometimes discordant. Our review summarises these results and highlights discrepancies between PG associations with BC and MD, thus serving as a guide for identifying PGs that warrant further research towards developing chemo-preventive or therapeutic agents targeting preinvasive or invasive breast lesions, respectively.
Collapse
|
25
|
Abstract
Introduction Mammographic density (MD) is considered a strong predictor of Breast Cancer (BC). The objective of the present study is to explore the association between MD and the compliance with the World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR) recommendations for cancer prevention. Methods Data of 3584 women attending screening from a population-based multicenter cross-sectional study (DDM-Spain) collected from October 7, 2007 through July 14, 2008, was used to calculate a score that measures the level of compliance with the WCRF/AICR recommendations: R1)Maintain adequate body weight; R2)Be physically active; 3R)Limit the intake of high density foods; R4)Eat mostly plant foods; R5)Limit the intake of animal foods; R6)Limit alcohol intake; R7)Limit salt and salt preserved food intake; R8)Meet nutritional needs through diet. The association between the score and MD (assessed by a single radiologist using a semi-quantitative scale) was evaluated using ordinal logistic models with random center-specific intercepts adjusted for the main determinants of MD. Stratified analyses by menopausal status and smoking status were also carried out. Results A higher compliance with the WCRF/AICR recommendations was associated with lower MD (OR1-unit increase = 0.93 95%CI:0.86;0.99). The association was stronger in postmenopausal women (OR = 0.91 95%CI:0.84;0.99) and nonsmokers (OR = 0.87;95%CI:0.80;0.96 for nonsmokers, OR = 1.01 95%CI:0.91;1.12 for smokers, P-interaction = 0.042). Among nonsmokers, maintaining adequate body weight (OR = 0.81 95%CI:0.65;1.01), practicing physical activity (OR = 0.68 95%CI:0.48;0.96) and moderating the intake of high-density foods (OR = 0.58 95%CI:0.40;0.86) and alcoholic beverages (OR = 0.76 95%CI:0.55;1.05) were the recommendations showing the strongest associations with MD. Conclusions postmenopausal women and non-smokers with greater compliance with the WCRF/AICR guidelines have lower MD. These results may provide guidance to design specific recommendations for screening attendants with high MD and therefore at higher risk of developing BC.
Collapse
|
26
|
First Pregnancy Characteristics, Postmenopausal Breast Density, and Salivary Sex Hormone Levels in a Population at High Risk for Breast Cancer. BBA CLINICAL 2015; 3:189-195. [PMID: 26317068 PMCID: PMC4547694 DOI: 10.1016/j.bbacli.2015.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND It remains unknown if later life breast cancer risk as determined by reproductive history is mediated by postmenopausal breast density and/or sex steroid levels. METHODS Increased breast density is a strong surrogate for future breast cancer risk. A cross-sectional study with a longitudinal follow up for breast health outcomes evaluated women without breast cancer (n = 1,023; 682 = parous), drawn from a high risk postmenopausal population, with questionnaire reported reproductive histories. The questionnaire was linked to prospective screening mammogram breast density measurements, and saliva biospecimens that were used to assess sex steroid hormone levels. RESULTS Expected age and postmenopause related declines in salivary estradiol (E), progesterone (P), dehydroepiandrosterone (DHEA) and testosterone (T) levels were observed. This was most pronounced for DHEA and T, which were also the only postmenopausal hormone levels significantly associated with any reproductive characteristics: parity and breast feeding for DHEA, age-at-first birth for T. Postmenopausal breast density was borderline significantly lower with parity and higher body mass index (BMI). After multivariate analysis, T was the only hormone level to retain any association (negative, p<0.05) with breast density. CONCLUSIONS AND GENERAL SIGNIFICANCE While reproductive characteristics, in particular parity, generally demonstrated independent associations with postmenopausal breast density and E, P and DHEA levels, T levels showed concordant inverse associations with age-at-first birth and breast density. These findings suggest that reproductive effects and later life salivary sex steroid hormone levels may have independent effects on later life breast density and cancer risk.
