Imperfect correlation of mammographic and clinical breast tissue density

Association of polycystic ovary syndrome with mammographic density in Turkish women: a population-based case-control study

OBJECTIVE

The objective of this study was to investigate the breast densities and Breast Imaging-Reporting and Data System scores of patients with polycystic ovary syndrome and normoovulatory women and to determine whether these patients constitute a high-risk population for breast cancer.

METHODS

This retrospective case-control study was conducted at our institution between January 2022 and December 2022, involving patients diagnosed with polycystic ovary syndrome. Menstrual periods, hyperandrogenemic findings, and ultrasound reports of the patients were retrieved from our hospital's database. Patients who met at least two of the Rotterdam criteria were included in the polycystic ovary syndrome group. A total of 70 premenopausal patients over the age of 40 years, diagnosed with polycystic ovary syndrome, and 70 normoovulatory women, matched for age and body mass index, were included in the study. The two groups were compared regarding age at menarche, menstrual pattern, gravida, parity, levels of follicle-stimulating hormone, luteinizing hormone, and estradiol, endometrial thickness, breast density category, and Breast Imaging-Reporting and Data System classifications.

RESULTS

Patients in the polycystic ovary syndrome group had a higher age at menarche (12.7 vs. 12.3, p=0.006). There was no difference between the gonadotropin levels in both groups. However, the estradiol level was higher in the polycystic ovary syndrome group (p<0.001). There was no statistically significant difference between the two groups in terms of breast density and Breast Imaging-Reporting and Data System scores (p=0.319 and p=0.650, respectively).

CONCLUSION

Although we can conclude that the risk of breast malignancy is not increased in patients with polycystic ovary syndrome, the impact of the complex hormonal status of polycystic ovary syndrome on breast cancer remains unclear in the literature.

Breast density in polycystic ovarian syndrome patients: A case-control study

Background

Epidemiological studies suggested a positive relationship between breast density and risk of breast cancer. One of the common hormonal disorders in women's reproductive age is polycystic ovarian syndrome (PCOS) and the results from the studies about the risk of breast cancer among PCOS patients are equivocal.

Objective

The objective was to evaluate the breast density in PCOS patients compared with the control group.

Materials and Methods

In this case-control study, the PCOS patients who were older than 40 years and were referred to infertility or gynecology outpatient clinic of Arash women's hospital between 2015 and 2017 were selected as the case group. Control group was selected from healthy women who attended the same hospital and were older than 40 years. By digital mammography, breast density was classified according to the Breast Imaging Reporting and Data System (BIRADS) of the American College of Radiology and it was graded by one expert radiologist.

Results

Final analysis in 68 cases and controls showed statistically significant differences between breast densities in PCOS patients compared to the control (p░=░0.03), and when the analysis was conducted by considering the category of age, the control group who were younger than 45 years had higher breast density compared with PCOS patient. Multivariate logistic regression analyses manifested a statistically significant adverse association between body mass index (OR░=░0.87, 95% CI: 0.79–0.95), vitamin D intake (OR░=░0.35, 95% CI: 0.16–0.81), and breast density.

Conclusion

Our data suggested that the PCOS patients had lower breast density compared with normal population. However, in multivariate analysis, considering other confounders, this association was not confirmed.

The relationship between breast density and bone mineral density in never users of postmenopausal hormone therapy

BACKGROUND

Estrogen is known to affect both mammographic breast density and bone mineral density (BMD), but there are inconsistent results about the association of these density measurements in postmenopausal women. Furthermore, there are scarce data on the relationship between breast density and BMD in never users of postmenopausal hormone therapy.

AIM

In this study, we examined the relationship between mammographic breast density and BMD in postmenopausal women who were never hormone replacement therapy users.

METHODS

A total of 293 postmenopausal women were enrolled in this cross-sectional study. Mammograms and BMD measurements for screening purposes were obtained. Assessment of mammographic breast density was performed by using breast imaging reporting and data system classification. The BMD was measured using dual-energy X-ray absorptiometry of the lumbar spine and femoral neck.

RESULTS

Grade 1 breast density was observed in 64 women (21.8 %), grade 2 in 113 women (38.6 %) and grades 3 and 4 in 116 (39.6 %) women. Breast density decreased with increasing age and body mass index (BMI). Meanwhile, no significant differences were detected in BMD measures of the hip (p = 0.14) and lumbar spine (p = 0.29) among the breast density categories. After adjusting for age and BMI, the differences in the mean BMD at the hip and lumbar spine across the breast density categories remained insignificant (p = 0.26 and 0.11, respectively).

CONCLUSION

There is no evidence of a relationship between mammographic breast density and BMD in postmenopausal women who had never used hormone replacement therapy.

Association of mammographic breast density with dairy product consumption, sun exposure, and daily activity

Background. Mammographic density is a risk factor, for breast cancer and its association with various factors is under investigation; we carried out a study to assess its relationship with daily dairy intake, sun exposure, and physical activities. Patients and Methods. Women ≥40 years of age were interviewed about habits of dairy product consumption, daily sun exposure and physical activity. Exclusion criteria consisted of history of breast cancer, consumption of calcium and vitamin D supplements, hormone replacement therapy, or renal disease. Mammographic densities were classified according to the classification system of the American College of Radiologists into 4 classes. Results. Overall 703 cases were entered in the study. The mean age was 48.2 ± 6.2 years. The most common and least frequent classes of mammographic density were classes 2 and 4, respectively. There was no significant association between mammographic density and rate of dairy consumption, amount of sunlight exposure, and daily physical activity. Conclusion. Relation of sunlight exposure and intake of milk products with mammographic density need further study, while the subject of physical activity can be evaluated by a systematic review and meta-analysis of the existing literature.