BackgroundMammographic density (MD) is one of the strongest breast cancer risk factors. Its age-related characteristics have been studied in women in western countries, but whether these associations apply to women worldwide is not known.Methods and findingsWe examined cross-sectional differences in MD by age and menopausal status in over 11,000 breast-cancer-free women aged 35–85 years, from 40 ethnicity- and location-specific population groups across 22 countries in the International Consortium on Mammographic Density (ICMD). MD was read centrally using a quantitative method (Cumulus) and its square-root metrics were analysed using meta-analysis of group-level estimates and linear regression models of pooled data, adjusted for body mass index, reproductive factors, mammogram view, image type, and reader. In all, 4,534 women were premenopausal, and 6,481 postmenopausal, at the time of mammography. A large age-adjusted difference in percent MD (PD) between post- and premenopausal women was apparent (–0.46 cm [95% CI: −0.53, −0.39]) and appeared greater in women with lower breast cancer risk profiles; variation across population groups due to heterogeneity (I2) was 16.5%. Among premenopausal women, the √PD difference per 10-year increase in age was −0.24 cm (95% CI: −0.34, −0.14; I2 = 30%), reflecting a compositional change (lower dense area and higher non-dense area, with no difference in breast area). In postmenopausal women, the corresponding difference in √PD (−0.38 cm [95% CI: −0.44, −0.33]; I2 = 30%) was additionally driven by increasing breast area. The study is limited by different mammography systems and its cross-sectional rather than longitudinal nature.ConclusionsDeclines in MD with increasing age are present premenopausally, continue postmenopausally, and are most pronounced over the menopausal transition. These effects were highly consistent across diverse groups of women worldwide, suggesting that they result from an intrinsic biological, likely hormonal, mechanism common to women. If cumulative breast density is a key determinant of breast cancer risk, younger ages may be the more critical periods for lifestyle modifications aimed at breast density and breast cancer risk reduction.
ABSTRACT.Purpose: To investigate the influence of sex hormones on ocular haemodynamics, blood flow velocities in the ophthalmic and central retinal arteries and serum levels of sex hormones were measured in pre-and postmenopausal women. Methods: Colour Doppler imaging (CDI) was used to determine the flow velocities (peak systolic velocity [PSV] and end-diastolic velocity [EDV]) and the resistive index (RI) in the ophthalmic and central retinal arteries in 22 premenopausal and 32 postmenopausal women, who had never received hormone replacement therapy. Serum levels were measured for oestradiol, free testosterone and follicle-stimulating hormone. The CDI parameters were compared between the two groups and the influence of serum levels of oestradiol and testosterone on blood flow velocities and the resistive indices were analysed. Results: After correcting for age and mean arterial blood pressure, an analysis of covariance disclosed a significantly lower EDV (p = 0.02) and a significantly higher RI (p = 0.01) in the central retinal artery of postmenopausal women compared with premenopausal women. Partial correlation analysis, controlling for age, revealed significant correlations between the CDI parameters and serum levels of oestradiol and testosterone. For premenopausal women, PSV (r = 0.58, p = 0.04) and EDV (r = 0.73, p = 0.006) in the ophthalmic artery correlated positively with serum oestradiol levels. The RI in the central retinal artery decreased with increasing oestradiol levels in both groups (premenopausal r = À 0.40, p = 0.04; postmenopausal r = À 0.32, p = 0.05). Peak systolic velocity in the central retinal artery correlated negatively (r = À 0.49, p = 0.04), whereas the RI correlated positively (r = 0.53, p = 0.02) with testosterone levels in the premenopausal group. Postmenopausal women with higher testosterone levels had lower EDV (r = À 0.53, p = 0.007) in the central retinal artery and higher RI in both vessels (ophthalmic artery r = 0.48, p = 0.01; central retinal artery r = 0.61, p = 0.002). Conclusion: Our data provide evidence of a relationship between serum sex hormone levels and blood flow velocities and resistive indices in retrobulbar arteries. Oestradiol appears to have beneficial effects on ocular haemodynamics, whereas testosterone may act as an antagonistic to the effects of oestrogen.
1 J. Magn. Reson. Imaging 2017;45:660-672.
SAFE (Scan and Find Early) is a novel microwave imaging device intended for breast cancer screening and early detection. SAFE is based on the use of harmless electromagnetic waves and can provide relevant initial diagnostic information without resorting to X-rays. Because of SAFE’s harmless effect on organic tissue, imaging can be performed repeatedly. In addition, the scanning process itself is not painful since breast compression is not required. Because of the absence of physical compression, SAFE can also detect tumors that are close to the thoracic wall. A total number of 115 patients underwent the SAFE scanning procedure, and the resultant images were compared with available magnetic resonance (MR), ultrasound, and mammography images in order to determine the correct detection rate. A sensitivity of 63% was achieved. Breast size influenced overall sensitivity, as sensitivity was lower in smaller breasts (51%) compared to larger ones (74%). Even though this is only a preliminary study, the results show promising concordance with clinical reports, thus encouraging further SAFE clinical studies.
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