Collapse
|
27
|
Peiró-Pérez R, Salas D, Vallés G, Abad-Fernandez MS, Vidal C, Sanchez-Contador Escudero C, Ascunce-Elizaga N, Zubizarreta R, Pedraz C, Pérez-Gómez B, Navarrete-Muñoz EM, Vioque J, Pollán M. Walking, biking or sport: how Spanish women attending breast cancer screening meet physical activity recommendations? Eur J Public Health 2015; 25:857-63. [PMID: 25767095 DOI: 10.1093/eurpub/cku248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The aim is to analyse physical activity (PA), the fulfillment recommendation of at least 150 min of moderate PA, through walking/biking (W&B), sport, both types of PA and the factors associated with inactivity by Spanish women who attended breast cancer screening programmes. METHODS The DDM-Spain is a multicentre cross-sectional study involving 3584 women, aged 45-68, attending screening in seven Spanish cities. Data were collected using a questionnaire, including age, socio-demographic and lifestyle characteristics, family burden and PA. PA was converted into metabolic equivalent of task (METs), categorized as low ≤ 600 METs min per week (m/w), moderate 600-3000 METs m/w and high ≥ 3000 METs m/w. A multivariate logistic regression was performed to identify variables associated with inactivity for each type of PA. RESULTS No women achieved a high level of PA through sport. 79.2% achieved a high or moderate level of PA by W&B. Lack of sport was associated with being overweight (odds ratio OR = 1.31; 95% confidence interval CI: 1.06 to 1.62), body mass index (BMI) ≥ 30 (OR = 1.85; 95% CI: 1.44 to 2.38), smoking (OR = 1.56; 95% CI: 1.22 to 2.00) and living with a disabled person (OR = 1.64; 95% CI: 1.0 to 2.81), whereas enough sport practice was associated with higher educational or socio-economic level (SEL). Regarding W&B, inactivity was associated with BMI ≥ 30 (OR = 1.91; 95% CI: 1.49 to 2.45) and living with someone >74 (OR = 1.96; 95% CI: 1.48 to 2.58). Inactivity for both types of exercise was associated with a BMI ≥ 30 (OR = 2.13; 95% CI: 1.63 to 2.8), smoking (OR = 1.41; 95% CI: 1.09 to 1.81) and living with someone >74 (OR = 1.69; 95% CI: 1.24 to 2.28). CONCLUSIONS Family burden and BMI ≥ 30 are inversely associated with both types of PA. W&B is the most common type of PA regardless of educational and SEL.
Collapse
Affiliation(s)
- Rosana Peiró-Pérez
- 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain 2 CIBER Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain 3 Breast Cancer Screening Programme, Valencian Public Health Directorate, Valencia, Spain
| | - Dolores Salas
- 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain 3 Breast Cancer Screening Programme, Valencian Public Health Directorate, Valencia, Spain
| | - Guillermo Vallés
- 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain
| | | | - Carmen Vidal
- 5 Cancer Prevention and Control Unit, Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Carmen Sanchez-Contador Escudero
- 6 Balearic Islands Breast Cancer Screening Programme, General Directorate Public Health and Consumer Affairs, Balearic Islands, Spain
| | - Nieves Ascunce-Elizaga
- 2 CIBER Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain
| | - Raquel Zubizarreta
- 8 Galicia Breast Cancer Screening Programme, Regional Authority of Health, Galicia Regional Government, A Coruna, Spain
| | - Carmen Pedraz
- 9 Castilla-Leon Breast Cancer Screening Programme, General Directorate Public Health, Burgos, Spain
| | - Beatriz Pérez-Gómez
- 2 CIBER Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain 11 Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Eva María Navarrete-Muñoz
- 2 CIBER Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain
| | - Jesús Vioque
- 2 CIBER Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain
| | - Marina Pollán
- 2 CIBER Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain 11 Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | | |
Collapse
|
28
|
Fernandez-Navarro P, González-Neira A, Pita G, Díaz-Uriarte R, Tais Moreno L, Ederra M, Pedraz-Pingarrón C, Sánchez-Contador C, Vázquez-Carrete JA, Moreo P, Vidal C, Salas-Trejo D, Stone J, Southey MC, Hopper JL, Pérez-Gómez B, Benitez J, Pollan M. Genome wide association study identifies a novel putative mammographic density locus at 1q12-q21. Int J Cancer 2014; 136:2427-36. [PMID: 25353672 DOI: 10.1002/ijc.29299] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 10/16/2014] [Indexed: 01/26/2023]
