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Bai S, Song D, Chen M, Lai X, Xu J, Dong F. The association between mammographic density and breast cancer risk in Chinese women: a systematic review and meta-analysis. BMC Womens Health 2024; 24:131. [PMID: 38378562 PMCID: PMC10877813 DOI: 10.1186/s12905-024-02960-0] [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: 11/13/2023] [Accepted: 02/08/2024] [Indexed: 02/22/2024] Open
Abstract
PURPOSE Breast density has consistently been shown to be an independent risk factor for breast cancer in Western populations; however, few studies have evaluated this topic in Chinese women and there is not yet a unified view. This study investigated the association between mammographic density (MD) and breast cancer risk in Chinese women. METHODS The PubMed, Cochrane Library, Embase, and Wanfang databases were systematically searched in June 2023 to include all studies on the association between MD and breast cancer risk in Chinese women. A total of 13,977 breast cancer cases from 14 studies were chosen, including 10 case-control/cross-sectional studies, and 4 case-only studies. For case-control/cross-sectional studies, the odds ratios (ORs) of MD were combined using random effects models, and for case-only studies, relative odds ratios (RORs) were combinations of premenopausal versus postmenopausal breast cancer cases. RESULTS Women with BI-RADS density category II-IV in case-control/cross-sectional studies had a 0.93-fold (95% confidence interval [CI] 0.55, 1.57), 1.08-fold (95% CI 0.40, 2.94), and 1.24-fold (95% CI 0.42, 3.69) higher risk compared to women with the lowest density category. Combined RORs for premenopausal versus postmenopausal women in case-only studies were 3.84 (95% CI 2.92, 5.05), 22.65 (95% CI 7.21, 71.13), and 42.06 (95% CI 4.22, 419.52), respectively, for BI-RADS density category II-IV versus I. CONCLUSIONS For Chinese women, breast cancer risk is weakly associated with MD; however, breast cancer risk is more strongly correlated with mammographic density in premenopausal women than postmenopausal women. Further research on the factors influencing MD in premenopausal women may provide meaningful insights into breast cancer prevention in China.
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Affiliation(s)
- Song Bai
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China
| | - Di Song
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China
| | - Ming Chen
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China
| | - Xiaoshu Lai
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China
| | - Jinfeng Xu
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China.
| | - Fajin Dong
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China.
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Kanbayti IH, Alzahrani MA, Yeslam YO, Habib NH, Hadadi I, Almaimoni Y, Alahmadi A, Ekpo EU. Association between Family History of Breast Cancer and Breast Density in Saudi Premenopausal Women Participating in Mammography Screening. Clin Pract 2024; 14:164-172. [PMID: 38391399 PMCID: PMC10887693 DOI: 10.3390/clinpract14010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 12/24/2023] [Accepted: 01/11/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Mammographic density and family history of breast cancer (FHBC) are well-established independent factors affecting breast cancer risk; however, the association between these two risk factors in premenopausal-screened women remains unclear. The aim of this study is to investigate the relationship between mammographic density and FHBC among Saudi premenopausal-screened women. METHODS A total of 446 eligible participants were included in the study. Mammographic density was assessed qualitatively using the Breast Imaging Reporting and Data System (BIRADS 4th edition). Logistic regression models were built to investigate the relationship between mammographic density and FHBC. RESULTS Women with a family history of breast cancer demonstrated an 87% greater chance of having dense tissue than women without a family history of breast cancer (95% CI: 1.14-3.08; p = 0.01). Having a positive family history for breast cancer in mothers was significantly associated with dense tissue (adjusted odds ratio (OR): 5.6; 95% CI: 1.3-24.1; p = 0.02). CONCLUSION Dense breast tissue in Saudi premenopausal women undergoing screening may be linked to FHBC. If this conclusion is replicated in larger studies, then breast cancer risk prediction models must carefully consider these breast cancer risk factors.
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Affiliation(s)
- Ibrahem Hussain Kanbayti
- Radiologic Sciences Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mayada A Alzahrani
- Radiologic Sciences Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Yara O Yeslam
- Radiologic Sciences Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Noora H Habib
- Radiologic Sciences Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ibrahim Hadadi
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Yousef Almaimoni
- Radiologic Sciences Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Adnan Alahmadi
- Radiologic Sciences Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ernest U Ekpo
- Medical Image Optimization and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Campus C4 75 East Street, Sydney, NSW 2141, Australia
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Wang S, Wen W, Zhao H, Liu J, Wan X, Lan Z, Peng Y. Prediction of clinical response to neoadjuvant therapy in advanced breast cancer by baseline B-mode ultrasound, shear-wave elastography, and pathological information. Front Oncol 2023; 13:1096571. [PMID: 37228493 PMCID: PMC10203521 DOI: 10.3389/fonc.2023.1096571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 04/18/2023] [Indexed: 05/27/2023] Open
Abstract
Background Neoadjuvant therapy (NAT) is the preferred treatment for advanced breast cancer nowadays. The early prediction of its responses is important for personalized treatment. This study aimed at using baseline shear wave elastography (SWE) ultrasound combined with clinical and pathological information to predict the clinical response to therapy in advanced breast cancer. Methods This retrospective study included 217 patients with advanced breast cancer who were treated in West China Hospital of Sichuan University from April 2020 to June 2022. The features of ultrasonic images were collected according to the Breast imaging reporting and data system (BI-RADS), and the stiffness value was measured at the same time. The changes were measured according to the Response evaluation criteria in solid tumors (RECIST1.1) by MRI and clinical situation. The relevant indicators of clinical response were obtained through univariate analysis and incorporated into a logistic regression analysis to establish the prediction model. The receiver operating characteristic (ROC) curve was used to evaluate the performance of the prediction models. Results All patients were divided into a test set and a validation set in a 7:3 ratio. A total of 152 patients in the test set, with 41 patients (27.00%) in the non-responders group and 111 patients (73.00%) in the responders group, were finally included in this study. Among all unitary and combined mode models, the Pathology + B-mode + SWE model performed best, with the highest AUC of 0.808 (accuracy 72.37%, sensitivity 68.47%, specificity 82.93%, P<0.001). HER2+, Skin invasion, Post mammary space invasion, Myometrial invasion and Emax were the factors with a significant predictive value (P<0.05). 65 patients were used as an external validation set. There was no statistical difference in ROC between the test set and the validation set (P>0.05). Conclusion As the non-invasive imaging biomarkers, baseline SWE ultrasound combined with clinical and pathological information can be used to predict the clinical response to therapy in advanced breast cancer.
