Breast Density and Breast Cancer Risk: Understanding of Biology and Risk

Pettersson, Andreas; Tamimi, Rulla M.

doi:10.1007/s40471-014-0018-0

Cited by 7 publications

(9 citation statements)

References 58 publications

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“…Recent genetic studies have identified certain single nucleotide polymorphisms (SNPs) with overlapping effects on both BC risk and MD, suggesting that the BC risk conferred by these loci is at least partly mediated through their effects on MD [ 60 ]. Polymorphisms of genes involved in epidermal growth factor (EGF), ER and insulin-like growth factor 1 (IGF1) signalling, cell proliferation, and migration are included [ 61 ].…”

Section: Resultsmentioning

confidence: 99%

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Mammographic density: a potential monitoring biomarker for adjuvant and preventative breast cancer endocrine therapies

et al. 2016

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Increased mammographic density (MD) has been shown beyond doubt to be a marker for increased breast cancer risk, though the underpinning pathobiology is yet to be fully elucidated. Estrogenic activity exerts a strong influence over MD, which consequently has been observed to change predictably in response to tamoxifen anti-estrogen therapy, although results for other selective estrogen receptor modulators and aromatase inhibitors are less consistent. In both primary and secondary prevention settings, tamoxifen-associated MD changes correlate with successful modulation of risk or outcome, particularly among pre-menopausal women; an observation that supports the potential use of MD change as a surrogate marker where short-term MD changes reflect longer-term anti-estrogen efficacy. Here we summarize endocrine therapy-induced MD changes and attendant outcomes and discuss both the need for outcome surrogates in such therapy, as well as make a case for MD as such a monitoring marker. We then discuss the process and steps required to validate and introduce MD into practice as a predictor or surrogate for endocrine therapy efficacy in preventive and adjuvant breast cancer treatment settings.

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Section: Resultsmentioning

confidence: 99%

“…Considering mammographically dense tissue from the perspective of whole tissue cellular interactions, the influence of MD on breast cells at risk, roles of stromal cells that appear to confer risk, and adipose cells that may confer protection are key questions [ 60 ].…”

Section: Resultsmentioning

confidence: 99%

Mammographic density: a potential monitoring biomarker for adjuvant and preventative breast cancer endocrine therapies

et al. 2016

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“…Our study is among the first to comprehensively explore associations of absolute NDA with breast tumor characteristics and, to our knowledge, is the largest to date. Current hypotheses to explain associations between increased MD and breast cancer risk have been reviewed recently (29) and include the higher amount of fibroglandular tissue “at risk” of transformation into cancer (30) and the increased epithelial and fibroblast cellular activity and interaction between stroma and epithelium in dense tissue (31, 32) as well as hormonal mechanisms, including the influence of sex steroid hormones and growth factors on density and breast cancer risk (33). Evaluating associations by tumor characteristics can provide insight into these hypothesized mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Dense and Nondense Mammographic Area and Risk of Breast Cancer by Age and Tumor Characteristics

Bertrand

Scott

Tamimi

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Mammographic density (MD) is a strong breast cancer risk factor. We previously reported associations of percent MD with larger and node-positive tumors across all ages, and estrogen receptor (ER)-negative status among women ages <55 years. To provide insight into these associations, we examined the components of percent MD (dense area (DA) and non-dense area (NDA) with breast cancer subtypes. Methods Data were pooled from six studies including 4095 breast cancers and 8558 controls. DA and NDA were assessed from digitized film-screen mammograms and standardized across studies. Breast cancer odds by density phenotypes and age according to histopathological characteristics and receptor status were calculated using polytomous logistic regression. Results DA was associated with increased breast cancer risk [odds ratios (OR) for quartiles: 0.65, 1.00(Ref), 1.22, 1.55; p-trend <0.001] and NDA was associated with decreased risk [ORs for quartiles: 1.39, 1.00(Ref), 0.88, 0.72; p-trend <0.001] across all ages and invasive tumor characteristics. There were significant trends in the magnitude of associations of both DA and NDA with breast cancer by increasing tumor size (p-trend<0.001) but no differences by nodal status. Among women <55 years, DA was more strongly associated with increased risk of ER+ vs. ER− tumors [p-heterogeneity (het) = 0.02] while NDA was more strongly associated with decreased risk of ER− vs. ER+ tumors [p-het = 0.03]. Conclusions DA and NDA have differential associations with ER+ vs. ER− tumors that vary by age. Impact DA and NDA are important to consider when developing age- and subtype-specific risk models.

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“…Texture measures also correlate with breast cancer [9]. Although investigated for many years, the connections between breast density and the underlying biological processes are not well understood [15]. Identifying other metrics with defined spatial scales related to breast cancer could be useful for informing future studies designed to understand the related biological processes with breast structure, in addition to risk prediction purposes.…”

Section: Introductionmentioning

confidence: 99%

“…The goal of breast density research is often to determine an automated metric that is optimal for predicting breast cancer risk or that replicates generally, noting these may not be mutually exclusive. Although investigated for many years, the connections between breast density and the underlying biological processes are not well understood [18]. At this time, we are investigating univariate measures that can be interpreted.…”

Section: Introductionmentioning

confidence: 99%

Spatial correlation and breast cancer risk

Fowler

Hathaway

Tillman

et al. 2019

Biomed. Phys. Eng. Express

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We present a novel method for evaluating the spatial correlation structure in two-dimensional (2D) mammograms and evaluate its merits for risk prediction. Two matched case-control studies were analyzed.Study 1 included women (N = 588 pairs) with mammograms acquired with either Hologic Selenia full field digital mammography (FFDM) units or Hologic Dimensions digital breast tomosynthesis units. Study 2 included women (N =180 pairs) with mammograms acquired with a General Electric Senographe 2000D FFDM unit. Matching variables included age, HRT usage/duration, screening history, and mammography unit. The local autocorrelation function was determined with Fourier analysis and compared with template defined as 2D double-sided exponential function with one spatial extent parameter: n = 4, 12, 24, 50, 74, 100, and 124 defined in pixel widths. The difference between local correlation and template was gauged within a kernel with an adjustable parameter and summarized, producing two measures: the mean (m n+1 ) , and standard (s n+1 ). Both adjustable parameters were varied in Study 1. Select measures that produced significant associations with breast cancer were translated to Study 2. Breast cancer associations were evaluated with conditional logistic regression, adjusted for body mass index and ethnicity. Odds ratios (ORs) were estimated as per standard increment with 95% confidence intervals (CIs).

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Breast Density and Breast Cancer Risk: Understanding of Biology and Risk

Cited by 7 publications

References 58 publications

Mammographic density: a potential monitoring biomarker for adjuvant and preventative breast cancer endocrine therapies

Mammographic density: a potential monitoring biomarker for adjuvant and preventative breast cancer endocrine therapies

Dense and Nondense Mammographic Area and Risk of Breast Cancer by Age and Tumor Characteristics

Spatial correlation and breast cancer risk

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