Abstract
Mammographic density (MD) is an intermediate phenotype for breast cancer. Previous studies have identified genetic variants associated with MD; however, much of the genetic contribution to MD is unexplained. We conducted a two-stage genome-wide association analysis among the participants in the "Determinants of Density in Mammographies in Spain" study, together with a replication analysis in women from the Australian MD Twins and Sisters Study. Our discovery set covered a total of 3,351 Caucasian women aged 45 to 68 years, recruited from Spanish breast cancer screening centres. MD was blindly assessed by a single reader using Boyd's scale. A two-stage approach was employed, including a feature selection phase exploring 575,374 SNPs in 239 pairs of women with extreme phenotypes and a verification stage for the 183 selected SNPs in the remaining sample (2,873 women). Replication was conducted in 1,786 women aged 40 to 70 years old recruited via the Australian Twin Registry, where MD were measured using Cumulus-3.0, assessing 14 SNPs with a p value <0.10 in stage 2. Finally, two genetic variants in high linkage disequilibrium with our best hit were studied using the whole Spanish sample. Evidence of association with MD was found for variant rs11205277 (OR = 0.74; 95% CI = 0.67-0.81; p = 1.33 × 10(-10) ). In replication analysis, only a marginal association between this SNP and absolute dense area was found. There were also evidence of association between MD and SNPs in high linkage disequilibrium with rs11205277, rs11205303 in gene MTMR11 (OR = 0.73; 95% CI = 0.66-0.80; p = 2.64 × 10(-11) ) and rs67807996 in gene OTUD7B (OR = 0.72; 95% CI = 0.66-0.80; p = 2.03 × 10(-11)). Our findings provide additional evidence on common genetic variations that may contribute to MD.
Collapse
Affiliation(s)
- Pablo Fernandez-Navarro
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Jones JA, Hartman TJ, Klifa CS, Coffman DL, Mitchell DC, Vernarelli JA, Snetselaar LG, Van Horn L, Stevens VJ, Robson AM, Himes JH, Shepherd JA, Dorgan JF. Dietary energy density is positively associated with breast density among young women. J Acad Nutr Diet 2014; 115:353-359. [PMID: 25300225 DOI: 10.1016/j.jand.2014.08.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 08/06/2014] [Indexed: 01/30/2023]
Abstract
BACKGROUND Breast density is an established predictor of breast cancer risk, and there is considerable interest in associations of modifiable lifestyle factors, such as diet, with breast density. OBJECTIVE To determine whether dietary energy density (ED) is associated with percent dense breast volume (%DBV) and absolute dense breast volume (ADBV) in young women. DESIGN A cross-sectional analysis was conducted with women who participated in the Dietary Intervention Study in Children Follow-Up Study. %DBV and ADBV were measured by magnetic resonance imaging. Diet was assessed by three 24-hour recalls. Dietary ED (kilocalories/gram) was calculated using three methods: food only, food and caloric beverages, and food and all beverages. PARTICIPANTS/SETTING One hundred seventy-two women (aged 25 to 29 years) who were enrolled in the Dietary Intervention Study in Children Follow-Up Study. Participants who reported breast augmentation or reduction surgery or were pregnant or lactating within 3 months before breast density assessment were excluded. MAIN OUTCOME MEASURES ADBV and %DBV. STATISTICAL ANALYSES PERFORMED Multivariable linear mixed effects models were used. Final models were adjusted for race, smoking status, education, parity, duration of sex hormone use, whole body percent fat, childhood body mass index z score, and energy from beverages. RESULTS After adjustment, each 1 kcal/g unit increase in food-only ED was associated with a 25.9% (95% CI 6.2% to 56.8%) increase in %DBV (P=0.01). Childhood body mass index z score modified the association between food-only ED and %DBV such that a significant positive association was observed only in women who were heavier as children. Food-only ED was not associated with ADBV in all women, but a borderline significant positive association was observed in women who had higher childhood body mass index z scores. CONCLUSIONS This is the first report to suggest a potential role for dietary ED in breast density; the effects of long-term exposure to high-ED diets on breast cancer risk remain unknown.