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Tran TXM, Chang Y, Kim S, Song H, Ryu S, Park B. Association of Breast Cancer Family History With Breast Density Over Time in Korean Women. JAMA Netw Open 2023; 6:e232420. [PMID: 36897591 DOI: 10.1001/jamanetworkopen.2023.2420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
IMPORTANCE Evidence suggests that women with a family history of breast cancer (FHBC) in first-degree relatives have a higher level of breast density; however, studies of premenopausal women remain limited. OBJECTIVE To investigate the association between FHBC and mammographic breast density and breast density changes among premenopausal women. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used population-based data obtained from the National Health Insurance Service-National Health Information Database of Korea. We included premenopausal women aged 40 to 55 years who underwent mammography for breast cancer screening once between January 1, 2015, and December 31, 2016 (n = 1 174 214), and women who underwent mammography twice (first in 2015-2016 and again between January 1, 2017 and December 31, 2018) (n = 838 855). EXPOSURES Family history of breast cancer was assessed using a self-reported questionnaire, which included information on FHBC in the mother and/or sister. MAIN OUTCOMES AND MEASURES Breast density, based on the Breast Imaging Reporting and Data System, was categorized as dense (heterogeneously or extremely dense) and nondense (almost entirely fat or scattered fibroglandular areas). Multivariate logistic regression was used to assess the association among FHBC, breast density, and changes in breast density from the first to second screening. Data analysis was performed from June 1 to September 31, 2022. RESULTS Of the 1 174 214 premenopausal women, 34 003 (2.4%; mean [SD] age, 46.3 [3.2] years) reported having FHBC among their first-degree relatives, and 1 140 211 (97.1%; mean [SD] age, 46.3 [3.2] years) reported no FHBC. Odds of having dense breasts was 22% higher (adjusted odds ratio [aOR], 1.22; 95% CI, 1.19-1.26) in women with FHBC than in women without FHBC, and the association varied by affected relatives: mother alone (aOR, 1.15; 95% CI, 1.10-1.21), sister alone (aOR, 1.26; 95% CI, 1.22-1.31), and both mother and sister (aOR, 1.64; 95% CI, 1.20-2.25). Among women with fatty breasts at baseline, the odds of developing dense breasts was higher in women with FHBC than in those without FHBC (aOR, 1.19; 95% CI, 1.11-1.26), whereas among women with dense breasts, higher odds of having persistently dense breasts were observed in women with FHBC (aOR, 1.11; 95% CI, 1.05-1.16) than in those without FHBC. CONCLUSIONS AND RELEVANCE In this cohort study of premenopausal Korean women, FHBC was positively associated with an increased incidence of having increased or persistently dense breasts over time. These findings suggest the need for a tailored breast cancer risk assessment for women with FHBC.
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Affiliation(s)
- Thi Xuan Mai Tran
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Soyeoun Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Huiyeon Song
- Department of Epidemiology and Biostatistics, Graduate School of Public Health, Hanyang University, Seoul, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
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Ali KAS, Fateh SM. Mammographic breast density status in women aged more than 40 years in Sulaimaniyah, Iraq: a cross-sectional study. J Int Med Res 2022; 50:3000605221139712. [DOI: 10.1177/03000605221139712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective Mammography is the gold standard screening procedure for the early diagnosis of breast cancer. This study aimed to determine the distribution of breast density among women older than 40 years in Sulaimaniyah, Iraq, and to examine the correlations between breast density and various risk factors. Methods This cross-sectional study included 750 women who received routine mammographic breast screening at Sulaimaniyah Breast Center. Bilateral standard two-view mammographic images (craniocaudal and mediolateral oblique projections) were acquired and reported using a picture archiving and communication system. American College of Radiology (ACR) Breast Imaging-Reporting and Data System (BI-RADS) assessment categories C and D were considered as dense. Results A total of 54.3% of breasts were classified as dense, with ACR-BI-RADS categories C or D. Breast density was significantly associated with age, body mass index, a family history of breast cancer, and pre-menopause, and women with no history of breastfeeding were more likely to have dense breasts than those with partial or complete breastfeeding. Conclusions This study revealed that women from Sulaimaniyah with a distinct breast-density profile at mammographic screening may have a significantly increased risk of breast cancer.
