Breast density in multiethnic women presenting for screening mammography

Oppong, Bridget A.; Dash, Chiranjeev; O’Neill, Suzanne C.; Li, Yinan; Makambi, Kepher H.; Pien, Edward; Makariou, Erini; Coleman, Tesha; Adams‐Campbell, Lucile L.

doi:10.1111/tbj.12941

Cited by 12 publications

(7 citation statements)

References 20 publications

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“…Random-effects logistic regression (panel variable, individual woman) was performed to estimate the likelihood of being assigned to dense versus nondense BI-RADS density category by each screening modality, adjusted for ethnicity, age, and BMI, which are the main confounders of breast density differences (17)(18)(19). To account for interreader variability in breast density assessments (20), the model was additionally adjusted for each interpreting radiologist.…”

Section: Discussionmentioning

confidence: 99%

Effect of Mammographic Screening Modality on Breast Density Assessment: Digital Mammography versus Digital Breast Tomosynthesis

et al. 2019

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ammographic breast density reflects the relative amounts of fat versus fibroglandular tissues in the breast (1) and is an established risk factor for breast cancer (2). Women with the highest level of breast density have four to six times the risk for breast cancer compared with women with the lowest levels of density (3), and high density is associated with larger and more aggressive tumors (4). Moreover, breast density can affect the sensitivity of mammography because of masking of tumors (5). As of December 2018, over 70% of states in the United States passed legislation mandating that women be notified of their breast density. In some states, women with high breast density are advised to both discuss the implication of their density with their health care provider and consider supplemental screening methods (6). The most commonly used breast density assessment is the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) (1). The BI-RADS system includes four categories of breast density (a, almost entirely fatty; b, scattered areas of fibroglandular density; c, hetereogeneously dense; and, d, extremely dense). According to most state notification laws, women assigned the latter two breast density categories are considered to have dense breasts whereas the first two density categories are considered nondense. In many states, having dense breast parenchyma prompts supplemental screening, most often with breast US. Studies show a strong relationship of high BI-RADS breast density categories to cancer risk (2), risk of masking (5), and high-risk benign breast disease (7).

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Section: Discussionmentioning

confidence: 99%

Effect of Mammographic Screening Modality on Breast Density Assessment: Digital Mammography versus Digital Breast Tomosynthesis

et al. 2019

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“…In a cohort of multiethnic women, evidence suggests that these women are more likely to have dense breast. 38 Legislatively, the Dense Breast Notification bill (SB 1034) mandates that women be informed of their breast density and was signed into law in California and five other states. This is a critical and vital law as evidence suggests that mammographic density is associated with an increased risk for TNBC and luminal subtypes 39 which as previously mentioned, a common subtype in some AAW.…”

Section: Implications For Community Practicementioning

confidence: 99%

Health Beliefs and Breast Cancer Screening Practices Among African American Women in California

Davis

2020

Int Q Community Health Educ

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Background African American women continue to have higher mortality rates of breast cancer when compared to other women, and evidence suggests that early detection of breast cancer can lead to favorable outcomes, yet there remains a paucity of literature about health beliefs and the utilization of three screening practices, namely breast self-examination, clinical breast examination and mammography in California, a state that currently has one of the highest breast cancer mortality rates among African American women. Purpose To investigate the relationship between health beliefs and three breast cancer detection practices, e.g. breast self-examination, clinical breast examination, and mammography in a cohort of African American women. Methods Using a descriptive correlational design, a convenience sample of two hundred and eighty-two (n = 282) self-identified women from six regional chapters of a national Black women’s political organization in California, completed a Demographic Data Questionnaire and Champion’s Health Belief Model Scale which assessed the hypothesized relationships of health beliefs and breast cancer detection practices. Results Among this culturally diverse group of women (49.8% American, 28.8% African, 21.4% West Indian), health motivation was positively related to the practice of BSE and annual physician visitation for clinical breast examinations. Health locus of control was positively related to the practice of BSE. Having relatives and friends who were diagnosed with breast cancer was strongly associated with having a mammogram and annual physician visitation for clinical breast examinations. Conclusion These findings may be used to target and develop interventions that are tailored to the unique characteristics of these diverse women.

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“…Breast density is well studied among Asian women, who have a high prevalence of heterogeneously/extremely dense breasts (15). However, most studies report results only for specific races/ethnicities or subgroups and for BMI or breast density separately, but not both (16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Breast Cancer Population Attributable Risk Proportions Associated with Body Mass Index and Breast Density by Race/Ethnicity and Menopausal Status

Bissell

Kerlikowske

Sprague

et al. 2020

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Overweight/obesity and dense breasts are strong breast cancer risk factors whose prevalences vary by race/ethnicity. The breast cancer population attributable risk proportions (PARP) explained by these factors across racial/ethnic groups are unknown.Methods: We analyzed data collected from 3,786,802 mammography examinations (1,071,653 women) in the Breast Cancer Surveillance Consortium, associated with 21,253 invasive breast cancers during a median of 5.2 years follow-up. HRs for body mass index (BMI) and breast density, adjusted for age and registry were estimated using separate Cox regression models by race/ethnicity (White, Black, Hispanic, Asian) and menopausal status. HRs were combined with observed risk-factor proportions to calculate PARPs for shifting overweight/obese to normal BMI and shifting heterogeneously/extremely dense to scattered fibroglandular densities.Results: The prevalences and HRs for overweight/obesity and heterogeneously/extremely dense breasts varied across races/ ethnicities and menopausal status. BMI PARPs were larger for postmenopausal versus premenopausal women (12.0%-28.3% vs. 1.0%-9.9%) and nearly double among postmenopausal Black women (28.3%) than other races/ethnicities (12.0%-15.4%). Breast density PARPs were larger for premenopausal versus postmenopausal women (23.9%-35.0% vs. 13.0%-16.7%) and lower among premenopausal Black women (23.9%) than other races/ethnicities (30.4%-35.0%). Postmenopausal density PARPs were similar across races/ethnicities (13.0%-16.7%).Conclusions: Overweight/obesity and dense breasts account for large proportions of breast cancers in White, Black, Hispanic, and Asian women despite large differences in risk-factor distributions.Impact: Risk prediction models should consider how race/ethnicity interacts with BMI and breast density. Efforts to reduce BMI could have a large impact on breast cancer risk reduction, particularly among postmenopausal Black women.

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Breast density in multiethnic women presenting for screening mammography

Cited by 12 publications

References 20 publications

Effect of Mammographic Screening Modality on Breast Density Assessment: Digital Mammography versus Digital Breast Tomosynthesis

Effect of Mammographic Screening Modality on Breast Density Assessment: Digital Mammography versus Digital Breast Tomosynthesis

Health Beliefs and Breast Cancer Screening Practices Among African American Women in California

Breast Cancer Population Attributable Risk Proportions Associated with Body Mass Index and Breast Density by Race/Ethnicity and Menopausal Status

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