Are mammographic density phenotypes associated with breast cancer treatment response and clinical outcomes? A systematic review and meta-analysis

Kanbayti, Ibrahem H.; Rae, William; McEntee, Mark F.; Ekpo, Ernest U.

doi:10.1016/j.breast.2019.07.002

Cited by 15 publications

(7 citation statements)

References 61 publications

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“…A normal linear mixed model for each density measure was fitted by maximum likelihood [26]. Fixed effects were included for (1) intercept, (2) group (tamoxifen vs no tamoxifen), (3) age (per 5 years), (4) body mass index (per 5 kg/m 2 ), (5) time greater than 1 year (indicator variable), (6) year for year 2 onwards, (7) interaction between terms (2) and (5) and (8) interaction between (2) and (6). Random effects at the participant level were included to allow for different trajectories for each woman for a random intercept and slope (time since baseline mammogram), which were assumed bivariate normal.…”

Section: Discussionmentioning

confidence: 99%

“…In the prevention setting, models are available to assess risk of breast cancer and may be used to help target preventive therapy with tamoxifen [5]. In both populations, there is evidence that mammographic density reduction associated with tamoxifen is a further prognostic factor [6][7][8][9][10][11][12][13][14]. This biomarker might help to personalise treatment and preventive therapy, suggesting different management when no reduction is seen.…”

Section: Introductionmentioning

confidence: 99%

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Mammographic density change in a cohort of premenopausal women receiving tamoxifen for breast cancer prevention over 5 years

et al. 2020

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Background A decrease in breast density due to tamoxifen preventive therapy might indicate greater benefit from the drug. It is not known whether mammographic density continues to decline after 1 year of therapy, or whether measures of breast density change are sufficiently stable for personalised recommendations. Methods Mammographic density was measured annually over up to 5 years in premenopausal women with no previous diagnosis of breast cancer but at increased risk of breast cancer attending a family-history clinic in Manchester, UK (baseline 2010-2013). Tamoxifen (20 mg/day) for prevention was prescribed for up to 5 years in one group; the other group did not receive tamoxifen and were matched by age. Fully automatic methods were used on mammograms over the 5-year follow-up: three area-based measures (NN-VAS, Stratus, Densitas) and one volumetric (Volpara). Additionally, percentage breast density at baseline and first follow-up mammograms was measured visually. The size of density declines at the first follow-up mammogram and thereafter was estimated using a linear mixed model adjusted for age and body mass index. The stability of density change at 1 year was assessed by evaluating mean squared error loss from predictions based on individual or mean density change at 1 year. Results Analysis used mammograms from 126 healthy premenopausal women before and as they received tamoxifen for prevention (median age 42 years) and 172 matched controls (median age 41 years), with median 3 years follow-up. There was a strong correlation between percentage density measures used on the same mammogram in both the tamoxifen and no tamoxifen groups (all correlation coeficients > 0.8). Tamoxifen reduced mean breast density in year 1 by approximately 17–25% of the inter-quartile range of four automated percentage density measures at baseline, and from year 2, it decreased further by approximately 2–7% per year. Predicting change at 2 years using individual change at 1 year was approximately 60–300% worse than using mean change at 1year. Conclusions All measures showed a consistent and large average tamoxifen-induced change in density over the first year, and a continued decline thereafter. However, these measures of density change at 1 year were not stable on an individual basis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mammographic density change in a cohort of premenopausal women receiving tamoxifen for breast cancer prevention over 5 years

et al. 2020

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“…A recent meta-analysis indicated that high MD at diagnosis was associated with an increased risk of recurrence and higher mortality, and that a reduction in MD during breast cancer treatment is a positive predictive factor. However, due to mostly retrospective studies and different assessment methods the results have to be interpreted carefully (36).…”

Section: Breast Densitymentioning

confidence: 99%

The effects of flaxseed and tamoxifen on the inflammatory microenvironment in normal breast tissue and in breast cancer

Lindahl

2019

Linköping University Medical Dissertations

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“…MBD is routinely classified, on the basis of the fibroglandular tissue proportion, into almost entirely fat (Breast Imaging-Reporting and Data System [BI-RADS] (1), scattered areas of fibroglandular density (BI-RADS (2), heterogeneously dense (BI-RADS (3), and extremely dense (BI-RADS (4) [1]. While the role of MBD on breast cancer (BC) risk has been widely assessed (with a 2 to 6-fold increase in risk between the highest and the lowest MBD category according to meta-analyses [2,3]), the prognostic effect of MBD on BC patients is still undefined [4,5].…”

Section: Introductionmentioning

confidence: 99%

Mammographic breast density and survival in women with invasive breast cancer

Pizzato

Carioli

Rosso

et al. 2022

Cancer Causes Control

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Purpose We explored the under-debate association between mammographic breast density (MBD) and survival. Methods From the Piedmont Cancer Registry, we identified 693 invasive breast cancer (BC) cases. We analyzed the overall survival in strata of MBD through the Kaplan-Meier method. Using the Cox proportional hazards model, we estimated the hazard ratios (HRs) of death; using the cause-specific hazards regression model, we estimated the HRs of BC-related and other causes of death. Models included term for Breast Imaging-Reporting and Data System (BI-RADS) MBD (categorized as BI-RADS 1 and BI-RADS 2-4) and were adjusted for selected patient and tumour characteristics. Results There were 102 deaths, of which 49 were from BC. After 5 years, the overall survival was 69% in BI-RADS 1 and 88% in BI-RADS 2-4 (p < 0.01). Compared to BI-RADS 2-4, the HRs of death for BI-RADS 1 were 1.65 (95% CI 1.06-2.58) in the crude model and 1.35 (95% CI 0.84-2.16) in the fully adjusted model. Compared to BI-RADS 2-4, the fully adjusted HRs for BI-RADS 1 were 1.52 (95% CI 0.74-3.13) for BC-related death and 1.83 (95% CI 0.84-4.00) for the other causes of death. Conclusion Higher MBD is one of the strongest independent risk factors for BC, but it seems not to have an unfavorable impact on survival.

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Are mammographic density phenotypes associated with breast cancer treatment response and clinical outcomes? A systematic review and meta-analysis

Cited by 15 publications

References 61 publications

Mammographic density change in a cohort of premenopausal women receiving tamoxifen for breast cancer prevention over 5 years

Mammographic density change in a cohort of premenopausal women receiving tamoxifen for breast cancer prevention over 5 years

The effects of flaxseed and tamoxifen on the inflammatory microenvironment in normal breast tissue and in breast cancer

Mammographic breast density and survival in women with invasive breast cancer

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