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Affiliation(s)
- Kalthum Abdullah Sofi Ali
- Department of Radiology/Surgery, College of Medicine, University of Sulaimani, 46001 Sulaimaniyah, Iraq
| | - Salah Muhammed Fateh
- Department of Radiology/Surgery, College of Medicine, University of Sulaimani, 46001 Sulaimaniyah, Iraq
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Li T, Li J, Heard R, Gandomkar Z, Ren J, Dai M, Brennan P. Understanding mammographic breast density profile in China: A Sino-Australian comparative study of breast density using real-world data from cancer screening programs. Asia Pac J Clin Oncol 2022; 18:696-705. [PMID: 35238173 PMCID: PMC9790382 DOI: 10.1111/ajco.13763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/27/2022] [Indexed: 12/30/2022]
Abstract
AIM This study aims at understanding mammographic density profile in China by comparing the density between women in China and Australia. METHODS Data of 3250 women aged 45-69 were obtained from the Cancer Screening Program in Urban China and data of 1384 Australian counterparts at same age range were gathered from the Lifepool project. Demographic and reproductive details and mammograms for each cohort were collected. Mammographic density was assessed using AutoDensity, and two metrics, percentage density (PD) and dense area (DA), were applied. T-tests were used to compare the means of mammographic density between two populations of all, premenopausal, and postmenopausal women. Two-way ANOVA was conducted to examine interactions of population (Chinese/Australian) and each variable of interest upon mammographic density. RESULTS Chinese women had 9.61%, 8.20%, and 9.28% higher PD than their Australian counterparts in all, premenopausal, and postmenopausal women, respectively (all p < 0.001). The mean differences in DA between two population were 1.81 cm2 (p < 0.001), 0.55 cm2 (p = 0.472), and 1.76 cm2 (p = 0.003) for all, premenopausal, and postmenopausal women, respectively. There were significant interactions between population and age (F[4, 4624] = 4.12, p = 0.003), BMI (F[2, 4628] = 3.92, p = 0.020), age at first birth (F[1, 4250] = 11.69, p < 0.001), breastfeeding history (F[1, 4479] = 17.79, p < 0.001), and breastfeeding duration (F[1, 3526] = 66.90, p < 0.001) upon PD. Interaction was only found for breastfeeding history (F[1, 4479] = 4.79, p = 0.029) and breastfeeding duration (F[1, 3526] = 17.72, p < 0.001) for DA. CONCLUSIONS Both PD and DA were found to be higher in Chinese women compared to Australian women. The density difference by menopause status was shown and breastfeeding history affected breast density differently in both populations.
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Affiliation(s)
- Tong Li
- Medical Imaging Science, School of Health Sciences, Faculty of Medicine and HealthThe University of SydneyCamperdownNew South WalesAustralia
| | - Jing Li
- Department of Diagnostic RadiologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Rob Heard
- School of Health Sciences, Faculty of Medicine and HealthThe University of SydneyCamperdownNew South WalesAustralia
| | - Ziba Gandomkar
- Medical Imaging Science, School of Health Sciences, Faculty of Medicine and HealthThe University of SydneyCamperdownNew South WalesAustralia
| | - Jiansong Ren
- Office of Cancer ScreeningNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Min Dai
- Office of Cancer ScreeningNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Patrick Brennan
- Medical Imaging Science, School of Health Sciences, Faculty of Medicine and HealthThe University of SydneyCamperdownNew South WalesAustralia
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Factors Influencing Mammographic Density in Asian Women: A Retrospective Cohort Study in the Northeast Region of Peninsular Malaysia. Diagnostics (Basel) 2022; 12:diagnostics12040860. [PMID: 35453907 PMCID: PMC9032698 DOI: 10.3390/diagnostics12040860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 02/05/2023] Open
Abstract
Mammographic density is a significant risk factor for breast cancer. In this study, we identified the risk factors of mammographic density in Asian women and quantified the impact of breast density on the severity of breast cancer. We collected data from Hospital Universiti Sains Malaysia, a research- and university-based hospital located in Kelantan, Malaysia. Multivariable logistic regression was performed to analyse the data. Five significant factors were found to be associated with mammographic density: age (OR: 0.94; 95% CI: 0.92, 0.96), number of children (OR: 0.88; 95% CI: 0.81, 0.96), body mass index (OR: 0.88; 95% CI: 0.85, 0.92), menopause status (yes vs. no, OR: 0.59; 95% CI: 0.42, 0.82), and BI-RADS classification (2 vs. 1, OR: 1.87; 95% CI: 1.22, 2.84; 3 vs. 1, OR: 3.25; 95% CI: 1.86, 5.66; 4 vs. 1, OR: 3.75; 95% CI: 1.88, 7.46; 5 vs. 1, OR: 2.46; 95% CI: 1.21, 5.02; 6 vs. 1, OR: 2.50; 95% CI: 0.65, 9.56). Similarly, the average predicted probabilities were higher among BI-RADS 3 and 4 classified women. Understanding mammographic density and its influencing factors aids in accurately assessing and screening dense breast women.
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Moini A, Salari E, Rashidi H, Maajani K, Abedi M, Bayani L, Alipour S. Evaluation of the association of endometriosis and mammographic breast density, a cross-sectional study. BMC Womens Health 2022; 22:81. [PMID: 35313883 PMCID: PMC8935711 DOI: 10.1186/s12905-022-01663-8] [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: 10/22/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background Endometriosis is a common benign but painful gynecologic condition. Studies suggest that the risk of some types of malignancies such as breast cancer is higher in women with endometriosis. Mammographic breast density (MBD) is known as an important predictor for breast cancer. The present study aimed to investigate the potential relationship between endometriosis and MBD. Methods This cross-sectional study was conducted on 370 women over 40 years of age. Laparoscopic surgery was carried out for the diagnosis of endometriosis. MBD was classified into four categories according to the ACR BI-RADS classification. Statistical analysis was performed using SPSS software to evaluate the potential association between variables. Results The mean age of all participants was 47.2 ± 6.4 years, and most participants (76.8%) were premenopausal. Multivariate analysis of the potential predictors of MBD, including age, body mass index, oral contraceptive consumption, progesterone consumption, family history of breast cancer and endometriosis showed that age (P value = 0.002), history of progesterone consumption (P value = 0.004) and endometriosis (P value = 0.006) were independent factors for MBD. Conclusion This study indicated that endometriosis had an inverse association with MBD. Age and history of progesterone use were also independent influential factors for MBD. This finding shows that the positive association between breast cancer and endometriosis is not mediated through MBD.