Collapse
|
30
|
First pregnancy events and future breast density: modification by age at first pregnancy and specific VEGF and IGF1R gene variants. Cancer Causes Control 2014; 25:859-68. [PMID: 24801045 PMCID: PMC4048469 DOI: 10.1007/s10552-014-0386-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 04/12/2014] [Indexed: 12/29/2022]
Abstract
Purpose
Pregnancy characteristics have been associated with breast cancer risk, but information is limited on their relationship with breast density. Our objective was to examine the relationship between first pregnancy characteristics and later life breast density, and whether the association is modified by genotype. Methods
The Marin Women’s Study was initiated to examine breast cancer in a high-incidence mammography population (Marin County, CA). Reproductive characteristics and pregnancy information including pregnancy-induced hypertension (PIH) were self-reported at the time of mammography. Forty-seven candidate single nucleotide polymorphisms were obtained from saliva samples; seven were assessed in relation to PIH and percent fibroglandular volume (%FGV). Breast density assessed as %FGV was measured on full-field digital mammograms by the San Francisco Mammography Registry. Results A multivariable regression model including 2,440 parous women showed that PIH during first pregnancy was associated with a statistically significant decrease in %FGV (b = −0.31, 95 % CI −0.52, −0.11), while each month of breast-feeding after first birth was associated with a statistically significant increase in %FGV (b = 0.01, 95 % CI 0.003, 0.02). PIH and breast-feeding associations with %FGV were modified by age at first birth. In a subsample of 1,240 women, there was evidence of modification in the association between PIH and %FGV by specific vascular endothelial growth factor (VEGF) (rs3025039) and insulin growth factor receptor-1 (IGFR1) (rs2016347) gene variants. Conclusion These findings suggest that first pregnancy characteristics may exert an influence on extent of breast density later in life and that this influence may vary depending on inherited IGFR1 and VEGF genotypes. Electronic supplementary material The online version of this article (doi:10.1007/s10552-014-0386-2) contains supplementary material, which is available to authorized users.
Collapse
|
31
|
García-Arenzana N, Navarrete-Muñoz EM, Lope V, Moreo P, Vidal C, Laso-Pablos S, Ascunce N, Casanova-Gómez F, Sánchez-Contador C, Santamariña C, Aragonés N, Pérez Gómez B, Vioque J, Pollán M. Calorie intake, olive oil consumption and mammographic density among Spanish women. Int J Cancer 2013; 134:1916-25. [PMID: 24254818 PMCID: PMC4166692 DOI: 10.1002/ijc.28513] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 09/16/2013] [Accepted: 09/19/2013] [Indexed: 01/08/2023]
Abstract
High mammographic density (MD) is one of the main risk factors for development of breast cancer. To date, however, relatively few studies have evaluated the association between MD and diet. In this cross-sectional study, we assessed the association between MD (measured using Boyd's semiquantitative scale with five categories: <10%, 10–25%, 25–50%, 50–75% and >75%) and diet (measured using a food frequency questionnaire validated in a Spanish population) among 3,548 peri- and postmenopausal women drawn from seven breast cancer screening programs in Spain. Multivariate ordinal logistic regression models, adjusted for age, body mass index (BMI), energy intake and protein consumption as well as other confounders, showed an association between greater calorie intake and greater MD [odds ratio (OR) = 1.23; 95% confidence interval (CI) = 1.10-1.38, for every increase of 500 cal/day], yet high consumption of olive oil was nevertheless found to reduce the prevalence of high MD (OR = 0.86;95% CI = 0.76-0.96, for every increase of 22 g/day in olive oil consumption); and, while greater intake of whole milk was likewise associated with higher MD (OR = 1.10; 95%CI 1.00-1.20, for every increase of 200 g/day), higher consumption of protein (OR = 0.89; 95% CI 0.80-1.00, for every increase of 30 g/day) and white meat (p for trend 0.041) was found to be inversely associated with MD. Our study, the largest to date to assess the association between diet and MD, suggests that MD is associated with modifiable dietary factors, such as calorie intake and olive oil consumption. These foods could thus modulate the prevalence of high MD, and important risk marker for breast cancer.
Collapse
Affiliation(s)
- Nicolás García-Arenzana
- National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Preventive Medicine Unit. Hospital Infanta Leonor, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Diet across the Lifespan and the Association with Breast Density in Adulthood. Int J Breast Cancer 2013; 2013:808317. [PMID: 23431461 PMCID: PMC3574651 DOI: 10.1155/2013/808317] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 11/30/2012] [Indexed: 02/01/2023] Open
Abstract
Studies have shown inconsistent results regarding the association between dietary factors across the lifespan and breast density and breast cancer in women. Breast density is a strong risk factor for breast cancer, and the mechanism through which it influences cancer risk remains unclear. Breast density has been shown to be modifiable, potentially through dietary modifications. The goal of this paper is to summarize the current studies on diet and diet-related factors across all ages, determine which dietary factors show the strongest association with breast density, the most critical age of exposure, and identify future directions. We identified 28 studies, many of which are cross-sectional, and found that the strongest associations are among vitamin D, calcium, dietary fat, and alcohol in premenopausal women. Longitudinal studies with repeated dietary measures as well as the examination of overall diet over time are needed to confirm these findings.
