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Pubertal timing and breast density in young women: a prospective cohort study. Breast Cancer Res 2019; 21:122. [PMID: 31727127 PMCID: PMC6857297 DOI: 10.1186/s13058-019-1209-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 10/15/2019] [Indexed: 01/11/2023] Open
Abstract
Background Earlier age at onset of pubertal events and longer intervals between them (tempo) have been associated with increased breast cancer risk. It is unknown whether the timing and tempo of puberty are associated with adult breast density, which could mediate the increased risk. Methods From 1988 to 1997, girls participating in the Dietary Intervention Study in Children (DISC) were clinically assessed annually between ages 8 and 17 years for Tanner stages of breast development (thelarche) and pubic hair (pubarche), and onset of menses (menarche) was self-reported. In 2006–2008, 182 participants then aged 25–29 years had their percent dense breast volume (%DBV) measured by magnetic resonance imaging. Multivariable, linear mixed-effects regression models adjusted for reproductive factors, demographics, and body size were used to evaluate associations of age and tempo of puberty events with %DBV. Results The mean (standard deviation) and range of %DBV were 27.6 (20.5) and 0.2–86.1. Age at thelarche was negatively associated with %DBV (p trend = 0.04), while pubertal tempo between thelarche and menarche was positively associated with %DBV (p trend = 0.007). %DBV was 40% higher in women whose thelarche-to-menarche tempo was 2.9 years or longer (geometric mean (95%CI) = 21.8% (18.2–26.2%)) compared to women whose thelarche-to-menarche tempo was less than 1.6 years (geometric mean (95%CI) = 15.6% (13.9–17.5%)). Conclusions Our results suggest that a slower pubertal tempo, i.e., greater number of months between thelarche and menarche, is associated with higher percent breast density in young women. Future research should examine whether breast density mediates the association between slower tempo and increased breast cancer risk.
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Terry MB, Cohn BA, Goldberg M, Flom JD, Wei Y, Houghton LC, Tehranifar P, McDonald JA, Protacio A, Cirillo P, Michels KB. Do Birth Weight and Weight Gain During Infancy and Early Childhood Explain Variation in Mammographic Density in Women in Midlife? Results From Cohort and Sibling Analyses. Am J Epidemiol 2019; 188:294-304. [PMID: 30383202 DOI: 10.1093/aje/kwy229] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/01/2018] [Indexed: 02/06/2023] Open
Abstract
High birth weight is associated with increased breast cancer risk and, less consistently, with higher mammographic density. In contrast, adolescent body size has been consistently, negatively associated with both MD and breast cancer risk. It is unclear when the direction of these associations changes and whether weight gain in infancy is associated with MD. We evaluated the associations of birth weight and postnatal weight (measured at 4 months, 1 year, and 4 years) by absolute and velocity measures (relative within-cohort percentile changes) with adult mammographic density, assessed using a computer-assisted thresholding program (Cumulus), using linear regression models with generalized estimating equations to account for correlation between siblings in the Early Determinants of Mammographic Density study (1959-2008; n = 700 women with 116 sibling sets; mean age = 44.1 years). Birth weight was positively associated with dense area (per 1-kg increase, β = 3.36, 95% confidence interval (CI): 0.06, 6.66). Weight gains from 0 months to 4 months and 1 year to 4 years were negatively associated with dense area (for 10-unit increase in weight percentile, β = -0.65, 95% CI: -1.23, -0.07, and β = -1.07, 95% CI: -1.98, -0.16, respectively). Findings were similar in the sibling subset. These results support the hypothesis that high birth weight is positively associated with increased breast density and suggest that growth spurts starting in early infancy reduce mammographic dense area in adulthood.