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Affiliation(s)
- Ashraf Moini
- Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran.,Department of Surgery, Arash Women's Hospital, Tehran University of Medical Sciences, Shahid Baghdarnia (North Rashid) Street, Ressalat Street, 1653915911, Tehran, Iran.,Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Elnaz Salari
- Department of Surgery, Arash Women's Hospital, Tehran University of Medical Sciences, Shahid Baghdarnia (North Rashid) Street, Ressalat Street, 1653915911, Tehran, Iran
| | - Hadi Rashidi
- Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Khadije Maajani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Abedi
- Department of Radiology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Bayani
- Department of Radiology, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadaf Alipour
- Breast Disease Research Center (BDRC), Tehran University of Medical Sciences, Tehran, Iran. .,Department of Surgery, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Al-Mohaissen M, Alkhedeiri A, Al-Madani O, Lee T, Hamdoun A, Al-Harbi M. Association of mammographic density and benign breast calcifications individually or combined with hypertension, diabetes, and hypercholesterolemia in women ≥40 years of age: a retrospective study. J Investig Med 2022; 70:1308-1315. [PMID: 35190487 PMCID: PMC9240332 DOI: 10.1136/jim-2021-002296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/08/2022]
Abstract
Recent evidence has linked certain mammographic characteristics, including breast calcifications (Bcs) and mammographic density (MD), with atherosclerotic cardiovascular disease risk factors in women, but data are limited and inconsistent. We aimed to evaluate the association of MD and/or Bcs with hypertension, diabetes, and hypercholesterolemia in women ≥40 years of age. Through hospital electronic records, we retrospectively identified mammograms of non-pregnant women aged ≥40 years and without breast cancer and retrieved reports and relevant data. MD and Bcs were recorded; risk factor status was diagnosed based on treatment profile and clinical and laboratory data. In total, 1406 women were included. MD was inversely related to hypertension, diabetes, hypercholesterolemia, triglyceride levels, age, and body mass index (BMI) (p value for trend <0.001). Bcs were positively associated with hypertension, diabetes, hypercholesterolemia, age, BMI, and elevated creatinine (p<0.05). Controlling for age and BMI, MD category A (MD-A) was independently associated with hypercholesterolemia; Bcs were independently associated with diabetes. Combining MD-A with Bcs did not increase the odds significantly. Analysis for additive interactions revealed a significant interaction between MD-A and BMI, increasing the odds of hypertension, and a trend for increased odds of diabetes by adding MD-A and/or Bcs to BMI. Decreased MD and presence of Bcs are associated with hypertension, diabetes, and hypercholesterolemia in women ≥40 years of age. MD-A may represent a new obesity index independently associated with hypercholesterolemia and additive to hypertension risk. Bcs are independently associated with diabetes. Combining MD and Bcs did not improve the odds significantly, which may reflect mechanistic differences.
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Affiliation(s)
- Maha Al-Mohaissen
- Department of Clinical Sciences (Cardiology), College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Arwa Alkhedeiri
- Department of Radiology, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Ohoud Al-Madani
- Department of Research Informatics, Saudi Food and Drug Authority, Riyadh, Saudi Arabia
| | - Terry Lee
- Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada
| | - Anas Hamdoun
- Department of Radiology, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Mohammad Al-Harbi
- Department of Radiology, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
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Han Y, Moore JX, Colditz GA, Toriola AT. Family History of Breast Cancer and Mammographic Breast Density in Premenopausal Women. JAMA Netw Open 2022; 5:e2148983. [PMID: 35175341 PMCID: PMC8855232 DOI: 10.1001/jamanetworkopen.2021.48983] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/28/2021] [Indexed: 11/14/2022] Open
Abstract
Importance Family history of breast cancer (FHBC) and mammographic breast density are independent risk factors for breast cancer, but the association of FHBC and mammographic breast density in premenopausal women is not well understood. Objectives To investigate the association of FHBC and mammographic breast density in premenopausal women using both quantitative and qualitative measurements. Design, Setting, and Participants This single-center cohort study examined 2 retrospective cohorts: a discovery set of 375 premenopausal women and a validation set of 14 040 premenopausal women. Data from women in the discovery set was collected between December 2015 and October 2016, whereas data from women in the validation set was collected between June 2010 and December 2015. Data analysis was performed between June 2018 and June 2020. Exposures Family history of breast cancer (FHBC). Main Outcomes and Measures The primary outcomes were mammographic breast density measured quantitatively as volumetric percent density using Volpara (discovery set) and qualitatively using BI-RADS (Breast Imaging Reporting and Data System) breast density (validation set). Multivariable regressions were performed using a log-transformed normal distribution for the discovery set and a logistic distribution for the validation set. Results Of 14 415 premenopausal women included in the study, the discovery set and validation set had similar characteristics (discovery set with FHBC: mean [SD] age, 47.1 [5.6] years; 15 [17.2%] were Black or African American women and 64 [73.6%] were non-Hispanic White women; discovery set with no FHBC: mean [SD] age, 47.7 [4.5] years; 87 [31.6%] were Black or African American women and 178 [64.7%] were non-Hispanic White women; validation set with FHBC: mean [SD] age, 46.8 [7.3] years; 720 [33.4%] were Black or African American women and 1378 [64.0%] were non-Hispanic White women]; validation set with no FHBC: mean [SD] age, 47.5 [6.1] years; 4572 [38.5%] were Black or African American women and 6632 [55.8%] were non-Hispanic White women]). In the discovery set, participants who had FHBC were more likely to have a higher mean volumetric percent density compared with participants with no FHBC (11.1% vs 9.0%). In the multivariable-adjusted model, volumetric percent density was 25% higher (odds ratio [OR], 1.25 ;95% CI, 1.12-1.41) in women with FHBC compared with women without FHBC; and 24% higher (OR, 1.24; 95% CI, 1.10-1.40) in women who had 1 affected relative, but not significantly higher in women who had at least 2 affected relatives (OR, 1.40; 95% CI, 0.95-2.07) compared with women with no relatives affected. In the validation set, women with a positive FHBC were more likely to have dense breasts (BI-RADS 3-4) compared with women with no FHBC (BI-RADS 3: 41.1% vs 38.8%; BI-RADS 4: 10.5% vs 7.7%). In the multivariable-adjusted model, the odds of having dense breasts (BI-RADS 3-4) were 30% higher (OR, 1.30; 95% CI, 1.17-1.45) in women with FHBC compared with women without FHBC; and 29% higher (OR, 1.29; 95% CI, 1.14-1.45) in women who had 1 affected relative, but not significantly higher in women who had at least 2 affected relatives (OR, 1.38; 95% CI, 0.85-2.23) compared with women with no relatives affected. Conclusions and Relevance In this cohort study, having an FHBC was positively associated with mammographic breast density in premenopausal women. Our findings highlight the heritable component of mammographic breast density and underscore the need to begin annual screening early in premenopausal women with a family history of breast cancer.