Collapse
|
33
|
Pollán M, Ascunce N, Ederra M, Murillo A, Erdozáin N, Alés-Martínez JE, Pastor-Barriuso R. Mammographic density and risk of breast cancer according to tumor characteristics and mode of detection: a Spanish population-based case-control study. Breast Cancer Res 2013; 15:R9. [PMID: 23360535 PMCID: PMC3672793 DOI: 10.1186/bcr3380] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 12/03/2012] [Accepted: 01/24/2013] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION It is not clear whether high mammographic density (MD) is equally associated with all subtypes of breast cancer (BC). We investigated the association between MD and subsequent BC, considering invasiveness, means of detection, pathologic subtype, and the time elapsed since mammographic exploration and BC diagnosis. METHODS BC cases occurring in the population of women who attended screening from 1997 through 2004 in Navarre, a Spanish region with a fully consolidated screening program, were identified via record linkage with the Navarre Cancer Registry (n = 1,172). Information was extracted from the records of their first attendance at screening in that period. For each case, we randomly selected four controls, matched by screening round, year of birth, and place of residence. Cases were classified according to invasiveness (ductal carcinoma in situ (DCIS) versus invasive tumors), pathologic subtype (considering hormonal receptors and HER2), and type of diagnosis (screen-detected versus interval cases). MD was evaluated by a single, experienced radiologist by using a semiquantitative scale. Data on BC risk factors were obtained by the screening program in the corresponding round. The association between MD and tumor subtype was assessed by using conditional logistic regression. RESULTS MD was clearly associated with subsequent BC. The odds ratio (OR) for the highest MD category (MD >75%) compared with the reference category (MD <10%) was similar for DCIS (OR = 3.47; 95% CI = 1.46 to 8.27) and invasive tumors (OR = 2.95; 95% CI = 2.01 to 4.35). The excess risk was particularly high for interval cases (OR = 7.72; 95% CI = 4.02 to 14.81) in comparison with screened detected tumors (OR = 2.17; 95% CI = 1.40 to 3.36). Sensitivity analyses excluding interval cases diagnosed in the first year after MD assessment or immediately after an early recall to screening yielded similar results. No differences were seen regarding pathologic subtypes. The excess risk associated with MD persisted for at least 7 to 8 years after mammographic exploration. CONCLUSIONS Our results confirm that MD is an important risk factor for all types of breast cancer. High breast density strongly increases the risk of developing an interval tumor, and this excess risk is not completely explained by a possible masking effect.
Collapse
Affiliation(s)
- Marina Pollán
- National Center for Epidemiology, Carlos III Institute of Health, Monforte de Lemos 5, Madrid, 28029 Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Carlos III Institute of Health, Monforte de Lemos 5, Madrid, 28029, Spain
| | - Nieves Ascunce
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Carlos III Institute of Health, Monforte de Lemos 5, Madrid, 28029, Spain
- Navarre Breast cancer Screening Program, Navarre Institute of Public Health, Leyre 15, Pamplona, 31003, Spain
| | - María Ederra
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Carlos III Institute of Health, Monforte de Lemos 5, Madrid, 28029, Spain
- Navarre Breast cancer Screening Program, Navarre Institute of Public Health, Leyre 15, Pamplona, 31003, Spain
| | - Alberto Murillo
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Carlos III Institute of Health, Monforte de Lemos 5, Madrid, 28029, Spain
- Navarre Breast cancer Screening Program, Navarre Institute of Public Health, Leyre 15, Pamplona, 31003, Spain
| | - Nieves Erdozáin
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Carlos III Institute of Health, Monforte de Lemos 5, Madrid, 28029, Spain
- Navarre Breast cancer Screening Program, Navarre Institute of Public Health, Leyre 15, Pamplona, 31003, Spain
| | - Jose Enrique Alés-Martínez
- Medical Oncology Unit, Nuestra Señora de Sonsoles Hospital, Avenida Juan Carlos I s/n, Avila, 05004, Spain
| | - Roberto Pastor-Barriuso
- National Center for Epidemiology, Carlos III Institute of Health, Monforte de Lemos 5, Madrid, 28029 Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Carlos III Institute of Health, Monforte de Lemos 5, Madrid, 28029, Spain
| |
Collapse
|
34
|