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Affiliation(s)
- Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York
- Imprints Center for Genetic and Environmental Lifecourse Studies, Mailman School of Public Health, Columbia University, New York, New York
| | - Barbara A Cohn
- The Child Health and Development Studies, Public Health Institute, Berkeley, California
| | - Mandy Goldberg
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Julie D Flom
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Ying Wei
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | - Lauren C Houghton
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Parisa Tehranifar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York
| | - Jasmine A McDonald
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Angeline Protacio
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Piera Cirillo
- The Child Health and Development Studies, Public Health Institute, Berkeley, California
| | - Karin B Michels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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Denholm R, De Stavola BL, Hipwell JH, Doran SJ, Holly JMP, Folkerd E, Dowsett M, Leach MO, Hawkes DJ, Dos-Santos-Silva I. Circulating Growth and Sex Hormone Levels and Breast Tissue Composition in Young Nulliparous Women. Cancer Epidemiol Biomarkers Prev 2018; 27:1500-1508. [PMID: 30228153 DOI: 10.1158/1055-9965.epi-18-0036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 04/30/2018] [Accepted: 09/07/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Endogenous hormones are associated with breast cancer risk, but little is known about their role on breast tissue composition, a strong risk predictor. This study aims to investigate the relationship between growth and sex hormone levels and breast tissue composition in young nulliparous women. METHODS A cross-sectional study of 415 young (age ∼21.5 years) nulliparous women from an English prebirth cohort underwent a MRI examination of their breasts to estimate percent-water (a proxy for mammographic percent density) and provided a blood sample to measure plasma levels of growth factors (insulin-like growth factor-I, insulin-like growth factor-II, insulin growth factor-binding protein-3, growth hormone) and, if not on hormonal contraception (n = 117) sex hormones (dehydroepiandrosterone, androstenedione, testosterone, estrone, estadiol, sex hormone-binding globulin, prolactin). Testosterone (n = 330) and sex hormone-binding globulin (n = 318) were also measured at age 15.5 years. Regression models were used to estimate the relative difference (RD) in percent-water associated with one SD increment in hormone levels. RESULTS Estradiol at age 21.5 and sex hormone-binding globulin at age 21.5 were positively associated with body mass index (BMI)-adjusted percent-water [RD (95% confidence interval (CI)): 3% (0%-7%) and 3% (1%-5%), respectively]. There was a positive nonlinear association between androstenedione at age 21.5 and percent-water. Insulin-like growth factor-I and growth hormone at age 21.5 were also positively associated with BMI-adjusted percent-water [RD (95% CI): 2% (0%-4%) and 4% (1%-7%), respectively]. CONCLUSIONS The findings suggest that endogenous hormones affect breast tissue composition in young nulliparous women. IMPACT The well-established associations of childhood growth and development with breast cancer risk may be partly mediated by the role of endogenous hormones on breast tissue composition.
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Affiliation(s)
- Rachel Denholm
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Bianca L De Stavola
- Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - John H Hipwell
- Centre for Medical Image Computing, Department of Medical Physics and Bioengineering, UCL, London, United Kingdom
| | - Simon J Doran
- Cancer Research UK Cancer Imaging Centre, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Jeff M P Holly
- IGFs & Metabolic Endocrinology Group, School of Translational Health Sciences, Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Elizabeth Folkerd
- The Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, United Kingdom
| | - Mitch Dowsett
- The Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, United Kingdom
| | - Martin O Leach
- Cancer Research UK Cancer Imaging Centre, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - David J Hawkes
- Centre for Medical Image Computing, Department of Medical Physics and Bioengineering, UCL, London, United Kingdom
| | - Isabel Dos-Santos-Silva
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom.
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De Stavola BL, Denholm R, dos-Santos-Silva I. THREE AUTHORS REPLY. Am J Epidemiol 2018; 187:2070-2071. [PMID: 29796653 PMCID: PMC6118065 DOI: 10.1093/aje/kwy109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 05/09/2018] [Accepted: 05/10/2018] [Indexed: 01/14/2023] Open
Affiliation(s)
- Bianca L De Stavola
- Population, Practice and Policy Programme, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Rachel Denholm
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | - Isabel dos-Santos-Silva
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
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McLean KE, Stone J. Role of breast density measurement in screening for breast cancer. Climacteric 2018; 21:214-220. [DOI: 10.1080/13697137.2018.1424816] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- K. E. McLean
- Centre for Genetic Origins of Health and Disease, Curtin University and The University of Western Australia, Perth, WA, Australia
| | - J. Stone
- Centre for Genetic Origins of Health and Disease, Curtin University and The University of Western Australia, Perth, WA, Australia
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