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Affiliation(s)
- Yunan Han
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Justin Xavier Moore
- Cancer Prevention, Control, and Population Health Program, Department of Medicine, Augusta University, Augusta, Georgia
| | - Graham A. Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
- Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri
| | - Adetunji T. Toriola
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
- Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri
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Yu T, Ye DM. The epidemiologic factors associated with breast density: A review. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2022; 27:53. [PMID: 36092490 PMCID: PMC9450246 DOI: 10.4103/jrms.jrms_962_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/14/2022] [Accepted: 01/26/2022] [Indexed: 11/04/2022]
Abstract
In recent years, some studies have evaluated the epidemiologic factors associated with breast density. However, the variant and inconsistent results exist. In addition, breast density has been proved to be a significant risk factor associated with breast cancer. Our review summarized the published studies and emphasized the crucial factors including epidemiological factors associated with breast density. In addition, we also discussed the potential reasons for the discrepant results with risk factors. To decrease the incidence and mortality rates for breast cancer, in clinical practice, breast density should be included for clinical risk models in addition to epidemiological factors, and physicians should get more concentrate on those women with risk factors and provide risk-based breast cancer screening regimens.
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Wen W, Liu J, Wang J, Jiang H, Peng Y. A National Chinese Survey on Ultrasound Feature Interpretation and Risk Assessment of Breast Masses Under ACR BI-RADS. Cancer Manag Res 2021; 13:9107-9115. [PMID: 34924771 PMCID: PMC8674576 DOI: 10.2147/cmar.s341314] [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: 10/04/2021] [Accepted: 11/27/2021] [Indexed: 02/05/2023] Open
Abstract
Purpose Through this nationwide survey on ACR BI-RADS including ultrasound images of 10 selected breast lesions, we aimed to learn about consistency in feature interpretation and assessment categories and to identify factors that might contribute to inconsistencies, thereby promoting the application of BI-RADS in China. Materials and Methods The survey was delivered through a self-developed website about blinded image interpretation and was released to the public through online platforms and social media. A total of 10 representative lesions were selected by an experienced radiologist to gather information about the general practice of BI-RADS lexicons and categories. The Kappa statistic, the chi-squared test, and descriptive statistics were used for data analysis. Results Nine hundred ultrasound workers completed the questionnaire, coming from all provinces and major cities in China. They had different positions, grades of work organization, and seniority. The interrater agreement of BI-RADS features was fair to substantial (kappa value: 0.37–0.66). For BI-RADS categories, the highest agreement was observed in the typical benign group (average constituent rate = 74.78%), and generally lower agreement was observed in the typical malignant (average constituent rate = 36.03%) and suspicious groups (average constituent rate = 39.02%). Conclusion We found inconsistencies in BI-RADS applications, providing direction for image feature research using big data. Therefore, we call for more efforts to improve the consistency of BI-RADS application and provide an evidence-based basis for identifying benign and malignant lesions by sonographic features.