Association analysis between breast cancer genetic variants and mammographic density in a large population-based study (Determinants of Density in Mammographies in Spain) identifies susceptibility loci in TOX3 gene. Eur J Cancer 2012; 49:474-81. [PMID: 23021931 DOI: 10.1016/j.ejca.2012.08.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 08/24/2012] [Accepted: 08/26/2012] [Indexed: 01/11/2023]
Abstract
BACKGROUND Mammographic density (MD) is regarded as an intermediate phenotype in breast cancer development. This association study investigated the influence of 14 breast cancer susceptibility loci identified through previous genome-wide association studies on MD among the participants in the "Determinants of Density in Mammographies in Spain" (DDM-Spain) study. METHODS Our study covered a total of 3348 Caucasian women aged 45-68years, recruited from seven Spanish breast cancer screening centres having DNA available. Mammographic density was blindly assessed by a single reader using a semiquantitative scale. Ordinal logistic models, adjusted for age, body mass index and menopausal status, were used to estimate the association between each genotype and MD. RESULTS Evidence of association with MD was found for variant rs3803662 (TOX3) (Odds Ratio (OR)=1.13, 95% Confidence Interval (CI)=1.03-1.25), and marginal evidence of association for susceptibility loci rs3817198 (LSP1) (OR=1.09, 95% CI=1.00-1.20) and rs2981582 (FGFR2) (OR=0.92, 95% CI=0.84-1.01). Two other loci were associated with MD solely among pre-menopausal women, namely, rs4973768 (SLC4A7) (OR=0.83, 95% CI=0.70-1.00) and rs4415084 (MEPS30) (OR=1.22, 95% CI=1.00-1.49). CONCLUSIONS Our findings lend some support to the hypothesis which links these susceptibility loci to MD.
Collapse
|
35
|
Pollán M, Lope V, Miranda-García J, García M, Casanova F, Sánchez-Contador C, Santamariña C, Moreo P, Vidal C, Peris M, Moreno MP, Vázquez-Carrete JA, Collado F, Pedraz-Pingarrón C, Ascunce N, Salas-Trejo D, Aragonés N, Pérez-Gómez B, Ruiz-Perales F. Adult weight gain, fat distribution and mammographic density in Spanish pre- and post-menopausal women (DDM-Spain). Breast Cancer Res Treat 2012; 134:823-38. [PMID: 22689088 PMCID: PMC3401511 DOI: 10.1007/s10549-012-2108-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 05/19/2012] [Indexed: 02/04/2023]
Abstract
High mammographic density (MD) is a phenotype risk marker for breast cancer. Body mass index (BMI) is inversely associated with MD, with the breast being a fat storage site. We investigated the influence of abdominal fat distribution and adult weight gain on MD, taking age, BMI and other confounders into account. Because visceral adiposity and BMI are associated with breast cancer only after menopause, differences in pre- and post-menopausal women were also explored. We recruited 3,584 women aged 45–68 years within the Spanish breast cancer screening network. Demographic, reproductive, family and personal history data were collected by purpose-trained staff, who measured current weight, height, waist and hip circumferences under the same protocol and with the same tools. MD was assessed in the left craniocaudal view using Boyd’s Semiquantitative Scale. Association between waist-to-hip ratio, adult weight gain (difference between current weight and self-reported weight at 18 years) and MD was quantified by ordinal logistic regression, with random center-specific intercepts. Models were adjusted for age, BMI, breast size, time since menopause, parity, family history of breast cancer and hormonal replacement therapy use. Natural splines were used to describe the shape of the relationship between these two variables and MD. Waist-to-hip ratio was inversely associated with MD, and the effect was more pronounced in pre-menopausal (OR = 0.53 per 0.1 units; 95 % CI = 0.42–0.66) than in post-menopausal women (OR = 0.73; 95 % CI = 0.65–0.82) (P of heterogeneity = 0.010). In contrast, adult weight gain displayed a positive association with MD, which was similar in both groups (OR = 1.17 per 6 kg; 95 % CI = 1.11–1.23). Women who had gained more than 24 kg displayed higher MD (OR = 2.05; 95 % CI = 1.53–2.73). MD was also evaluated using Wolfe’s and Tabár’s classifications, with similar results being obtained. Once BMI, fat distribution and other confounders were considered, our results showed a clear dose–response gradient between the number of kg gained during adulthood and the proportion of dense tissue in the breast.
Collapse
Affiliation(s)
- Marina Pollán
- Cancer Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Monforte de Lemos 5, 28029 Madrid, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|