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Affiliation(s)
- Wen Wen
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jingyan Liu
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Junren Wang
- Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Heng Jiang
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Yulan Peng
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
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Yang Y, Hu Y, Shen S, Jiang X, Gu R, Wang H, Liu F, Mei J, Liang J, Jia H, Liu Q, Gong C. A new nomogram for predicting the malignant diagnosis of Breast Imaging Reporting and Data System (BI-RADS) ultrasonography category 4A lesions in women with dense breast tissue in the diagnostic setting. Quant Imaging Med Surg 2021; 11:3005-3017. [PMID: 34249630 DOI: 10.21037/qims-20-1203] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/05/2021] [Indexed: 11/06/2022]
Abstract
Background Biopsy has been recommended for Breast Imaging Reporting and Data System (BI-RADS) category 4 lesions. However, the malignancy rate of category 4A lesions is very low (2-10%). Therefore, most biopsies of category 4A lesions are benign, and the results will generally cause additional health care costs and patient anxiety. Methods A prediction model was developed based on an analysis of 418 BI-RADS ultrasonography (US) category 4A patients at Sun Yat-sen Memorial Hospital. Univariate and multivariate logistic regression analyses were applied to identify significant variables for inclusion in the final nomogram. The predictive accuracy and discriminative ability were evaluated using the concordance index (C-index) and calibration curves. An independent cohort of 97 patients from the Second Affiliated Hospital of Guangzhou Medical University was used for external validation. Results The independent risk factors from the multivariate analysis for the training cohort were family history of breast cancer (OR =4.588, P=0.004), US features [margin (OR =2.916, P=0.019), shape (irregular vs. oval, OR =2.474, P=0.044; round vs. oval, OR =1.935, P=0.276), parallel orientation vs. not parallel (OR =2.204, P=0.040)], low suspicious lymph nodes (OR =7.664, P=0.019), and suspicious calcifications on mammography (MG) (OR =6.736, P=0.001). The C-index was good in the training [0.813, 95% confidence interval (95% CI), 0.733 to 0.893] and validation cohorts (0.765, 95% CI, 0.584 to 0.946). The calibration curves showed optimal agreement between the nomogram prediction and actual observations for the probability of malignancy. Also, the cutoff score was set to 100 for discriminating high and low risk. The model performed well in discerning different risk groups. Conclusions We developed a well-discriminated and calibrated nomogram to predict the malignancy of BI-RADS US category 4A lesions in dense breast tissue, which may help clinicians identify patients at lower or higher risk.
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Affiliation(s)
- Yaping Yang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yue Hu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shiyu Shen
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaofang Jiang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ran Gu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hongli Wang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Fengtao Liu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jingsi Mei
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jing Liang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haixia Jia
- Department of Breast Surgery, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qiang Liu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chang Gong
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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S VS, Royea R, Buckman KJ, Benardis M, Holmes J, Fletcher RL, Eyk N, Rajendra Acharya U, Ellenhorn JDI. An introduction to the Cyrcadia Breast Monitor: A wearable breast health monitoring device. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 197:105758. [PMID: 33007593 DOI: 10.1016/j.cmpb.2020.105758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/10/2020] [Indexed: 05/08/2023]
Abstract
BACKGROUND The most common breast cancer detection modalities are generally limited by radiation exposure, discomfort, high costs, inter-observer variabilities in image interpretation, and low sensitivity in detecting cancer in dense breast tissue. Therefore, there is a clear need for an affordable and effective adjunct modality that can address these limitations. The Cyrcadia Breast Monitor (CBM) is a non-invasive, non-compressive, and non-radiogenic wearable device developed as an adjunct to current modalities to assist in the detection of breast tissue abnormalities in any type of breast tissue. METHODS The CBM records thermodynamic metabolic data from the breast skin surface over a period of time using two wearable biometric patches consisting of eight sensors each and a data recording device. The acquired multi-dimensional temperature time series data are analyzed to determine the presence of breast tissue abnormalities. The objective of this paper is to present the scientific background of CBM and also to describe the history around the design and development of the technology. RESULTS The results of using the CBM device in the initial clinical studies are also presented. Twenty four-hour long breast skin temperature circadian rhythm data was collected from 93 benign and 108 malignant female study subjects in the initial clinical studies. The predictive model developed using these datasets could differentiate benign and malignant lesions with 78% accuracy, 83.6% sensitivity and 71.5% specificity. A pilot study of 173 female study subjects is underway, in order to validate this predictive model in an independent test population. CONCLUSIONS The results from the initial studies indicate that the CBM may be valuable for breast health monitoring under physician supervision for confirmation of any abnormal changes, potentially prior to other methods, such as, biopsies. Studies are being conducted and planned to validate the technology and also to evaluate its ability as an adjunct breast health monitoring device for identifying abnormalities in difficult-to-diagnose dense breast tissue.
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Affiliation(s)
- Vinitha Sree S
- Cyrcadia Health, 1325 Airmotive Way, Ste. 175-L, Reno, NV 89502, United States; Cyrcadia Asia, Ltd., Hong Kong.
| | | | - Kevin J Buckman
- Cyrcadia Health, 1325 Airmotive Way, Ste. 175-L, Reno, NV 89502, United States; Adventist Health Lodi Memorial Hospital, Lodi, CA 95240, United States
| | - Matt Benardis
- Cyrcadia Health, 1325 Airmotive Way, Ste. 175-L, Reno, NV 89502, United States
| | - Jim Holmes
- Cyrcadia Health, 1325 Airmotive Way, Ste. 175-L, Reno, NV 89502, United States
| | - Ronald L Fletcher
- Cyrcadia Health, 1325 Airmotive Way, Ste. 175-L, Reno, NV 89502, United States
| | - Ng Eyk
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798
| | - U Rajendra Acharya
- School of Engineering, Division of ECE, Ngee Ann Polytechnic, Singapore 599489; Department of Biomedical Engineering, School of Science and Technology, Singapore University of Social Sciences, Singapore; Department of Biomedical Informatics and Medical Engineering, Asia University, Taiwan
| | - Joshua D I Ellenhorn
- Cyrcadia Health, 1325 Airmotive Way, Ste. 175-L, Reno, NV 89502, United States; Cyrcadia Asia, Ltd., Hong Kong; Surgery Group LA, Cedars-Sinai Medical Towers, Los Angeles, CA 90048, United States; John Wayne Cancer Clinics, Santa Monica, CA 90404, United States
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Wang JM, Zhao HG, Liu TT, Wang FY. Evaluation of the association between mammographic density and the risk of breast cancer using Quantra software and the BI-RADS classification. Medicine (Baltimore) 2020; 99:e23112. [PMID: 33181680 PMCID: PMC7668426 DOI: 10.1097/md.0000000000023112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To determine the association between mammographic density (MD) and the risk of breast cancer (BC) in Chinese women and to investigate the role of fertility risk factors in regulating the relationship between MD and BC.We used Quantra software and the BI-RADS classification to assess MD in 466 patients and 932 controls. Conditional matched logistic multiple regression analysis was used to determine the relationship between MD and BC, and risk was evaluated with the odds ratio (OR) and 95% confidence interval (CI).The ORs for category 4 versus category 2 were 1.95 (95% confidence interval [95% CI] (1.42∼2.66)) and 1.76 (95% CI (1.28∼2.42)) for the BI-RADS and Quantra classifications, respectively. The ORs for category 5 volumetric breast density (VBD) versus category 2 VBD and 5 fibroglandular tissue volume (FGV) versus category 2 FGV were 1.63 (95% CI (1.20∼2.23)) and 1.92 (95% CI (1.40∼2.63)), respectively. Females with category 5 VBD whose age at menarche was ≤13 years had the highest risk of BC (OR = 2.16, 95% CI (1.24∼3.79)), and females with category 5 FGV whose age at menarche was = 15 years had the lowest risk of BC (OR = 1.65, 95% CI (1.05∼2.62)). Females with categories 3-5 VBD and categories 3-5 FGV had reduced risks of BC with increasing number of births. Females with category 5 VBD had an increased risk of BC with increasing age at first childbirth (the OR increased from 1.49 to 1.95). Those with category 5 VBD had a reduced risk of BC with increasing breastfeeding duration (the OR decreased from 2.08 to 1.55). Females with category 5 FGV had a reduced risk of BC with increasing breastfeeding duration (the OR decreased from 4.12 to 1.62).Both the BI-RADS density classification and Quantra measures indicated that MD is positively associated with the risk of BC in Chinese women and that associations between MD and BC risk differ by age at menarche, parity, age at first childbirth and breastfeeding duration.
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Yang Y, Liu J, Peng M, Su F, Xie X, Liu Z, Wu J, Wei W, Zhou D, Li W, Zhang A, Su G, Yang W, Chen J, Ma D, Cai Y, Chen K, Zhu L, Liu Q, Song E. Introduction of a multicenter online database for non-metastatic breast cancer in China. SCIENCE CHINA. LIFE SCIENCES 2020; 63:1417-1420. [PMID: 32088826 DOI: 10.1007/s11427-019-1625-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 01/10/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Yaping Yang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Jieqiong Liu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Min Peng
- Diseases Registry Center of Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Fengxi Su
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Xiaoming Xie
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
| | - Zhenzhen Liu
- Department of Breast Surgery, Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, China
| | - Jundong Wu
- The Breast Center, Shantou University Medical College Cancer Hospital, Shantou, 515041, China
| | - Wei Wei
- Department of Breast and Thyroid Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Dongxian Zhou
- Department of Breast and Thyroid Surgery, Shenzhen People's Hospital, Shenzhen, 518020, China
| | - Weiwen Li
- Breast and Thyroid Surgery Department, Jiangmen Central Hospital, Jiangmen, 529030, China
| | - Ailing Zhang
- Department of Breast Surgery, Dongguan People's Hospital, Dongguan, 523059, China
| | - Guosen Su
- Department of Breast Surgery, Gaozhou People's Hospital, Gaozhou, 525200, China
| | - Weixiong Yang
- Department of Breast Disease, Maoming People's Hospital, Maoming, 525000, China
| | - Jishang Chen
- Department of Breast Surgery, Yangjiang People's Hospital, Yangjiang, 29500, China
| | - Dekui Ma
- Breast Disease Treatment Center, The First People's Hospital of Zhaoqing, Zhaoqing, 526000, China
| | - Yongguang Cai
- Department of Oncology, Guangdong Agricultural Reclamation Center Hospital, Zhanjiang, 524002, China
| | - Kai Chen
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Liling Zhu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Qiang Liu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
| | - Erwei Song
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
- Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510005, China.
- Fountain-Valley Institute for Life Sciences, Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, 4th Floor, Building D, Guangzhou, 510530, China.
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Characteristics of Mammographic Breast Density and Associated Factors for Chinese Women: Results from an Automated Measurement. JOURNAL OF ONCOLOGY 2019; 2019:4910854. [PMID: 31015834 PMCID: PMC6444251 DOI: 10.1155/2019/4910854] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 02/01/2019] [Accepted: 02/19/2019] [Indexed: 11/18/2022]
Abstract
Background Characteristics of mammographic density for Chinese women are understudied. This study aims to identify factors associated with mammographic density in China using a quantitative method. Methods Mammographic density was measured for a total of 1071 (84 with and 987 without breast cancer) women using an automatic algorithm AutoDensity. Pearson tests examined relationships between density and continuous variables and t-tests compared differences of mean density values between groupings of categorical variables. Linear models were built using multiple regression. Results Percentage density and dense area were positively associated with each other for cancer-free (r=0.487, p<0.001) and cancer groups (r=0.446, p<0.001), respectively. For women without breast cancer, weight and BMI (p<0.001) were found to be negatively associated (r=-0.237, r=-0.272) with percentage density whereas they were found to be positively associated (r=0.110, r=0.099) with dense area; age at mammography was found to be associated with percentage density (r=-0.202, p<0.001) and dense area (r=-0.086, p<0.001) but did not add any prediction within multivariate models; lower percentage density was found within women with secondary education background or below compared to women with tertiary education. For women with breast cancer, percentage density demonstrated similar relationships with that of cancer-free women whilst breast area was the only factor associated with dense area (r=0.739, p<0.001). Conclusion This is the first time that mammographic density was measured by a quantitative method for women in China and identified associations should be useful to health policy makers who are responsible for introducing effective models of breast cancer prevention and diagnosis.
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Breast cancer risk factors and mammographic density among high-risk women in urban China. NPJ Breast Cancer 2018; 4:3. [PMID: 29423438 PMCID: PMC5802809 DOI: 10.1038/s41523-018-0055-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 12/05/2017] [Accepted: 01/03/2018] [Indexed: 01/05/2023] Open
Abstract
Elevated mammographic density (MD) is an established breast cancer risk factor. Studies examining relationships between MD and breast cancer risk factors are limited in China, where established breast cancer risk factors are less prevalent but dense breasts are more prevalent than Western countries. This study included 11,478 women (45-69 years; 36% premenopausal) participating in an ongoing national cancer screening program in 11 urban provinces in China and predicted as having high-risk for breast cancer. Polytomous logistic regression was performed to assess associations between MD and risk factors by comparing each higher Breast Imaging Reporting and Data System (BI-RADS) category (2, 3, or 4) to the lowest category (BI-RADS, 1). We found associations of increasing age, body mass index, weight, postmenopausal status, and parity with lower MD. Higher levels of education, increasing height, and later first birth were associated with higher MD. These associations did not vary by menopausal status. Additionally, the association between longer period of breastfeeding and lower MD was seen among postmenopausal women only (Pinteraction = 0.003). Having first-degree relatives with breast cancer diagnosed before 50 years was associated with lower MD only among premenopausal women (Pinteraction = 0.061). We found effects of established breast cancer risk factors on MD showed similar directions in Chinese and Western women, supporting the hypothesis that MD represents cumulative exposure to breast cancer risk factors over the life course. Our findings help to understand the biological basis of the association of MD with breast cancer risk and have implications for breast cancer prevention research in China.
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Sleep patterns, sleep disorders and mammographic density in spanish women: The DDM-Spain/Var-DDM study. Maturitas 2017; 99:105-108. [PMID: 28364862 DOI: 10.1016/j.maturitas.2017.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/27/2017] [Indexed: 11/21/2022]
Abstract
We explored the relationship between sleep patterns and sleep disorders and mammographic density (MD), a marker of breast cancer risk. Participants in the DDM-Spain/var-DDM study, which included 2878 middle-aged Spanish women, were interviewed via telephone and asked questions on sleep characteristics. Two radiologists assessed MD in their left craneo-caudal mammogram, assisted by a validated semiautomatic-computer tool (DM-scan). We used log-transformed percentage MD as the dependent variable and fitted mixed linear regression models, including known confounding variables. Our results showed that neither sleeping patterns nor sleep disorders were associated with MD. However, women with frequent changes in their bedtime due to anxiety or depression had higher MD (eβ:1.53;95%CI:1.04-2.26).
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Ziembicki S, Zhu J, Tse E, Martin LJ, Minkin S, Boyd NF. The Association between Alcohol Consumption and Breast Density: A Systematic Review and Meta-analysis. Cancer Epidemiol Biomarkers Prev 2016; 26:170-178. [DOI: 10.1158/1055-9965.epi-16-0522] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 09/01/2016] [Accepted: 09/14/2016] [Indexed: 11/16/2022] Open
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Islami F, Liu Y, Jemal A, Zhou J, Weiderpass E, Colditz G, Boffetta P, Weiss M. Breastfeeding and breast cancer risk by receptor status--a systematic review and meta-analysis. Ann Oncol 2015; 26:2398-407. [PMID: 26504151 DOI: 10.1093/annonc/mdv379] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 08/06/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Breastfeeding is inversely associated with overall risk of breast cancer. This association may differ in breast cancer subtypes defined by receptor status, as they may reflect different mechanisms of carcinogenesis. We conducted a systematic review and meta-analysis of case-control and prospective cohort studies to investigate the association between breastfeeding and breast cancer by estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status. DESIGN We searched the PubMed and Scopus databases and bibliographies of pertinent articles to identify relevant articles and used random-effects models to calculate summary odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS This meta-analysis represents 27 distinct studies (8 cohort and 19 case-control), with a total of 36 881 breast cancer cases. Among parous women, the risk estimates for the association between ever (versus never) breastfeeding and the breast cancers negative for both ER and PR were similar in three cohort and three case-control studies when results were adjusted for several factors, including the number of full-term pregnancies (combined OR 0.90; 95% CI 0.82-0.99), with little heterogeneity and no indication of publication bias. In a subset of three adjusted studies that included ER, PR, and HER2 status, ever breastfeeding showed a stronger inverse association with triple-negative breast cancer (OR 0.78; 95% CI 0.66-0.91) among parous women. Overall, cohort studies showed no significant association between breastfeeding and ER+/PR+ or ER+ and/or PR+ breast cancers, although one and two studies (out of four and seven studies, respectively) showed an inverse association. CONCLUSIONS This meta-analysis showed a protective effect of ever breastfeeding against hormone receptor-negative breast cancers, which are more common in younger women and generally have a poorer prognosis than other subtypes of breast cancer. The association between breastfeeding and receptor-positive breast cancers needs more investigation.
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Affiliation(s)
- F Islami
- Surveillance and Health Services Research, American Cancer Society, Atlanta Institute for Translational Epidemiology and the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York
| | - Y Liu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, USA
| | - A Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta
| | - J Zhou
- Institute for Translational Epidemiology and the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York
| | - E Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø Cancer Registry of Norway, Oslo, Norway Department of Genetic Epidemiology, Folkhälsan Research Center, Helsinki, Finland
| | - G Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, USA Siteman Cancer Center, Washington University School of Medicine, St Louis
| | - P Boffetta
- Institute for Translational Epidemiology and the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York
| | - M Weiss
- Breastcancer.org/breasthealth.org, Lankenau Medical Center, Wynnewood, USA
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